The University of Vermont College of Medicine (UVM) is situated in the rolling hills, scenic countryside, skiing, and autumn colors of one of the country’s most picturesque states. Taking advantage of these optimal surroundings, the school has provided a nurturing environment in which to learn medicine. One of the things that sets UVM apart is its emphasis on clinical experience: basic science is compressed into a fairly intense year and a half, followed by two and a half years of clinical rotations.

THE PRE-CLINICAL YEARS

That first year and a half includes ten major subject areas, starting with gross anatomy, microscopic anatomy (histology) and biochemistry. The course in anatomy is a perennial favorite, with excellent teaching augmented by anatomical models created in-house by the faculty. This is followed by physiology, microbiology, neuroscience, general and then systemic pathology, psychopathology, and pharmacology. The pathology department does a particularly outstanding job, although histology, biochemistry, and psychopathology often get below-average ratings.

The professors and other faculty actually seem to care about teaching, and are available pretty much day or night to help students out. Their friendliness and dedication don't, however, prevent them from writing difficult exams. Similarly, the staff and administration seem to go out of their way to make the time spent at the school as bearable as possible. They get to know each student personally, can be reached at any time, and can be counted on for useful advice.

Starting almost from day one, UVM students have a good deal of exposure to clinical medicine. The first semester includes "Doctoring Skills," a class on the use of exam tools, interviewing skills, history taking, and the fundamentals of the physical exam, practiced on "patient instructors" hired to provide feedback to students. After winter break, every student is assigned to an area primary care doctor for an afternoon every other week. These mentors range from country doctors to multi-physician city practitioners, from pediatrics to family practice to internal medicine. Many students cite this year-long relationship as their most important learning experience of the Basic Science Core.

UVM’s physical plant could use some work. The unattractive medical school building is fairly old, contains a small library, and sports uncomfortable lecture hall seats. Although the school is located on a campus teeming with undergraduates, it seems that you never see anyone other than medical school classmates. The bitterness of the winters is overrated by our California contingent, but the long walk from the parking lot to the school can be painful in a howling wind.

THE CLINICAL YEARS

Halfway through the second year, students begin a year of "Clinical Core," consisting of required rotations through the major areas of medicine — surgery, pediatrics, psychiatry, OB/GYN, family practice, and internal medicine. The rotations are spread through three hospitals: Fletcher Allen in Burlington, Vermont; Maine Medical Center in Portland, Maine; and Champlain Valley in Plattsburgh, New York. Most students say the experiences at all three are extremely positive, although the quality of a given rotation varies with the attendings and residents to whom students are assigned. The population of Burlington is mostly white and middle class, which makes for a fairly homogenous clinical experience.

Most students — excepting those with children — are required to spend at least two months (usually four or more) in Maine, which can be difficult for those with spouses, pets, leases, or other obligations in Burlington. The Plattsburgh rotations start and end each day with a long commute and ferry ride, which can be annoying. The silver lining to all of this is that even the first day on clinical rotations, UVM students function at a reasonably high level, thanks to their previous clinical training.

This clinical advantage seems to carry over even into residencies, with UVM students getting consistently high ratings from residency directors. After one year of rotations, students return to the classroom for a month of "Advanced Science," consisting of genetics, epidemiology, and a series of elective classes including ACLS and embryology. Although these classes can help students prepare for the USMLE Step I (which UVM students tend to take a year or so after their colleagues around the country) many view them as a welcome break from the hectic pace of the hospital.

The last year and a half is composed entirely of elective clinical rotations. The school requires that some rotations be completed in Vermont, and some of the rotations must be scheduled as "Acting Internships" (the actual requirements differ based on whether students choose the "surgery major" for this period or not), but most take this time to prepare for and take the boards, to travel to rotations around the country and the world, to interview for residencies, and to spend a little time with friends and family. Advising on post-graduate training is considered excellent, with between 85 and 90 percent of students matching at one of their top three program choices.

SOCIAL LIFE

Students tend to be a friendly bunch. Most are laid-back people with some experience in fields other than medicine. The admissions process selects for people with a history of community service, and the student body tends to be pretty active in the community and in supporting one another.

Living in Burlington is a mixed blessing. Compared to major cities, there isn’t a huge amount happening culturally. Most people find entertainment in hiking and skiing in the surrounding countryside, intramural athletics (student organized), movies, and the small city club scene of Burlington. Crime is not a problem, and the lack of big city distractions makes studying less painful. If you need to be in a big city, Montreal is one and a half hours away, and Boston is four hours away. Although good housing can be hard to find, rent is reasonable: $600-800 for a nice-sized two bedroom apartment, with higher prices for housing closer to the school.

THE BOTTOM LINE

If you’re looking for a non-clinical education, lots of experience with inner-city populations, or an ultra-modern facility with a huge library, go somewhere other than UVM. If you’re looking to be treated like a human being while you’re in med school, some outstanding clinical training, and you "play well with others," think about UVM.

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