Will there ever be too many medical schools in the US?

[Silent Cool]

You still do OMM in those residencies, actually. You have to, it's a required component of all osteopathic residencies:

The program must train residents in the clinical application of osteopathic manipulative medicine. At a minimum this must include:
a. A clearly defined mechanism to measure and document competency in OMM.
b. Training in outpatient and inpatient settings.
c. Didactic instruction and hands on training.
d. Exposure to multiple treatment technique approaches.
e. Documentation of OMM in the medical record.
f. Coding and reimbursement.

One more reason to avoid DO residencies (as if there weren't enough already).

---

Members don't see this ad.

 

[DermViser]

I've actually heard that many programs prefer a foreign MD over a DO because the public etc view MD as a gold standard and that DO is a sign of inferior quality.

That and a foreign MD had no choice but to attend the school in his/her home country, so hardly a decrease in quality.

 

[Dires]

Oh, and let's not forget that there's plenty of MD schools that are offering courses in CAM nowadays as well. It's not like it's an exclusively DO thing.

https://www.aamc.org/newsroom/reporter/feb2012/273812/therapies.html

Completely out of context. We take those classes in order to be educated about what our patients are doing on the side. Not to necessarily recommend them.

"We aren’t educating CAM practitioners,” he said. “But we are giving medical students knowledge so they can talk with their patients in an open-minded way from informed positions, and educate them on the potential risks of mixing complementary techniques or herbal supplements with prescription medications.”

 

[AlbinoHawk DO]

You can scream "D.O. discrimination" all you want, but it makes you sound foolish to any rational individual. Your scenario was based off of equal rotations, different board scores, as if institution doesn't make a difference. Northwestern will be treated differently than Meharry, and that's just in the MD world. Same for D.O. schools. Institutions matter. Period.

Why? What's special of institutions? I think the best doctors should win, not based on some institutions reputation.

 

[Silent Cool]

Why? What's special of institutions? I think the best doctors should win, not based on some institutions reputation.

Usually the best doctors went to the best institutions...

 

[DermViser]

Why? What's special of institutions? I think the best doctors should win, not based on some institutions reputation.

I would love to live in your utopia. Just like your utopia of using Step 1 score as a barometer of smarts - with same clerkships. As if there aren't other factors - like research, etc. But no, the WashU grad and Meharry grad are on the same footing, no question.

 

[Mad Jack]

Usually the best doctors went to the best institutions...

It's pretty difficult to define who the "best doctors" are. I've yet to see a study correlating school attended or Step scores with patient outcomes or complications. We assume the best doctors are the best because of the names attached to where they went, but there's no objective proof of it, just a subjective value attached to the names on their diplomas.

 

[AlbinoHawk DO]

Usually the best doctors went to the best institutions...

Usually. You used the right word, so why discriminate if the best will remain the best?

 

[BestDoctorEver]

You can scream "D.O. discrimination" all you want, but it makes you sound foolish to any rational individual. Your scenario was based off of equal rotations, different board scores, as if institution doesn't make a difference. Northwestern will be treated differently than Meharry, and that's just in the MD world. Same for D.O. schools. Institutions matter. Period.

This true, but that does not make it right... I think LCME requires a minimum standard for a US school to be accredited. Therefore, PDs know that every US school meets that standard... I talked to a med student 2 years ago who was going to a top 20 school and he did not have kind words about his rotations. He thought many were more like observer-ship... Why would PDs think an applicant from Northwestern is better than someone from Meharry when the one from Meharry has better rotation grades and board scores is beyond me... I feel like PDs are still judging applicants on their undergrad accomplishment to a certain extent...

 

[Mad Jack]

This true, but that does not make it right... I think LCME requires a minimum standard for a US school to be accredited. Therefore, PDs know that every US school meets that standard... I talked to a med student 2 years ago who was going to a top 20 school and he did not have kind words about his rotations. He thought many were more like observer-ship... Why would PDs think an applicant from Northwestern is better than someone from Meharry when the one from Meharry has better rotation grades and board scores is beyond me... I feel like PDs are still judging applicants on their undergrad accomplishment to a certain extent...

And getting into a top college is more dependent on high school grades and tests you took in high school than it is on actual potential, so judging someone based on their undergraduate school and the opportunities it offered is really just an extension of judging them based on their high school performance.

 

[DermViser]

This true, but that does not make it right... I think LCME requires a minimum standard for a US school to be accredited. Therefore, PDs know that every US school meets that standard... I talked to a med student 2 years ago who was going to a top 20 school and he did not have kind words about his rotations. He thought many were more like observer-ship... Why would PDs think an applicant from Northwestern is better than someone from Meharry when the one from Meharry has better rotation grades and board scores is beyond me... I feel like PDs are still judging applicants on their undergrad accomplishment to a certain extent...

Bc getting Honors on a Medicine rotation at WashU is harder to get than Honors at some podunk hospital thru Meharry. PDs know this.

 

[Silent Cool]

Usually. You used the right word, so why discriminate if the best will remain the best?

Because it is the most logical filtering mechanism along with Step 1 scores.

 

[BestDoctorEver]

Bc getting Honors on a Medicine rotation at WashU is harder to get than Honors at some podunk hospital thru Meharry. PDs know this.

I don't know... You might be right, but from talking to some med students, I got the impression that 3 year grades are very subjective... They said it depends on the attending--some of them are very lax and others are dicks...

 

[sazerac]

just because it doesn't hurt me job-wise doesn't mean I'm ok with it. it devalues the whole profession and not really about FMG/IMG because they don't routinely have multiple facets of their treatment arsenal deemed ineffective or useless. It's more the nature of DO medicine in general I have a problem with. I know a lot of good DO doctors, yet none of them practice medicine in the DO sense, they practice just like an MD would. I also know a few that you'd literally think were insane if you heard them talk about the stuff they believe about the body. Hugely anecdotal, just saying.

So what you're saying is DOs devalue the whole profession, whereas an MD would just devalue a disease (like fibromyalgia)?

 

[Wordead]

You know my background DV, I worked with interns that were often fed from top 10s and the vast majority of them were functionally ******ed when it came to actually prcticing medicine during intern year. Rare was the intern that wasnt outright dangerously incompetent. Residency makes you competent, not medical school.

Mistakes don't equal incompetence, dude. Everyone starting out is going to miss things and prescribe incorrect treatments. The fact that you think a competent intern should be able to run the floor flawlessly speaks more to your ignorance of what constitutes a good intern more than anything else.

Why? What's special of institutions? I think the best doctors should win, not based on some institutions reputation.

During your 4th year, if you spend time at a quality academic institution and compare it to some community hospital you would understand. It really is night and day. I felt cheated after my aways when comparing them to some of my home rotations.[/QUOTE]

 

[Mad Jack]

Mistakes don't equal incompetence, dude. Everyone starting out is going to miss things and prescribe incorrect treatments. The fact that you think a competent intern should be able to run the floor flawlessly speaks more to your ignorance of what constitutes a good intern more than anything else.



During your 4th year, if you spend time at a quality academic institution and compare it to some community hospital you would understand. It really is night and day. I felt cheated after my aways when comparing them to some of my home rotations.

[/QUOTE]
There's a difference between not running a floor flawlessly and not understanding basic anatomy, physiology, and assessment. By definition, they are incompetent, but all interns are because that's just how it goes.

in·com·pe·tence
inˈkämpətəns,iNG-/
noun

1. inability to do something successfully

As to fourth year, I'll compare my solid aways with my home rotations and get back to you. You might very well be right that there's a difference in rotation quality, but I am arguing that the rotation quality ultimately has little to do with post-residency physician quality, as rotations are more an exercise in exposure and indoctrination than they are one in truly developing a generalist, specialist, or subspecialist in anything beyond the most basic of clinical capacities.

 

[Baller MD]

So what you're saying is DOs devalue the whole profession, whereas an MD would just devalue a disease (like fibromyalgia)?

Uhhh, no they don't. Stop making stuff up. DO students need to stop being so salty.

 

[Wordead]

erstanding basic anatomy, physiology, and assessment. By definition, they are incompetent, but all interns are because that's just how it goes.

in·com·pe·tence
inˈkämpətəns,iNG-/
noun

1. inability to do something successfully

As to fourth year, I'll compare my solid aways with my home rotations and get back to you. You might very well be right that there's a difference in rotation quality, but I am arguing that the rotation quality ultimately has little to do with post-residency physician quality, as rotations are more an exercise in exposure and indoctrination than they are one in truly developing a generalist, specialist, or subspecialist in anything beyond the most basic of clinical capacities.

Then what is the point of medical school in your mind, if no intern is competent?

 

[Wordead]

Uhhh, no they don't. Stop making stuff up. DO students need to stop being so salty.

Fibromyalgia is just code for this patient is bat**** crazy.

 

[maxxor]

Then what is the point of medical school in your mind, if no intern is competent?

Check back in 2 years once he's a third year. Preclinical + prior life healthcare experiences = pontification

 

[Wordead]

Check back in 2 years once he's a third year. Preclinical + prior life healthcare experiences = pontification

It was mostly rhetorical anyway....we've all met that ER tech that thinks he can do whatever better than the docs.

 

[AlbinoHawk DO]

Because it is the most logical filtering mechanism along with Step 1 scores.

Oh okay, if it is too hard to do your job: finding the best doctors for the people with medicare money which is given by the people, then by all means...

 

[GoSpursGo]

I would love to live in your utopia. Just like your utopia of using Step 1 score as a barometer of smarts - with same clerkships. As if there aren't other factors - like research, etc. But no, the WashU grad and Meharry grad are on the same footing, no question.

They're not, and no one is arguing that they are. But just as you argue that step 1 score and clerkship grades can't be used as the sole barometer, neither should someone's institution--you have to take the entire picture.

 

[Baller MD]

They're not, and no one is arguing that they are. But just as you argue that step 1 score and clerkship grades can't be used as the sole barometer, neither should someone's institution--you have to take the entire picture.

Random: Congrats on the chip this year. Timmy ages like fine wine.

 

[hallowmann]

Bc getting Honors on a Medicine rotation at WashU is harder to get than Honors at some podunk hospital thru Meharry. PDs know this.

Unless your rotations are like 70%+ based on your score on the shelf exam, the majority of a rotation grade can be very subjective. To automatically assume that its "easier" to honor a rotation at a smaller community hospital as opposed to a big university hospital is ridiculous. It depends on your preceptor/attending, and in a lot of cases your school. Are we going to assume that when 80% of a top-20 med school class gets Honors in a rotation, that means they're just all amazingly dedicated med students and each one is better than any of the 10% of people who get Honors at an unranked school? Or are we going to think the more likely explanation that grading for that rotation at the top-20 school is lax/inflated.

You can't really compare a clinical grade at one school's hospital with one at another (unless of course they are heavily weighted based on shelf score - in which case at least that is a bit more objective), especially if the class distributions of those grades don't follow a normal curve.

Now I can buy the fact that an average student at WashU is probably a better student than an average student at Meharry, but to imply that its a known fact that its "easier" to get Honors in a smaller community hospital than in a highly ranked academic center is a erroneous.

I have some friends at a top-20 MD program. Some of their preceptors rarely see them (they're too busy with their fellows, residents, and interns). Half the time they leave early and only show up on hours or days they know the preceptor will see them, and they end up honoring the rotations. Compare that to a community hospital where everyday they have to show up from 6/7am to 3/4pm and its only them and the attending working all day. On top of that, no one knows when they are going to get that preceptor that only believes in giving x number of students Honors.

 

[DermViser]

Unless your rotations are like 70%+ based on your score on the shelf exam, the majority of a rotation grade can be very subjective. To automatically assume that its "easier" to honor a rotation at a smaller community hospital as opposed to a big university hospital is ridiculous. It depends on your preceptor/attending, and in a lot of cases your school. Are we going to assume that when 80% of a top-20 med school class gets Honors in a rotation, that means they're just all amazingly dedicated med students and each one is better than any of the 10% of people who get Honors at an unranked school? Or are we going to think the more likely explanation that grading for that rotation at the top-20 school is lax/inflated.

You can't really compare a clinical grade at one school's hospital with one at another (unless of course they are heavily weighted based on shelf score - in which case at least that is a bit more objective), especially if the class distributions of those grades don't follow a normal curve.

Now I can buy the fact that an average student at WashU is probably a better student than an average student at Meharry, but to imply that its a known fact that its "easier" to get Honors in a smaller community hospital than in a highly ranked academic center is a erroneous.

I have some friends at a top-20 MD program. Some of their preceptors rarely see them (they're too busy with their fellows, residents, and interns). Half the time they leave early and only show up on hours or days they know the preceptor will see them, and they end up honoring the rotations. Compare that to a community hospital where everyday they have to show up from 6/7am to 3/4pm and its only them and the attending working all day. On top of that, no one knows when they are going to get that preceptor that only believes in giving x number of students Honors.

Has nothing to do with easy. Has to do with being a known entity. Barnes-Jewish Hospital is a known entity as are the faculty there (in this case IM). Some community hospital is not. Everything in life can't be standardized. Names matter, pedigree matters.

 

[maxxor]

I have some friends at a top-20 MD program. Some of their preceptors rarely see them (they're too busy with their fellows, residents, and interns). Half the time they leave early and only show up on hours or days they know the preceptor will see them, and they end up honoring the rotations.

This has not been my experience as one of those "top 20 MD program" people. Everyone is evaluating you, even if the attending / preceptor is away. You can bet they are asking the chiefs, residents, and interns what they think of you from all facets. You aren't getting full 360 degree feedback from nurses and such, but it's pretty close.

 

[hallowmann]

Has nothing to do with easy. Has to do with being a known entity. Barnes-Jewish Hospital is a known entity as are the faculty there (in this case IM). Some community hospital is not. Everything in life can't be standardized. Names matter, pedigree matters.

I don't inherently disagree. What I disagreed with was your statement that "getting Honors on a Medicine rotation at WashU is harder to get than Honors at some podunk hospital thru Meharry. PDs know this." While certainly PDs know about a WashU hospital rotation and may know nothing about the random Meharry one, that doesn't mean its somehow "easier" to get Honors on the latter than the former. My point was that it is not a given that it's "easier" just because its a random community hospital affiliated with Meharry, and WashU is WashU.

This has not been my experience as one of those "top 20 MD program" people. Everyone is evaluating you, even if the attending / preceptor is away. You can bet they are asking the chiefs, residents, and interns what they think of you from all facets. You aren't getting full 360 degree feedback from nurses and such, but it's pretty close.

I don't doubt that. My friends at the program I mentioned have some very good rotations that really make them work hard, interact with lots of people, and actively learn a lot. But there are also some that just aren't that way.

I in no way meant to imply that all rotations from top 20 schools are always like that, just that they can be. Rotations vary, my point is that you can't say one is obviously "easier" to honor simply because its at a smaller community hospital.

 

[maxxor]

My point was that it is not a given that it's "easier" just because its a random community hospital affiliated with Meharry, and WashU is WashU.

I think DV's ultimate point is that Honors from WashU is worth more than honors from Meharry.

 

[hallowmann]

I think DV's ultimate point is that Honors from WashU is worth more than honors from Meharry.

Its more like being from WashU (honors or not) is obviously worth more than not. Whether it should be that way or not, that is the way it is. Like I said, I don't disagree with that point, I disagree with what he said justifying it. Its not because its easier at Meharry, its because people care about pedigree.

 

[DocVapor]

Oh my. When did Pre-Allo and Pre-Osteo invade the Allo forum?

Edit: Last post was 9:39 last night. Should have looked first and just let this abomination die.

 

[AlbinoHawk DO]

Bc getting Honors on a Medicine rotation at WashU is harder to get than Honors at some podunk hospital thru Meharry. PDs know this.

So since I directly rotate with UCLA students. It is harder for them to get honors as opposed to me in the same rotation?

I still find you funny because you're so close to just admitting that you're really bigoted toward DO but keep trying to fake that there's an objective reason.

 

[DermViser]

So since I directly rotate with UCLA students. It is harder for them to get honors as opposed to me in the same rotation?

I still find you funny because you're so close to just admitting that you're really bigoted toward DO but keep trying to fake that there's an objective reason.

Yawn. You're actually rotating with UCLA medical students at the UCLA Medical Center?

 

[DermViser]

Its more like being from WashU (honors or not) is obviously worth more than not. Whether it should be that way or not, that is the way it is. Like I said, I don't disagree with that point, I disagree with what he said justifying it. Its not because its easier at Meharry, its because people care about pedigree.

WashU is known to rotate at certain places and Meharry is known to rotate at certain places, that's the point.

 

[hallowmann]

WashU is known to rotate at certain places and Meharry is known to rotate at certain places, that's the point.

Again, that wasn't what I disagreed with. What I disagreed with was your statement "getting Honors on a Medicine rotation at WashU is harder to get than Honors at some podunk hospital thru Meharry". That's not really necessarily true. Its not because one is inherently "harder", its because one is considered more known/prestigious.

 

[DermViser]

Again, that wasn't what I disagreed with. What I disagreed with was your statement "getting Honors on a Medicine rotation at WashU is harder to get than Honors at some podunk hospital thru Meharry". That's not really necessarily true. Its not because one is inherently "harder", its because one is considered more known/prestigious.

Sorry, but WashU or really Barnes-Jewish, doesn't throw "H"s for Internal Medicine like candy, maybe HP, but not H. The standards and the people are Barnes are known, some community podunk hospital with no residency program is not a known entity.

 

[PL198]

Yawn. You're actually rotating with UCLA medical students at the UCLA Medical Center?

I'd be pissed if this was the case.

Again, that wasn't what I disagreed with. What I disagreed with was your statement "getting Honors on a Medicine rotation at WashU is harder to get than Honors at some podunk hospital thru Meharry". That's not really necessarily true. Its not because one is inherently "harder", its because one is considered more known/prestigious.

You're clearly more likely to have an attending that gives out honors like candy at a podunk hospital than a big one... We're talking about the large scale here.

 

[AlbinoHawk DO]

Yawn. You're actually rotating with UCLA medical students at the UCLA Medical Center?

We can rotate there, but lets play into your loophole. How about UCR students rotating with us?

 

[DermViser]

We can rotate there, but lets play into your loophole. How about UCR students rotating with us?

You can rotate and do all your MS-3 clerkships at UCLA Medical Center?

What is UCR? Is this a new med school?

 

[PL198]

We can rotate there, but lets play into your loophole. How about UCR students rotating with us?

That wouldn't be necessary, bc allo schools always have their rotations planned out.

 

[darklabel]

WashU is known to rotate at certain places and Meharry is known to rotate at certain places, that's the point.

But sometimes it only comes down to the reputation of the school. For instance, both Morehouse and Emory rotate in Grady, but the Emory students clearly have better opportunities than the Morehouse students because of the reputation of the school and research opportunities available. It just is what it is and despite what some people say, not all MD schools have equal opportunities and I say this as a student at an unranked school.

 

[DermViser]

But sometimes it only comes down to the reputation of the school. For instance, both Morehouse and Emory rotate in McGrady, but the Emory students clearly have better opportunities than the Morehouse students because of the reputation of the school and research opportunities available. It just is what it is and despite what some people say, not all MD schools have equal opportunities and I say this as a student at an unranked school.

Do Emory students solely rotate at Grady?

 

[Mad Jack]

I'd be pissed if this was the case.




You're clearly more likely to have an attending that gives out honors like candy at a podunk hospital than a big one... We're talking about the large scale here.

The general vibe I got working at the hospital I was at was "he's top 10 quality by virtue of being here, he deserves a HP at worst." I can't imagine it being any easier to get a HP in a community hospital lol.

 

[sinombre]

What is UCR? Is this a new med school?

Yeah... it was a joint program w/ UCLA for ~30 years, and is now an independent medical school.

 

[maxxor]

Do Emory students solely rotate at Grady?

Emory has a lot of sites.

http://www.med.emory.edu/education/curriculum/md/index.html

 

[Mad Jack]

Then what is the point of medical school in your mind, if no intern is competent?

The point of medical school is to demonstrate that you have the foundational knowledge to take partial responsibility for patients and continue the educational process of becoming a physician, as demonstrated by passage of the USMLE.

If you believe interns to be so competent, would you ever let a fresh intern care for a family member in absence of an attending physician? How about if they were critically ill? Personally, I wouldn't trust a freshly minted PGY-1 to do much of anything.

 

[DermViser]

Yeah... it was a joint program w/ UCLA for ~30 years, and is now an independent medical school.

Ok so it's not a UCR (undergrad)/UCLA (med school) program, where the students are UCLA students.

I don't think UCLA's med school will allow another independent medical school (UCR) to have an affiliation agreement to allow their students to rotate at their own medical center.

 

[DermViser]

The point of medical school is to demonstrate that you have the foundational knowledge to take partial responsibility for patients and continue the educational process of becoming a physician, as demonstrated by passage of the USMLE.

If you believe interns to be so competent, would you ever let a fresh intern care for a family member in absence of an attending physician? How about if they were critically ill? Personally, I wouldn't trust a freshly minted PGY-1 to do much of anything.

Well there are certain "competencies" you are expected to reach as an MD graduate from any medical school (in theory) before you enter internship.

 

[AlbinoHawk DO]

You can rotate and do all your MS-3 clerkships at UCLA Medical Center?

What is UCR? Is this a new med school?

Not 3rd year clerkships, but neither do all UCLA students do that. Besides, how is an OB/Gyn rotation going to say something substantial of someone that wants to be a psychiatrist? Or what can a psychiatry rotation grade have to do with an Ortho Surgeon? UCR is UC Riverside, and yes, it is new. You're simply grasping at straws "well, you got a 260 and honored all your general surgery rotations, but we'll take the 210 MD without honors because he did his family med rotation at University of Nevada."

 

[DermViser]

Not 3rd year clerkships, but neither do all UCLA students do that. Besides, how is an OB/Gyn rotation going to say something substantial of someone that wants to be a psychiatrist? Or what can a psychiatry rotation grade have to do with an Ortho Surgeon? UCR is UC Riverside, and yes, it is new.

Sigh. 3rd year required clerkships are not irrelevant bc you're not going into the specialty, in question.