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

[NontradCA]

They weren't PGY-1s, they were PGY-3s at the time. I was just saying the difference between them was how they spent their PGY-1 year.

Well, that's when you should have jumped in and done effleurage followed by HVLA.

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[hallowmann]

Well, that's when you should have jumped in and done effleurage followed by HVLA.

Haha, just clarifying the story. Besides I prefer tapotement.

 

[jakeislove]

lol while I don't disagree that stuff isn't interrelated, the idea that you need OB/Gyn as a psychiatrist is ludicrous. What if I get a patient who had an orthopedic procedure and went through rehabilitation and I never did those elective rotations? I guess I wouldn't be qualified to do psychiatry. It's not as is if you're trained as a psychiatrist during residency, right?

Trust me. Anyone with a pregnant wife needs experience in psychiatry.

 

[AlbinoHawk DO]

Why have MS-3 clerkships at all then if it will all be in residency? You realize that on IM and Surgery, you learn to read radiographs and the attending many times goes thru the imaging themselves right? It's not all relegated to Rads and IM/Surgery just read their reports and trust it. You're expounding on something you know nothing about. Again. @maxxor is right. I'm done here bc you're either being purposefully obtuse or are just naive.

The purpose is to get some exposure and general knowledge about the field, but like anything, it changes a lot over time. Is a Ortho in his 60s today useless because his 4 weeks of Psychiatry were 40 years ago and the field has changed drastically? No. It's good to be able to learn some of every service, but the idea that those 4 weeks all of a sudden is what makes or breaks your entire profession is ludicrus. Besides, I'm not advocating for them to be taken away. I'm not saying they are useless, but your argument is resting on this idea that they are game changers.

 

[AlbinoHawk DO]

It's still going to help you. No one is saying that doing a rotation makes you a pro at whatever the service is, it just gives you some idea what the other services are like and stuff they encounter that might help you later on down the road. It's honestly pretty cool to get to see such a wide range of stuff over a year in my opinion. I don't see your alternative. Specialize in 3rd year?

My argument is not to take away any services. My argument is not that they are useless. My argument is that to pretend that one single rotation ob/gyn is what makes you a psychiatrist and otherwise you're a "psych NP" is absolutely ludicrous. I'm all for exposure and learning basics through experience, but at the same time I'm not going to over-glorify those experiences. This is like saying that one general ed class in undergrad was what made you an Engineer. That class is good and the exposure is helpful, but lets not pretend it's scoring the winning goal in the world cup final.

 

[Psai]

Oh man, so you're telling me if I didn't do 4 weeks of OB/GYN and honored it that my psychiatry residency would never teach me post-partum depression? Remember guyz, those 4 weeks or you're f-ed. Man, my school doesn't require I do a radiology rotation, so I guess when I go into Neurology, I'll never understand a radiograph.

Did you even start your classes yet lol
Stfu kid

 

[PL198]

My argument is not to take away any services. My argument is not that they are useless. My argument is that to pretend that one single rotation ob/gyn is what makes you a psychiatrist and otherwise you're a "psych NP" is absolutely ludicrous. I'm all for exposure and learning basics through experience, but at the same time I'm not going to over-glorify those experiences. This is like saying that one general ed class in undergrad was what made you an Engineer. That class is good and the exposure is helpful, but lets not pretend it's scoring the winning goal in the world cup final.

I don't think anyone is saying it's going to make you into a rock star OB, just that it's pretty invaluable to have the exposure to other services.

 

[AlbinoHawk DO]

I don't think anyone is saying it's going to make you into a rock star OB, just that it's pretty invaluable to have the exposure to other services.

I don't think anyone is saying it makes you a rockstar OB either, but the entire discussion derived from Dermviser arguing the superiority of certain graduates and degrees just because of the location of 3rd year clerkships. I said since there's a minimum standard at locations that offer them, depending on specialty you want to go into (e.g. psychiatry), going to the rotation at Wayne State (OB/Gyn) vs Harvard says nearly nothing about the applicant since the rotation merely gives you exposure. Then they started to twist the argument around to make it seem like I'm saying 3rd year rotations shouldn't exist or have no value whatsoever when I said nothing to that effect. My point is that they are simply exaggerating the value of 4 weeks for some rotations in comparison to what your entire specialty is (e.g. While OB/Gyn exposure is good, it is ludicrous to act like a psychiatrist wouldn't be able to treat post-partum depression or that experience alone is what made them proficient at treating it.)

 

[PL198]

I don't think anyone is saying it makes you a rockstar OB either, but the entire discussion derived from Dermviser arguing the superiority of certain graduates and degrees just because of the location of 3rd year clerkships. I said since there's a minimum standard at locations that offer them, depending on specialty you want to go into (e.g. psychiatry), going to the rotation at Wayne State (OB/Gyn) vs Harvard says nearly nothing about the applicant since the rotation merely gives you exposure. Then they started to twist the argument around to make it seem like I'm saying 3rd year rotations shouldn't exist or have no value whatsoever when I said nothing to that effect. My point is that they are simply exaggerating the value of 4 weeks for some rotations in comparison to what your entire specialty is (e.g. While OB/Gyn exposure is good, it is ludicrous to act like a psychiatrist wouldn't be able to treat post-partum depression or that experience alone is what made them proficient at treating it.)

why does that matter if it's relevant to their chosen service or not? it doesn't matter if they're going into whatever, one rotation is more prestigious and thus less likely to randomly grade, and another is more community and more likely to randomly grade.

 

[NickNaylor]

I don't think anyone is saying it makes you a rockstar OB either, but the entire discussion derived from Dermviser arguing the superiority of certain graduates and degrees just because of the location of 3rd year clerkships. I said since there's a minimum standard at locations that offer them, depending on specialty you want to go into (e.g. psychiatry), going to the rotation at Wayne State (OB/Gyn) vs Harvard says nearly nothing about the applicant since the rotation merely gives you exposure. Then they started to twist the argument around to make it seem like I'm saying 3rd year rotations shouldn't exist or have no value whatsoever when I said nothing to that effect. My point is that they are simply exaggerating the value of 4 weeks for some rotations in comparison to what your entire specialty is (e.g. While OB/Gyn exposure is good, it is ludicrous to act like a psychiatrist wouldn't be able to treat post-partum depression or that experience alone is what made them proficient at treating it.)

Have you done any rotations yet? There's actually quite a bit you can learn in 4 weeks. I did a month-long rotation in derm, and while I'm by no means a derm expert I would guess that I can describe derm lesions better than at least half of the IM interns (and possibly even residents) based on that experience alone.

If you don't pay attention and/or waste the opportunity to learn, then you won't get much out of it. But as I said, 4 weeks is a good chunk of time. You might be surprised what you would learn in that amount of time.

 

[DermViser]

I don't think anyone is saying it makes you a rockstar OB either, but the entire discussion derived from Dermviser arguing the superiority of certain graduates and degrees just because of the location of 3rd year clerkships. I said since there's a minimum standard at locations that offer them, depending on specialty you want to go into (e.g. psychiatry), going to the rotation at Wayne State (OB/Gyn) vs Harvard says nearly nothing about the applicant since the rotation merely gives you exposure. Then they started to twist the argument around to make it seem like I'm saying 3rd year rotations shouldn't exist or have no value whatsoever when I said nothing to that effect. My point is that they are simply exaggerating the value of 4 weeks for some rotations in comparison to what your entire specialty is (e.g. While OB/Gyn exposure is good, it is ludicrous to act like a psychiatrist wouldn't be able to treat post-partum depression or that experience alone is what made them proficient at treating it.)

Do you seriously think that the institution you graduate from has no affect at all on what type of education/quality of education you receive? Don't get me wrong, I think a lot of years are overpriced - i.e. the first 2 years of basic science coursework (at least the way it is taught now). But do you really think that all basic science education across the nation is the same in quality? That all clinical rotations are equal across the nation with respect to difficulty in grading/expectations, etc. No field is like this - Engineering, Law, Business etc. Why would medicine be any different?

Should Liberty University School of Osteopathic Medicine be treated exactly the same as University of Virginia (UVa)? You think someone who got Honors at Wayne State in OB-Gyn is exactly the same as the person who got Honors in OB-Gyn at Brigham and Women's?

You actually think there are no Derm patients who have underlying psychopathology to their skin disease (delusions of parasitosis, neurotic excoriations, etc.) or that psychiatric conditions and psychotropic medications can have or exacerbate skin side effects?

 

[AlbinoHawk DO]

why does that matter if it's relevant to their chosen service or not? it doesn't matter if they're going into whatever, one rotation is more prestigious and thus less likely to randomly grade, and another is more community and more likely to randomly grade.

Do you seriously think that the institution you graduate from has no affect at all on what type of education/quality of education you receive? Don't get me wrong, I think a lot of years are overpriced - i.e. the first 2 years of basic science coursework (at least the way it is taught now). But do you really think that all basic science education across the nation is the same in quality? That all clinical rotations are equal across the nation with respect to difficulty in grading/expectations, etc. No field is like this - Engineering, Law, Business etc. Why would medicine be any different?

Should Liberty University School of Osteopathic Medicine be treated exactly the same as University of Virginia (UVa)? You think someone who got Honors at Wayne State in OB-Gyn is exactly the same as the person who got Honors in OB-Gyn at Brigham and Women's?

You actually think there are no Derm patients who have underlying psychopathology to their skin disease (delusions of parasitosis, neurotic excoriations, etc.) or that psychiatric conditions and psychotropic medications can have or exacerbate skin side effects?

The answer to your institutional quality is a complex one. In undergrad, I attended a mid-tier UC campus. As a post-bacc, I attended 2 community colleges and a top UC school . I also worked at another top UC. I did have many instances where my community college courses were tougher and better taught. The opposite is also true. The advantage of larger and better known universities is in resources (economic and EC), but they don't necessarily dictate the quality of the graduate. As I'm sitting in anatomy lecture, I'm around graduates from Cornell, La Sierra University, UCLA, Arizona State, etc. We all got to the same place and not necessarily do we fall into this neat categories where top undergrad = better performance. Education is very complex and time sensitive. That said, I'm not saying LUCOM or UVA or any other institution should be treated equally to the next. I'm saying individuals should be treated individually by their strengths, weaknesses and potentials. Maybe someone was able to annihilate O. Chem and a few other classes and made it into NYU. Next guy may have not done so hot and gone to West Virginia University. Does it necessarily follow that because of their undergraduate performance their capacity in med school is destined where top grad necessitates to be on top? I don't think so.

 

[PL198]

The answer to your institutional quality is a complex one. In undergrad, I attended a mid-tier UC campus. As a post-bacc, I attended 2 community colleges and a top UC school . I also worked at another top UC. I did have many instances where my community college courses were tougher and better taught. The opposite is also true. The advantage of larger and better known universities is in resources (economic and EC), but they don't necessarily dictate the quality of the graduate. As I'm sitting in anatomy lecture, I'm around graduates from Cornell, La Sierra University, UC Santa Cruz, Arizona State, etc. We all got to the same place and not necessarily do we fall into this neat categories where top undergrad = better performance. Education is very complex and time sensitive. That said, I'm not saying LUCOM or UVA or any other institution should be treated equally to the next. I'm saying individuals should be treated individually by their strengths, weaknesses and potentials. Maybe someone was able to annihilate O. Chem and a few other classes and made it into NYU. Next guy may have not done so hot and gone to West Virginia University. Does it necessarily follow that because of their undergraduate performance their capacity in med school is destined where top grad necessitates to be on top? I don't think so.

I don't see how your post is related to the issue. People are treated individually, it's just that grades definitely have a "strength rating " or something behind them. We're not saying that getting a P at a high ranking hospital is better than honors at a community one, but if you take two people that got same score at both, it would of course fall in favor of the higher ranked one. That's just one rotation grade though. Probably not going to make or break your app..

I don't get what individuals treated by their strengths means, we're evaluating apps which have ratings which are subjective to the institution they were received from. Not to mention I'm pretty sure if someone isa surgery PD you probably have a better handle on the quality of the surgery environments at x y and z places than any of us do and therefore their ability to adequately weight each score would be as good as it can be.

 

[AlbinoHawk DO]

Have you done any rotations yet? There's actually quite a bit you can learn in 4 weeks. I did a month-long rotation in derm, and while I'm by no means a derm expert I would guess that I can describe derm lesions better than at least half of the IM interns (and possibly even residents) based on that experience alone.

If you don't pay attention and/or waste the opportunity to learn, then you won't get much out of it. But as I said, 4 weeks is a good chunk of time. You might be surprised what you would learn in that amount of time.

I haven't, and I'm not saying you cannot learn anything or that it is an experience with no value, but the value of those 4 weeks has its limits and depends on the specialty you want to go into. Does that mean that derm should be a required rotation or do you think it's okay to be in IM without the experience?

 

[AlbinoHawk DO]

I don't see how your post is related to the issue. People are treated individually, it's just that grades definitely have a "strength rating " or something behind them. We're not saying that getting a P at a high ranking hospital is better than honors at a community one, but if you take two people that got same score at both, it would of course fall in favor of the higher ranked one. That's just one rotation grade though. Probably not going to make or break your app..

I don't get what individuals treated by their strengths means, we're evaluating apps which have ratings which are subjective to the institution they were received from. Not to mention I'm pretty sure if someone isa surgery PD you probably have a better handle on the quality of the surgery environments at x y and z places than any of us do and therefore their ability to adequately weight each score would be as good as it can be.

It is related to the issue if you go back into what the original discussion with DermViser has been. He keeps arguing that merely by the fact of being an MD or going to a top school that you must be better than a DO applicant or a low tier applicant who has objectively better scores. I proposed the scenario of a DO with 260 vs an MD with 220 from the same institution (MSU grants both MD and DO), but he keeps arguing for MD being better solely on flimsy things like a single rotation or something similar.

 

[PL198]

It is related to the issue if you go back into what the original discussion with DermViser has been. He keeps arguing that merely by the fact of being an MD or going to a top school that you must be better than a DO applicant or a low tier applicant who has objectively better scores. I proposed the scenario of a DO with 260 vs an MD with 220 from the same institution (MSU grants both MD and DO), but he keeps arguing for MD being better solely on flimsy things like a single rotation or something similar.

I'm not speaking for him but I doubt he'd say they'd prefer the md candidate for sure. All of these things are way more abstract than you make it out to be. A 260 DO student is a stud, whereas a 220 MD student is slightly below avg. it's probably leaning in favor of the DO student in my opinion

I mean what you do matters most, but how you get there also matters. If two people have the same exact app, one is MD and one is DO , the MD wins 100/100. Why ? Because everything they did is the exact same except the MD achieved at a higher level before ( hence why they're at an MD school ) which results in them being a superior candidate.

 

[Silent Cool]

Do you seriously think that the institution you graduate from has no affect at all on what type of education/quality of education you receive? Don't get me wrong, I think a lot of years are overpriced - i.e. the first 2 years of basic science coursework (at least the way it is taught now). But do you really think that all basic science education across the nation is the same in quality? That all clinical rotations are equal across the nation with respect to difficulty in grading/expectations, etc. No field is like this - Engineering, Law, Business etc. Why would medicine be any different?

Should Liberty University School of Osteopathic Medicine be treated exactly the same as University of Virginia (UVa)? You think someone who got Honors at Wayne State in OB-Gyn is exactly the same as the person who got Honors in OB-Gyn at Brigham and Women's?

You actually think there are no Derm patients who have underlying psychopathology to their skin disease (delusions of parasitosis, neurotic excoriations, etc.) or that psychiatric conditions and psychotropic medications can have or exacerbate skin side effects?

Dude, that's what OMM is for.

 

[DermViser]

It is related to the issue if you go back into what the original discussion with DermViser has been. He keeps arguing that merely by the fact of being an MD or going to a top school that you must be better than a DO applicant or a low tier applicant who has objectively better scores. I proposed the scenario of a DO with 260 vs an MD with 220 from the same institution (MSU grants both MD and DO), but he keeps arguing for MD being better solely on flimsy things like a single rotation or something similar.

No, not really. But keep talking.

 

[DermViser]

The answer to your institutional quality is a complex one. In undergrad, I attended a mid-tier UC campus. As a post-bacc, I attended 2 community colleges and a top UC school . I also worked at another top UC. I did have many instances where my community college courses were tougher and better taught. The opposite is also true. The advantage of larger and better known universities is in resources (economic and EC), but they don't necessarily dictate the quality of the graduate. As I'm sitting in anatomy lecture, I'm around graduates from Cornell, La Sierra University, UCLA, Arizona State, etc. We all got to the same place and not necessarily do we fall into this neat categories where top undergrad = better performance. Education is very complex and time sensitive. That said, I'm not saying LUCOM or UVA or any other institution should be treated equally to the next. I'm saying individuals should be treated individually by their strengths, weaknesses and potentials. Maybe someone was able to annihilate O. Chem and a few other classes and made it into NYU. Next guy may have not done so hot and gone to West Virginia University. Does it necessarily follow that because of their undergraduate performance their capacity in med school is destined where top grad necessitates to be on top? I don't think so.

Yeah, but you guys have similar matriculation characteristics - esp. with respect to MCAT. You talk all about being treated individually but have no way to do it. So far you've based it on a numerical 3 digit board score. But you're an MS-1 who apparently knows better on evaluation and assessment than program directors of residencies who've been doing it for years.

So even undergrad performance is unimportant to med school performance? Ok.

 

[Arkangeloid]

We have people from Harvard and Duke and UPenn and all kinds of places at my med school, and the people who top the class disproportionately come from State U. Where you went to undergrad don't mean ****.

If you haven't figured out by now that med school doesn't give a crap about how "smart" you are, you're in for a rude awakening. All that matters is how much you go ham up in this ****.

 

[DermViser]

We have people from Harvard and Duke and UPenn and all kinds of places at my med school, and the people who top the class disproportionately come from State U. Where you went to undergrad don't mean ****.

If you haven't figured out by now that med school doesn't give a crap about how "smart" you are, you're in for a rude awakening. All that matters is how much you go ham up in this ****.

Funny, I saw the exact opposite trend. I wonder if a lot of people at the State U - bc it was so easy (relatively speaking) took basic sciences but at the undergrad level - Anatomy, Histology, Physiology, etc. so that when they go to your med school they destroyed exams due to previous exposure. It wouldn't be at all surprising that the science majors who went ham in undergrad, did better than non-science majors who now have to start going ham in med school.

 

[Arkangeloid]

Funny, I saw the exact opposite trend. I wonder if a lot of people at the State U - bc it was so easy (relatively speaking) took basic sciences but at the undergrad level - Anatomy, Histology, Physiology, etc. so that when they go to your med school they destroyed exams due to previous exposure. It wouldn't be at all surprising that the science majors who went ham in undergrad, did better than non-science majors who now have to start going ham in med school.

Perhaps that could be it.

Then again, the dudes at Sinai looked at this specifically with their HuMed program, and found no difference in the performance of humanities students and science students. Also, I think if there was a difference, then med schools would have stopped admitting non-science grads years ago.

 

[DermViser]

Perhaps that could be it.

Then again, the dudes at Sinai looked at this specifically with their HuMed program, and found no difference in the performance of humanities students and science students. Also, I think if there was a difference, then med schools would have stopped admitting non-science grads years ago.

Actually if you read the article - they did: http://www.nytimes.com/2010/07/30/nyregion/30medschools.html?pagewanted=all&_r=0 Their board scores were a little lower on average (probably due to not having certain sciences and skipping right ahead), they were more likely to go into Psychiatry (probably due to Humanities background), and nearly all of those students came from elite schools.

Comments as usual hilarious and very telling.

Problem is that this is predictable for the first 2 years, not the clinical clerkship year.

 

[Arkangeloid]

Also, having experienced both the premed weedout classes and upper division liberal arts classes, I have to say that I find arguments that the latter are significantly easier are largely unfounded.

I will grant that the effort floor is significantly higher in the premed classes. During our peer-review sessions, I had the pleasure of reading utterly abysmal work from future humanities grads (most of whom would be going into schoolteaching, I feel bad for our kids). It's easy to slide by in lib arts classes, much easier than it is in science classes.

But I would say that if you want to be the student who tops the class, who gets beast recommendations that will get you into medical school, the effort ceiling is the same. I spent many late, Monster-filled nights writing my term papers. More than I spent studying for physics and OChem exams.

 

[DermViser]

Also, having experienced both the premed weedout classes and upper division liberal arts classes, I have to say that I find arguments that the latter are significantly easier are largely unfounded.

I will grant that the effort floor is significantly higher in the premed classes. During our peer-review sessions, I had the pleasure of reading utterly abysmal work from future humanities grads (most of whom would be going into schoolteaching, I feel bad for our kids). It's easy to slide by in lib arts classes, much easier than it is in science classes.

But I would say that if you want to be the student who tops the class, who gets beast recommendations that will get you into medical school, the effort ceiling is the same. I spent many late, Monster-filled nights writing my term papers. More than I spent studying for physics and OChem exams.

General Physics is a lower level science course, so not surprised. You would feel differently if you had taken, for example, Cell Biology or Immunology, an upper level science in undergrad.

 

[Arkangeloid]

Actually if you read the article - they did: http://www.nytimes.com/2010/07/30/nyregion/30medschools.html?pagewanted=all&_r=0 Their board scores were a little lower on average (probably due to not having certain sciences and skipping right ahead), they were more likely to go into Psychiatry (probably due to Humanities background), and nearly all of those students came from elite schools.

Comments as usual hilarious.

Problem is that this is predictable for the first 2 years, not the clinical clerkship year.

But don't you think that the MCAT exemption may play a part in this? The MCAT is a standardized exam, and serves to weed out students who are not good at standardized test-taking (and the STEP-1 is also a standardized exam). This is a significant confounder.

As for the Psych thing, I'm not surprised. In my experience, a lot of med students are people who despise anything that isn't cut-and-dry and as objective as possible. One girl I know says that she hates Psychiatry as a field of medicine because she thinks it's subjective and "stupid." Lib Arts grads don't mind things that are "subjective," because they've spent years dealing with subjective issues, different viewpoints, etc.

General Physics is a lower level science course, so not surprised. You would feel differently if you had taken, for example, Cell Biology or Immunology, an upper level science in undergrad.

I took Cell Bio and Biochem through the 400 level, that was a requirement to obtain a committee letter at my school.

 

[DermViser]

But don't you think that the MCAT exemption may play a part in this? The MCAT is a standardized exam, and serves to weed out students who are not good at standardized test-taking (and the STEP-1 is also a standardized exam). This is a significant confounder.

As for the Psych thing, I'm not surprised. In my experience, a lot of med students are people who despise anything that isn't cut-and-dry and as objective as possible. One girl I know says that she hates Psychiatry (and has yet to do rotations) as a field of medicine because she thinks it's subjective and "stupid." Lib Arts grads don't mind things that are "subjective," because they've spent years dealing with subjective issues, different viewpoints, etc.

Right, and so they're going into medical school without the quality-control of an objective metric to standardize GPAs from different institutions - the MCAT. But in the HuMed program I believe they actually skip courses - "They forgo organic chemistry, physics and calculus — though they get abbreviated organic chemistry and physics courses during a summer boot camp run by Mount Sinai." -- which you know those abbreviated courses will be watered down like crazy. That being said, the HuMed program "heavily favor elite schools."

It's not at all surprising that a hard science major might not like Psychiatry. It's too "soft", it's not "well-defined", I think I've heard it all. The problem that simpleton who said that about Psychiatry doesn't realize is that real clinical medicine is not cut-and-dry, black-and-white, the way basic sciences presents it to be. If that was the case, then medical malpractice in which misdiagnosis happens would never occur. These are the same fools who think that basic science is more important than their physical diagnosis course so they skip the latter so they have more time to study for the former and theoretically ace Step 1. Then they hit MS-3, are completely lost, and expect their interns/residents to teach them skills that their Physical Diagnosis course should have taught them. When they start seeing patients and doing H&Ps, etc. they see that there is no "classic" presentation of the diseases they learned and that real clinical medicine is a complex ruling in-ruling out of possibilities based on physical exam findings, history, imaging, labs, etc. They start panicking - don't present well, and their evals reflect that.

If only real life was as cut and dry as basic science, medicine would be so much easier and straightforward, but it isn't.

 

[Arkangeloid]

Right, and so they're going into medical school without the quality-control of an objective metric to standardize GPAs from different institutions - the MCAT. But in the HuMed program I believe they actually skip courses - "They forgo organic chemistry, physics and calculus — though they get abbreviated organic chemistry and physics courses during a summer boot camp run by Mount Sinai." -- which you know those abbreviated courses will be watered down like crazy. That being said, the HuMed program "heavily favor elite schools."

It's not at all surprising that a hard science major might not like Psychiatry. It's too "soft", it's not "well-defined", I think I've heard it all. The problem that simpleton who said that about Psychiatry doesn't realize is that real clinical medicine is not cut-and-dry, black-and-white, the way basic sciences presents it to be. If that was the case, then medical malpractice in which misdiagnosis happens would never occur. These are the same fools who think that basic science is more important than their physical diagnosis course so they skip the latter so they have more time to study for the former and theoretically ace Step 1. Then they hit MS-3, are completely lost, and expect their interns/residents to teach them skills that their Physical Diagnosis course should have taught them. When they start seeing patients and doing H&Ps, etc. they see that there is no "classic" presentation of the diseases they learned and that real clinical medicine is a complex ruling in-ruling out of possibilities based on physical exam findings, history, imaging, labs, etc. They start panicking - don't present well, and their evals reflect that.

If only real life was as cut and dry as basic science, medicine would be so much easier and straightforward, but it isn't.

All right, you've made your point. I won't skip the phys diag lectures. Actually, I was reading Bates yesterday, the physical exam tips will be helpful on the exam, which will require us to correlate phys exam findings with patho ****.

I don't think she was a "simpleton," I think that some med students have a blind, absolute faith in facts and hard sciences, and get annoyed when things contradict that. This is why some students in my class referred to Epidemiology as a "nonsense" class whose purpose was just to tell us that "blah blah we don't know what we think we know" (word for word, that's what they said).

When you're a hammer, everything looks like a nail. That's why the technocrats, who came from a background of comp sci, think that with enough money and computers, we can solve everything in education (and medicine!). And that's why some hard science students think that medicine should revolve around memorizing a series of concrete, objective facts, and are annoyed when that isn't the case: because that's the background they came from in college.

 

[DermViser]

All right, you've made your point. I won't skip the phys diag lectures. Actually, I was reading Bates yesterday, the physical exam tips will be helpful on the exam, which will require us to correlate phys exam findings with patho ****.

I don't think she was a "simpleton," I think that some med students have a blind, absolute faith in facts and hard sciences, and get annoyed when things contradict that. This is why some students in my class referred to Epidemiology as a "nonsense" class whose purpose was just to tell us that "blah blah we don't know what we think we know" (word for word, that's what they said).

When you're a hammer, everything looks like a nail. That's why the technocrats, who came from a background of comp sci, think that with enough money and computers, we can solve everything in education (and medicine!). And that's why some hard science students think that medicine should revolve around memorizing a series of concrete, objective facts, and are annoyed when that isn't the case: because that's the background they came from in college.

Yeah, I figured you were. I understand why it's on the back burner for you in terms of priority, but it's not something you should skip. You have recorded lectures anyways, so as long as you view them, take notes, and go to whatever patient sessions they have you go to to hear how normal sounds like, you should be fine. Oh and how to write SOAP notes - which they usually teach in that class.

That's what I'm telling you - her blind absolute faith in facts and hard science makes her a simpleton bc real clinical medicine isn't like that. Epidemiology/Biostats is important bc that's how you read the clinical literature which affects treatment and management. Clinicians on the wards aren't using textbooks which are years out of date anyways, when it comes to their management. They read journal articles. That stuff is more important in clinical medicine than the Zinc finger and Leucine Zipper motif in Biochemistry.

 

[username456789]

FWIW, in my school out of the top 10 students in the class, 7 of us went to state schools in undergrad (3 from the same one). The other 3 were from smaller liberal arts schools that many people on here probably never heard of. We had out fair share of Ivy alumni, but they were largely middle-of-the-packers in med school.

 

[PL198]

Lol who said epidemiology was useless.... They're an idiot. I will say that a lot of epidemiology has political slants, but whoever said it's not useful is a straight fool

 

[DermViser]

FWIW, in my school out of the top 10 students in the class, 7 of us went to state schools in undergrad (3 from the same one). The other 3 were from smaller liberal arts schools that many people on here probably never heard of. We had out fair share of Ivy alumni, but they were largely middle-of-the-packers in med school.

Was your school private or public? I guess it also depends into which tier the med school falls as well, bc certain schools like recruiting from certain undergrad pedigrees - i.e. Vanderbilt vs. Indiana University. I wonder if the Ivys in your school "burned out" in undergrad so to speak - although that threshold is very different for different people.

 

[Mad Jack]

Was your school private or public? I guess it also depends into which tier the med school falls as well, bc certain schools like recruiting from certain undergrad pedigrees - i.e. Vanderbilt vs. Indiana University. I wonder if the Ivys in your school "burned out" in undergrad so to speak - although that threshold is very different for different people.

Ivy does not necessarily mean "better." To get into an Ivy, you have to do well in high school, on the SAT, and be lucky. Being a quality high school student != being a good college student.

 

[PL198]

Ivy does not necessarily mean "better." To get into an Ivy, you have to do well in high school, on the SAT, and be lucky. Being a quality high school student != being a good college student.

I mean yeah but most great college students are pretty darn good in high school..

 

[DermViser]

Ivy does not necessarily mean "better." To get into an Ivy, you have to do well in high school, on the SAT, and be lucky. Being a quality high school student != being a good college student.

Yes, the assumption here is he same effort is put in. Most college science major Ivy premeds don't suddenly become lazy.

 

[Psai]

Right, and so they're going into medical school without the quality-control of an objective metric to standardize GPAs from different institutions - the MCAT. But in the HuMed program I believe they actually skip courses - "They forgo organic chemistry, physics and calculus — though they get abbreviated organic chemistry and physics courses during a summer boot camp run by Mount Sinai." -- which you know those abbreviated courses will be watered down like crazy. That being said, the HuMed program "heavily favor elite schools."

It's not at all surprising that a hard science major might not like Psychiatry. It's too "soft", it's not "well-defined", I think I've heard it all. The problem that simpleton who said that about Psychiatry doesn't realize is that real clinical medicine is not cut-and-dry, black-and-white, the way basic sciences presents it to be. If that was the case, then medical malpractice in which misdiagnosis happens would never occur. These are the same fools who think that basic science is more important than their physical diagnosis course so they skip the latter so they have more time to study for the former and theoretically ace Step 1. Then they hit MS-3, are completely lost, and expect their interns/residents to teach them skills that their Physical Diagnosis course should have taught them. When they start seeing patients and doing H&Ps, etc. they see that there is no "classic" presentation of the diseases they learned and that real clinical medicine is a complex ruling in-ruling out of possibilities based on physical exam findings, history, imaging, labs, etc. They start panicking - don't present well, and their evals reflect that.

If only real life was as cut and dry as basic science, medicine would be so much easier and straightforward, but it isn't.

Yeah I wish I worked harder in my physical exam class. I supplemented with the ucsd website and umich but still feel like my exam is deficient and that residents don't have time to check it for me

 

[DermViser]

Yeah I wish I worked harder in my physical exam class. I supplemented with the ucsd website and umich but still feel like my exam is deficient and that residents don't have time to check it for me

Yeah, I hear you. Part of the problem with the physical exam courses at most medical schools is that if at all, you're only exposed to normal, not abnormal and you have enough trouble keeping up with basic science coursework which is graded (so naturally you prioritize it higher).

For example, you hear clear lungs sounds (if your school does standardized patients), but you never get to hear abnormal pathology which is what real patients have: rales, rhonchi, etc. The first time you even hear those things is in MS-3 when intern/resident/attending have their own **** to do and don't have time to quality check what you're doing. That might be changing though with "simulators" that can mimic those things. Or hearing normal heart sounds, but not hearing how a murmur sounds like. But then when you say that you can't hear a murmur in MS-3, you're told by the attending it's ok - you just have to hear enough of them. Ok whatever, but the problem is as an intern/resident, I will have to be able to ID them and look like a fool when the attending asks how I can't hear such an obvious murmur.

LOL I used that website too! http://meded.ucsd.edu/clinicalmed/introduction.htm (to think it was from 2004)

 

[budda10000]

QUOTE="DermViser, post: 15589877, member: 257548"]No, it isn't a strong indicator. Your med school is a strong indicator as to the quality of your education esp. the quality of the MS-3 clerkships and the institutions they're done at. If what you say were true, SGU would be high in quality.[/QUOTE]

http://www.sciencedirect.com/science/article/pii/S1072751505018636
http://www.ncbi.nlm.nih.gov/pubmed/21292930
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2951767/
http://www.ncbi.nlm.nih.gov/pubmed/22911295

Research say's otherwise, your a practitioner of evidence based medicine aren't you? USMLE step 1/2 are the single strongest indicator of a successful resident(not the only), that is why they made it. Note that NONE of these studies cited the school being a significant factor. Ill give you this, an SGU student can bump there score up a bit due to extra time. However by your own argument a DO student or low-tier MD with a high USMLE is superior to a high-tier MD w/ lower usmle since they have less/same time to study for it.

Prior medical school is predictive of three things:
1)You probably were exposed to some rare pathology that smaller schools/community based programs did not see.(This can be overcome by doing away rotations)
2)you did better in your UG education and/or built a stronger resume.(who cares about this after med school?)
3)you had access to better research(does not mean you took part in it).

People from top 20 schools are, in general, very bright individuals. For that very reason they should have higher board scores as well, if they cannot stack up then they have obviously gotten lazy and failed to take advantage of all that their school offers. Why would you want that resident?

In my own experience this seems to be the case. The best residents I have seen while shadowing(UCLA, UCI, UCD, Loma Linda) were not always from high end programs. They did all have high USMLE scores however. Furthermore some of the best researchers in my area went to non-prestigious programs.(the top heme-onc guy is a DO w/ >200 publications)
high usmle tells me 2 things
1)they learn fast
2)they are hard workers
These are the two traits that every resident needs.
Applicants should not be screened by school attended or degree, they should be screened by step 1/2 scores and class rank 1st, then other factors should be accounted for like research experience and yes, even school attended. Doing it any other way makes programs lose out on some great talent and is a slap in the face to hard work.

 

[DermViser]

http://www.sciencedirect.com/science/article/pii/S1072751505018636
http://www.ncbi.nlm.nih.gov/pubmed/21292930
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2951767/
http://www.ncbi.nlm.nih.gov/pubmed/22911295

Research say's otherwise, your a practitioner of evidence based medicine aren't you? USMLE step 1/2 are the single strongest indicator of a successful resident(not the only), that is why they made it. Note that NONE of these studies cited the school being a significant factor. Ill give you this, an SGU student can bump there score up a bit due to extra time. However by your own argument a DO student or low-tier MD with a high USMLE is superior to a high-tier MD w/ lower usmle since they have less/same time to study for it.

Prior medical school is predictive of three things:
1)You probably were exposed to some rare pathology that smaller schools/community based programs did not see.(This can be overcome by doing away rotations)
2)you did better in your UG education and/or built a stronger resume.(who cares about this after med school?)
3)you had access to better research(does not mean you took part in it).

People from top 20 schools are, in general, very bright individuals. For that very reason they should have higher board scores as well, if they cannot stack up then they have obviously gotten lazy and failed to take advantage of all that their school offers. Why would you want that resident?

In my own experience this seems to be the case. The best residents I have seen while shadowing(UCLA, UCI, UCD, Loma Linda) were not always from high end programs. They did all have high USMLE scores however. Furthermore some of the best researchers in my area went to non-prestigious programs.(the top heme-onc guy is a DO w/ >200 publications)
high usmle tells me 2 things
1)they learn fast
2)they are hard workers
These are the two traits that every resident needs.
Applicants should not be screened by school attended or degree, they should be screened by step 1/2 scores and class rank 1st, then other factors should be accounted for like research experience and yes, even school attended. Doing it any other way makes programs lose out on some great talent and is a slap in the face to hard work.

Wrong. USMLE Step 1 and 2 are not strong indictors of how successful as a resident you will be. They've been more correlated with ITE scores during residency.

MS-3 clerkships can't be made up with 1 month audition electives.

"In my own experience this seems to be the case. The best residents I have seen while shadowing(UCLA, UCI, UCD, Loma Linda) were not always from high end programs." --- you're a premed shadowing. You have no experience and no gravitas to evaluate the quality of residents. PERIOD.

Sorry but I trust that Residency PDs know more about evaluating residents for interviews than you do.

 

[EM Doc to be]

there already are too many and the whackjobs at the AOA as already mentioned are not helping it one bit. I wanted to strangle the admin at my school when I heard the incoming CLASS was is 270 this year. Greedy pos that only cares about their wallet.

Wow...that's a huge class. Are all the schools increasing their class size?

 

[EM Doc to be]

So from what I understand..there is a huge shortage of physicians..well lets be clear, there is a huger shortage of primary care physicians.

They are infact increasing medical school class sizes and even opening new schools. And yes DOs popping up all over the place. oh and FYI MDs should be able to apply to DO programs starting next year. But does that mean it will help fill the shortage of primary care??

Most AMGs will shoot for a specialty mainly because of the lifestyle and compensation. Which has left the door wide open for IMGs.

So I guess when they close this gap of spots that go to IMGs by increasing the number graduates, the specialties will become more competitive and it will force AMGs to take primary care spots.

I dont think Med school will be the new Law school, because health care will always be in demand, and the goverment is looking to cut GME funding as much as possible. They could have increased the number of graduates a long time ago to fill the spots that are left over after all if not most AMGs take a spot...but I feel that they did not increase the number of residencies because they want to make sure that we have job security. - just my opinion here...worst case scenario...if they do overflood the market, our salaries will go down drastically.

MDs applying to DO residencies? Do they have to learn OMT?

 

[PL198]

lol step 1 was made for the purpose of evaluating who would be a strong resident? That's funny I thought it was made so that when students passed, they'd be competent enough in the basic sciences to be ready to learn in the hospital setting.

 

[Psai]

It is related to the issue if you go back into what the original discussion with DermViser has been. He keeps arguing that merely by the fact of being an MD or going to a top school that you must be better than a DO applicant or a low tier applicant who has objectively better scores. I proposed the scenario of a DO with 260 vs an MD with 220 from the same institution (MSU grants both MD and DO), but he keeps arguing for MD being better solely on flimsy things like a single rotation or something similar.

If you're an MD applicant, you will be better than a DO by default. It's easier to get into DO schools and their applicant pool is much weaker. That doesn't mean there is no overlap but your example is dishonest. If you have a lot of time to study for an exam, you will likely do better than someone who has less time. Your proposed scenario is also unrealistic. There will be many more people at MD schools who will score higher on step 1 than people at DO schools. 260 is a ridiculous score by the way, it's more than 1 standard deviations above the mean and the mean is no joke. Also as other people said, it's a test that is looking for basic competence in the basic sciences. It wasn't designed as an objective measure of someone's mastery of the breadth of medical education in general

 

[DermViser]

If you're an MD applicant, you will be better than a DO by default. It's easier to get into DO schools and their applicant pool is much weaker. That doesn't mean there is no overlap but your example is dishonest. If you have a lot of time to study for an exam, you will likely do better than someone who has less time. Your proposed scenario is also unrealistic. There will be many more people at MD schools who will score higher on step 1 than people at DO schools. 260 is a ridiculous score by the way, it's more than 1 standard deviations above the mean and the mean is no joke. Also as other people said, it's a test that is looking for basic competence in the basic sciences. It wasn't designed as an objective measure of someone's mastery of the breadth of medical education in general

Exactly. Even the getting the mean itself takes work to achieve, esp. since it keeps going up higher and higher every year. This isn't 1991 when the average was 200. Only a fool would think a USMLE Step 1 score encompasses everything, and erases everything. It's ridiculous.

 

[AlbinoHawk DO]

If you're an MD applicant, you will be better than a DO by default. It's easier to get into DO schools and their applicant pool is much weaker. That doesn't mean there is no overlap but your example is dishonest. If you have a lot of time to study for an exam, you will likely do better than someone who has less time. Your proposed scenario is also unrealistic. There will be many more people at MD schools who will score higher on step 1 than people at DO schools. 260 is a ridiculous score by the way, it's more than 1 standard deviations above the mean and the mean is no joke. Also as other people said, it's a test that is looking for basic competence in the basic sciences. It wasn't designed as an objective measure of someone's mastery of the breadth of medical education in general

Not denying any of those facts. I'm simply saying there's no reason to discriminate when you get people with the higher scores and great experiences that went to DO schools.

 

[DermViser]

Not denying any of those facts. I'm simply saying there's no reason to discriminate when you get people with the higher scores and great experiences that went to DO schools.

#1 - IT'S NOT DISCRIMINATION. You can keep calling it that, but it isn't.

#2 - Medical school residency applicants are defined by more than their Step scores.

 

[histidine]

There's talk that Step scores are going to be hidden from residency applications in 5 or so years. It will probably make it even harder for DOs to get into MD residencies.

 

[jw3600]

There's talk that Step scores are going to be hidden from residency applications in 5 or so years. It will probably make it even harder for DOs to get into MD residencies.

Source?

 

[AlbinoHawk DO]

#1 - IT'S NOT DISCRIMINATION. You can keep calling it that, but it isn't.

#2 - Medical school residency applicants are defined by more than their Step scores.

It is discrimination. You keep saying it is not, but it is. Soon residencies will be owned by both MD and DO, so discrimination MUST end.

 

[DermViser]

It is discrimination. You keep saying it is not, but it is. Soon residencies will be owned by both MD and DO, so discrimination MUST end.

Will you be inviting Al Sharpton or Jesse Jackson to speak at your rallies?