ACGME vs. AOA Neurosurg Job Outlook

[postbacpremed87]

Would you say that any neurosurgeon, be it a ns that trained in an ACGME or AOA residency, will always have plenty of job opportunities? Will DO neurosurgeons who completed AOA NS always practice at a community setting, maybe a larger community setting?

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[DrPapa]

AOA trained neurosurgeons shouldn't have any trouble finding jobs. Even ACGME academics aren't out of the question if you complete a fellowship at an ACGME program.

 

[postbacpremed87]

AOA trained neurosurgeons shouldn't have any trouble finding jobs. Even ACGME academics aren't out of the question if you complete a fellowship at an ACGME program.

Does the recent merger change anything?

 

[Yoyomama88]

wonder if it helps MD students more than DO students or the other way around. I guess it's tough to tell. Do many very competitive DOs applying to neurosurgery forego the ACGME match?

 

[deleted564680]

There is an enormous bias against DOs in the ACGME realm of neurosurgery. It doesn't matter whether you are very competitive or not, only very few places will even look at you and you will be ranked lower just because of your degree. The merger will only hurt future DO students wanting neurosurgery because 1. some DO programs will close/stop taking residency because they won't meet ACGME standards and 2. the "MD" programs won't magically get rid of their bias just because there was a merger.

Source: personal experience

 

[Yoyomama88]

Kind of crazy if you ask me. Would you take a DO with a 260 step 1, tons of research or an MD with 215 step 1, no research?

 

[DrPapa]

If you're a quality applicant, you have a shot, regardless of being a DO or an MD. A marginal MD will have an easier time matching than a marginal DO, but an outstanding DO will match over a marginal MD.

An MD with a 215 and no research will have a tough time matching and a DO with a 260 and research shouldn't have a problem. A lot also depends on personality, how you do on audition rotations and letters, however.

 

[THH]

There is an enormous bias against DOs in the ACGME realm of neurosurgery. It doesn't matter whether you are very competitive or not, only very few places will even look at you and you will be ranked lower just because of your degree. The merger will only hurt future DO students wanting neurosurgery because 1. some DO programs will close/stop taking residency because they won't meet ACGME standards and 2. the "MD" programs won't magically get rid of their bias just because there was a merger.

Source: personal experience

Cubs, do you think the stronger DO programs (St. John's, PCOM, VCOM) are relatively safe post-merger?

 

[deleted564680]

First, I can personally tell you as a DO, a 260 doesn't get it done. The bias is too large and actually borders on outright discrimination. I even received an email from a program stating they didn't take DOs for neurosurg nor did they know of any programs that did and that I should "be sure to check first before applying." They even graciously advised me that I should pursue general surgery. There is even a preference for carib. over DO from what I personally noticed on the interview trail. Hopefully, 5-10 years down the road, this will not be the case. There have been DOs that have matched but it seems they were special circumstances or matched way down on a rank list. I will gladly share more information on this if anyone is interested in a PM.

As far as post-merger programs, I think SJP and Carilion are good as they stand right now with Columbus, PCOM, and the NJ program being "on edge" and the rest in a group that needs to re-evaluate whether or not it's worth the trouble to enact huge changes to remain in compliance.
The ACGME requires a program to have myriad other programs if they want to have neurosurgery such as gen surg, neurology, anesthesiology, etc. Obviously only SJP and Carilion can claim these at their base hospitals as of now. This doesn't even begin to delve deeper into the neurosurgery requirements themselves such as the number of each types of procedures/cases/etc.

The merger should help the cause of DOs in the future and probably long-term in all specialties, however the short-term for DOs in neurosurgery is definitely more bleak than bright. It remains to be seen how many formerly AOA programs will continue to take residents in the coming years and if the MD programs will finally eliminate their bias (I doubt it). There are those that speculate that DOs will become the "degree of primary care" since MDs will eventually be applying to the formerly AOA programs as well. I'm not sure if I am that pessimistic.

If I had to guess, I would say that SJP, Carilion, PCOM, Columbus, and then maybe 2 out of 3 or 1 out of 3 of Bromenn, NJ, Arrowhead will survive past 2020.

 

[neusu]

If you're a quality applicant, you have a shot, regardless of being a DO or an MD. A marginal MD will have an easier time matching than a marginal DO, but an outstanding DO will match over a marginal MD.

An MD with a 215 and no research will have a tough time matching and a DO with a 260 and research shouldn't have a problem. A lot also depends on personality, how you do on audition rotations and letters, however.

This is false. It seems as though that should be the case, but in reality, it is not. Sorry to be the bearer of bad news.

 

[deleted564680]

This is false. It seems as though that should be the case, but in reality, it is not. Sorry to be the bearer of bad news.

Neusu has this right. They will take a 215 MD all day long over the 260 DO. You can say all you want about personality, poor rotations, etc. as well but I can assure you that isn't the case either. The chairmen at MD institutions will gladly write you great letters and tell you that you would be a good resident, but they just don't want to be the ones to take you.

 

[DrPapa]

I've got to respectfully disagree with both of you, also from personal experience.

Yes, a good number of programs have a bias, but there are enough that don't. So you won't match at Barrow, UCSF, Yale or Stanford. Big deal. Go for the mid tier programs and you'll match. I can assure you that a good rotation at the right institution will make up for being a DO.

 

[deleted564680]

I've got to respectfully disagree with both of you, also from personal experience.

Yes, a good number of programs have a bias, but there are enough that don't. So you won't match at Barrow, UCSF, Yale or Stanford. Big deal. Go for the mid tier programs and you'll match. I can assure you that a good rotation at the right institution will make up for being a DO.

It must just be very program specific and you must have just gotten a good experience while I had gotten a bad one. I had good rotations but apparently they weren't at the "right" institutions. I rotated at an upper and two mid tier programs and all showed bias. I don't want to go into details but it certainly did not seem that I could have had any sort of application that would have swayed them unless I had an MD. It's a shame that I didnt experience the same things you did. I hope that future people will get more of yours and less of mine.

 

[Murph.]

This is a very old thread, but I haven't been able to find anything more recent about AOA neurosurgery residencies. Could any DO neurosurgery residents or physicians add insight to this? All of the other threads are very pessimistic but are coming from DO's in internal medicine/psych/Emergency/etc residencies, so they are not as reliable as an actual surgery resident. I hope that didn't sound rude.. I'm just saying it's hard to find information from those who have actually applied (matched or not) to surgical residencies as a DO.
Let me start by saying that I am not jaded enough to believe that matching into neurosurgery will be easy. But I also know that osteopathic med students do match into AOA neurosurg residencies every year. I personally know 2 of the 4 neurosurgeons just in my town are DO's, and they went through AOA residencies. And the recent match data shows 16 AOA neurosurg positions, all 16 were filled last year, and only 19 osteopathic medical students applied for those positions. Those seem to me to be extremely good odds. I do also understand that a lot of "self selection" goes into that small number of applicants. Maybe the years and years of threads on SDN I just read through (stating NSG is "impossible" for a DO, etc) has something to do with the few applicants. Also, very few people, DO's or not, want to do a 7-year residency. It just seems to me that all of the negative info I've seen are only referring to DO's applying for ACGME residency positions, and I'm not sure why when there are 16 neuro positions in the US specifically for DO's. Can someone clear that up for me? Is there a reason a DO that's extremely interested in NSG should not apply for the AOA positions? Match data seems to conflict with SDN commentary on the subject.
Also, are there any BroMenn neurosurgery residents out there willing to share any info on that program? The website makes it sound phenomenal. And can anyone comment on why the neurosurgery residency in Chicago, IL, isn't taking applicants for the next 2 years? Sorry for all the questions, but there is VERY little information on this topic.

Full disclosure: I'm a 2nd year DO student in the top 25% of my class (I know that means nothing but I haven't taken step 1 yet, so I have no other academic stratification data to offer). I've worked in and shadowed neurosurgery since I was 16. I have published research in cardiology and am currently working on a research project in neurosurgery. I had a paid research position for 2 years with NASA during undergrad. I have strong letters of recommendation from 2 neurosurgeons. I have been interested in Neurosurgery for as long as I can remember, and my only other interests are in general surgery and interventional cardiology. I would really appreciate advice or guidance from anyone out there who has applied for an AOA neuro residency position (matched or unmatched) as a DO. Thank you!

 

[bannie22]

Good luck. I know it will be very difficult. Neurosurgery is so competitive now the most recent Step 1 average was 249.
Back then people were suggesting that programs would take a 45point gap disadvantaged MD over DO.
Given the most recent average, you would have to be perfect on Step 1...

I would say stop all the ECs and start making some serious connections.

 

[InTheMaking]

https://apps.acgme.org/ads/Public/Sponsors/Search?

Go there and check to see what DO programs have applied and are pre-accredited or accredited by the acgme. If a program is not pre-accredited or applied for accreditation then they will not be accepting new residents.

On first check, Barnabas, Providence, PCOM, Grant (Columbus) and Arrowhead are continued pre-accreditation which means they've submitted apps.
Only one thats made the transition is Virginia-Carillion, which is now fully accredited.