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  1. #1
    Cyberia is offline Senior Member 515 points
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    A comment/change for 5th semester

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    I’m a current student in 5th semester in Miami, and I’m writing this not to complain about AUA or the staff, but perhaps so the administrators can make the school better for both the students, and the reputation for the university itself. First off, a little background about 5th. 5th is setup as an “intro into family practice and internal medicine” with some step 1 prep and history/physical exam classes thrown in between. My typical week thus far has been anywhere from 12 to 30 hours in the hospital with classes lasting anywhere from 1-2 hours every day (excluding sun, although you do have an occasional ER shift on Sundays). We do rotate to some great places in the hospital. I’ve personally been in the ER, NICU, and Cardiology thus far. I’m actually learning a lot and think it’s a great experience…BUT…I don’t think I’m able to take advantage of this great opportunity as I should be. I don’t think I should be anywhere near the hospital at this point until after I successfully pass step 1. I do think all of the training we’re getting is excellent, and very necessary; however I just think it’s too soon right now. I feel that I’m either “forgetting” basic science information right now since I’m learning clinical info..or I’m unable to fully “commit myself” towards learning clinical medicine since I’m still trying to find time to study/prepare for step 1. If I had my way, here’s how I’d do it.
    1. Raise the comp passing rate to 64. Yes..i know this will be met with lots of bellyaching. But please..bear with me somewhat. The min score was raised to 62 as of jan 1st and the 3.0 rule is no longer in effect, so I think it’s only the natural progression that the school will raise the level in a year or 2. If a student PASSES the comp on island, go to 2. If the student fails to pass the comp on island, see #3.
    2.If a student passes the comp on the island, certify them to sit for step 1..period (provided they take it within 12 months). Do not pass Go, do not collect $200. They have proven themselves capable to take the step 1 (according to NBME anyway) and if it’s good enough for NBME, it should be good enough for AUA too. If the student PASSES step 1, go to #4. If the student FAILS the step, go to #3.
    3.If the student FAILS the comp on the island or FAILS step 1 on the first try, the student is then placed into Atlanta for a “step 1 study semester”. Atlanta is the biggest 5th site (we were told it could hold our entire class of 200 students last semester) and already includes didactic lectures every other week. This site should NOT have students rotate into any clinical sites in the hospitals, etc. Basically my idea is to turn ATL into a big step 1 prep/remediation class. Students come in, get their review course, and (hopefully) pass the comp. I’d also allow students who passed on island but wished to have a review course, come to Atlanta too. This is both a ‘win’ for the students and the university as a whole. First, the university is getting an ‘extra’ semester of tuition out of these students..plus it will hopefully boost step 1 scores and pass rates (thus boosting our reputation). For the students, it’s obvious in that they’re getting a (hopefully) intense review course, which would allow them to pass the step 1 on the first try.
    4.After completing step 1, now have these students go to each of the other “traditional” 5th semester sites (MI, NY, or FL). These sites would ONLY have the clinical side of our current 5th programs, and would allow students to really FOCUS on learning to take histories, perform accurate physical exams, etc. I mean, if I took 6 months off to study for the step now (as a lot of students from AUA do), when I’m finally ready to do my clinical rotations, I’m sure I would look really “sloppy” for the first few weeks (thus giving AUA a bad reputation). Practically speaking, you could have each site start 1 month apart from the rest (MI’s first day would be in Jan, FL’s first day would be in Feb, and so on) with each program still 4 months long, and when each student receives his/her step score, the max they’re waiting to start would be 30 days.
    Again, I’m not writing this to complain about my 5th semester experiences thus far, but more of a “thinking out loud” for possible improvements to our school. I’d appreciate any comments/thoughts anyone else has, especially from any student who has passed step 1 already and is in his/her clinical rotations. Sorry in advance for the “choose your own adventure” format above. If you don’t like this format, go to #5. And Tipton, if you wouldn’t mind passing this along the chain of command I’d be grateful (I’m not sure who the most appropriate person to email this to would be). Thanks.

  2. #2
    HeroLike is offline Member 523 points
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    i do agree that the time spent from end 5th semester to first rotation is incredibly long, and you're right we forget the clinical fundamentals of history/exams and risk looking very silly in front of attendings/residents. I wouldn't mind a quick 2wk refresher workshop on it before rotations start.
    Last edited by HeroLike; 01-27-2010 at 06:08 PM.

  3. #3
    rajrdeo is offline Junior Member 510 points
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    actually rotating through the sites is a really good opportunity to expand what you read in the books and apply it to stuff in real life... once you get into the rotations more in 5th semester and actually apply the knowledge you should have learned then things should come a little easier as concepts start to flow... though if anything, as your class likes to complain, education is not the thing to complain about in 5th semester! its the lack of organization that should be fixed!!!

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