When we were in process of applying to medical school, I often searched the Internet trying to find out information about the process, the details, the options, what happened when, etc. One of my intentions in starting this blog was to share the trials and tribulations of said process, and I have done a poor job of holding up my end of the bargain. So here's a little update:
It's now the end of January 2009, and we are 18 months into the process of going through medical school. (As always, I use 'we' because this is a group effort, folks). Big Daddy has started the 2nd semester of his 2nd year of DO school, and this is the downhill slope of his class time. I can't even tell you how much he is looking forward to getting away from lectures and into some hands-on patient interaction.
This is also the time when thoughts turn towards Boards. For us, "Boards" refers to the COMLEX, part 1. This is taken at the end of the 2nd year of a DO program, and you must pass the test in order to move on to clinical rotations at the beginning of your 3rd year. DMU states it has a 96% pass rate, while the national average is 90%. I am a little fuzzy on the details, but I believe COMLEX, part 1 covers information gleaned from the first 2 years of class time plus a plethora of other medical knowledge. It's a big, bad, super stress-inducing test. And costs $600, so that's an extra sweet little cherry on the top of the testing sundae.
If you're a 2nd year DO student and you haven't started thinking about it, start now.
COMLEX, part 2 happens in school year 4 and requires that the student travel to Pennsylvania to take the test. Finally, there's a COMLEX, part 3, and that is taken in year 1 of residency. Once all tests are passed, state licensure is issued, and you are officially licensed to practice medicine. Amen.
Let's rewind for a moment, shall we?
Good. Stay with me now, it will all be worthwhile.
In addition to thinking about Boards, this is a time when we start thinking about clinical rotations. Rotations are the first chance to get into the field and get some real-life interaction with patients while shadowing health professionals in the field. In the 3rd year, you end up in a core hospital, and rotations are done in 4 week blocks, running through many of the basic fields of medicine: OB/Gyn, Family Practice, Emergency Medicine, Psychiatry, etc. I think there are 6 or 8 in all. A very busy time. Now, although you are assigned a core hospital, that doesn't mean you'll be in that hospital the entire time. You may have to travel somewhere else (locally) to do your family practice rotation, etc. Just gotta keep you on your toes, you know.
And how are rotations chosen? Well, that's what I'm here to tell you about.
DMU utilizes a lottery system. The student is given a list of rotation sites that are spread throughout a number of states. For us, this included sites in IA, MN, MI, OH, MO, and WY. The first lottery determines your general area. Here you can choose from IA/ Midwest (includes MI and MN), OH, MO, or WY. You make a first, second, and third choice, and hope for the best.
FYI - throughout the process, the school states that 90%+ of students end up with their first choice of rotation sites.
The second lottery is the nail-biter. This is the grand decision which will determine where you go for the next 2 years, and will likely also heavily influence the type and location of your residency after graduation. Once you've determined your general area (for us it was Iowa/ Midwest), then you have to choose from the actual hospital locations.
Sidebar: About half the class wants to stay in the Des Moines area. If you are one of those who wants to be in Des Moines, this makes it much more competitive in the lottery process. Thus far, there are 17 students who were granted a special exemption to stay in Des Moines. I found this rather surprising, as from what Big Daddy told me about the exemption process, it was stated that exemptions would not be given for people pleading the case of a 'spouse with a job in the local area', 'home ownership', or 'children enrolled in local schools'. And yet 17 people were granted exemptions. Funny, and I don't mean ha ha. At first I was bitter about this, as I saw those people as cutting into our chances to stay in Des Moines (because of course it's all about us), but I have since made my peace with it.
Back to our regularly scheduled programming.....
2nd round lottery: You finally choose from specific hospitals in the area where you landed from the first round. To my knowledge, beyond a name, city, and number of seats available, there is no information given about these programs. So we opened up our friendly neighborhood Internet browser and started poking around. We put together our list (top 4 choices), and hit submit yesterday evening. Results should post on Friday, and if it's anything like the first round, Big Daddy will be waking me up at 1am Friday morning to tell me where we will be for the next 2 years.
A little more about rotations: 3rd year runs as explained above. You go through your set course of rotations in various fields of medicine. Hopefully this steers you in one direction or another, and helps determine what kind of medicine you want to practice. 4th year is where the pressure is on once again. 4th year is when you do your interview rotations. Hopefully you've decided what kind of medicine you want to practice, and you've done some research about various residency programs that might be a good match for you. You then request to do an "interview rotation" at some or all of the sites where you think you'd like to do a residency. It gives you a chance to size up the staff & program & allows both of you (you and them) to see if you'd be a good fit there. While this is great - sort of like an extended job interview - it can also mean lots of time away from your home base and family. And coupled with the pressure of COMLEX, part 2 at the end of the year, it's sure to an induce an ulcer in someone (probably me).
Anyway, I hope you've enjoyed our trip through the maze of medical school. Please exit the ride now, making sure to collect all your belongings on your way out.
(oh, and if I got something wrong, Big Daddy will let me know, so check back and see if I've made any revisions)