chances in competitive residency

[futurehealer117]

Hello everyone,

I'm a pre med student and If I'm fortunate enough to get accepted to any medical school I frankly don't care what letters are afixed to my name. I think becoming a strong clinician and a compassionate healer is the true measure of a physician. However, I very much want to go into Oncology and I'm slightly worried that if I go to a D.O. program, particularly the one in my state (Rocky Vista), I'll have no legitimate shot of getting into such a competitive specialty. Any thoughts?

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[DrMom]

This has been discussed in a lot of threads on SDN. There's a pretty current one in the Osteo forum.

 

[futurehealer117]

Please ignore the hostility of this title I simply want people to take a firm stance on this. It seems to me, in my admittedly limited knowledge, that the A.O.A. isn't doing nearly enough to inform the American Public about the benefits, or even the EXISTANCE of Osteopathic Medicine. I can only speak for my home state of Colorado but it seems that only a very small percentage, perhaps one in ten have any idea what a D.O. is and even a smaller percentage are aware of the full scope of Osteopathic Medicine. And it seems as though the greatest concern of the A.O.A is to emphasize the equality of D.O's and M.D.'s, then take a "thanks, but no thanks" attitude when the A.M.A. reaches out. If my impression is wrong, please correct me but my question is this: is there anyone trying to bring Osteopathic Medicine to public attention?

 

[DrMom]

Most people don't notice or don't care about the letters after their physician's name. DOs are approximately 6% of the physicians in the US, so we just aren't out there in big numbers in most areas of the country.

Honestly, it isn't hard to explain to patients that DO=MD. I've never had it become an issue with a patient.

I'd recommend that you do more research on osteopathic med schools, residencies, etc. The 2 things you've brought up so far aren't huge issues for the vast majority of DOs.

 

[futurehealer117]

Please Please Please! Let me clarify this now. I LOVE D.O'S, MY P.C.P IS A D.O., beyond the ability to get into a competitive residency I have 0 worries about becoming a D.O. My statement is in relation to the lack of awarness amongst the general public about the benefits of Osteopathic Medicine, and how the A.O.A is seeming to do little to rectify the situation.

 

[DrMom]

My point is that most of the general public never even notices the letters. It rarely is an issue and when it is brought up it is pretty easy to explain that we're full physicians with the same education as MDs, just different letters for the degree.

I don't know that I can say there really is a "benefit of Osteopathic Medicine," and I think it is not a good idea to try to say we're different or better. Very few of us use OMM, and there are excellent and terrible DOs and MDs alike. If more of us used OMM, which I think can be an excellent modality in certain situations, then we'd be legit in saying we're different.

How would you propose the AOA "advertise" DOs?

 

[PipiChen]

My point is that most of the general public never even notices the letters. It rarely is an issue and when it is brought up it is pretty easy to explain that we're full physicians with the same education as MDs, just different letters for the degree.

I don't know that I can say there really is a "benefit of Osteopathic Medicine," and I think it is not a good idea to try to say we're different or better. Very few of us use OMM, and there are excellent and terrible DOs and MDs alike. If more of us used OMM, which I think can be an excellent modality in certain situations, then we'd be legit in saying we're different.

How would you propose the AOA "advertise" DOs?

My view is that the general public never notices the letters because they think all of us are MDs. I have seen patients at ERs start to act all skeptical when they realize the doctors treating them are not MDs. I agree with OP that AOA isn't doing enough to promote the profession. From reading AOA exec's blogs, I felt that they think we are osteopaths rather than physicians. Also, AOA would rather associate with groups that use manipulation alone than the full scope of medicine. Then, they exert their view upon all other DOs through administrative measures.

Meidicine is universal, so are diseases. However, with current lvl of AOA's effort and orientation, DOs are not benefitting from the international perspective. Espeically at medical hubs outside the states, such as Japan, Singapore, Spain, France, etc etc. These countries outright deny DOs' request to practice and train in a medical setting. I think OP brings out the point that the new generation of DOs need to focus on letting people know about us instead of keeping hiding behind the assumption that "no one cares".

 

[DrMom]

Letting people know is something I have done on a person by person basis whenever asked by patients/family.

Again, how do you propose the AOA "promote" DOs? Ads saying DOs are the same/equivalent to MDs? TV characters? (they considered this a few years ago) Flyers? Emails? Something else?

I'm afraid that the AOA will focus too much on MD + more, making us seem like chiropractors/naturopaths/etc to the uninformed general public. I find the explanation of DOs being the same education/training as MDs and that we train together in residencies & work together in hospitals/clinics to be a very simple explanation for people. Maybe it helps that they already are seeing me in a hospital setting.

As far as international practice goes, very few US trained physicians (DO or MD) are going to relocate to practice full-time in another country. Also, many of the countries that don't currently allow DOs to become licensed also block *any* foreign trained physician or make it very difficult for foreign-trained physicians to become licensed. That said, this is something that the AOA has been working on and the DO international practice rights list has expanded over the past few years.

 

[Semicolon]

Considering that the AOA doesn't really reflect the opinions and practice of the majority of DOs, perhaps it's best that they don't advertise...

 

[DrMom]

Considering that the AOA doesn't really reflect the opinions and practice of the majority of DOs, perhaps it's best that they don't advertise...

Hence my concern that they'll make us look like quacks rather than physicians.

 

[MossPoh]

Oncology is a fellowship. Not a residency. Your mind will probably change a million times before that point. The residency you get will dictate more than the medical school for a fellowship. Oncology isn't that competitive relative to cards and GI. It sounds nice but many people sway away from it later on.

 

[scpod]

.....I'm slightly worried that if I go to a D.O. program, particularly the one in my state (Rocky Vista), I'll have no legitimate shot of getting into such a competitive specialty. Any thoughts?

The truth is that if you are the top student in your class, you can go just about anywhere you want-- doesn't matter if you are an MD or DO. For everyone else....well, the plot thickens.

As a pre-med, you may think you are on the top of the world, with a 3.9, a great MCAT and professors that just worship the ground you walk on. The reality is that after the first Anatomy exam...half of the matriculants in the US (about 11,000 per year now) are suddenly struggling in the bottom half of their classes.

How many college athletes really succeed in the pros? Not many. That's the same jump you get between college and med school. You may be the top one or two people in every undergrad class....but it just doesn't carry over.

MOST matriculants will NOT get into those competitive specialties that pre-meds are whining about. Where you go to school means much less than how you perform and how well you fit in with the existing residents and attendings at the programs you apply to.

The only way you can guarantee success is by being the number one person in your class. Strive to do the best that you can....and other things will follow.

 

[JaggerPlate]

My view is that the general public never notices the letters because they think all of us are MDs. I have seen patients at ERs start to act all skeptical when they realize the doctors treating them are not MDs. I agree with OP that AOA isn't doing enough to promote the profession. From reading AOA exec's blogs, I felt that they think we are osteopaths rather than physicians. Also, AOA would rather associate with groups that use manipulation alone than the full scope of medicine. Then, they exert their view upon all other DOs through administrative measures.

Meidicine is universal, so are diseases. However, with current lvl of AOA's effort and orientation, DOs are not benefitting from the international perspective. Espeically at medical hubs outside the states, such as Japan, Singapore, Spain, France, etc etc. These countries outright deny DOs' request to practice and train in a medical setting. I think OP brings out the point that the new generation of DOs need to focus on letting people know about us instead of keeping hiding behind the assumption that "no one cares".

Never seen this in any type of practice ... let alone an ER where people wait 4 hours to see a physician. I'm pretty sure in the ER you could send in ANY physician and the person will be thrilled to finally see someone.

 

[TeamZissou]

As a pre-med, you may think you are on the top of the world, with a 3.9, a great MCAT and professors that just worship the ground you walk on. The reality is that after the first Anatomy exam...half of the matriculants in the US (about 11,000 per year now) are suddenly struggling in the bottom half of their classes.

How many college athletes really succeed in the pros? Not many. That's the same jump you get between college and med school. You may be the top one or two people in every undergrad class....but it just doesn't carry over.

MOST matriculants will NOT get into those competitive specialties that pre-meds are whining about. Where you go to school means much less than how you perform and how well you fit in with the existing residents and attendings at the programs you apply to.

The only way you can guarantee success is by being the number one person in your class. Strive to do the best that you can....and other things will follow.

Great succinct post scpot!

 

[scpod]

My view is that the general public never notices the letters because they think all of us are MDs. I have seen patients at ERs start to act all skeptical when they realize the doctors treating them are not MDs....

I call major BS on that one. The general public, at least 99 % of them, don't care who treats them in the emergency department. They just want help. And, as has already been pointed out, MD is not a universal degree. You don't automatically get granted the rights to practice in another country. Most often, you have to take their own version of the boards in their language first-- just like they have to do here. You may even have to practice for a year under the supervision of someone else first.

 

[PipiChen]

I call major BS on that one. The general public, at least 99 % of them, don't care who treats them in the emergency department. They just want help. And, as has already been pointed out, MD is not a universal degree. You don't automatically get granted the rights to practice in another country. Most often, you have to take their own version of the boards in their language first-- just like they have to do here. You may even have to practice for a year under the supervision of someone else first.

First, why the "scary" tone? I am sorry if it is something you do not believe in but even if you did not experience one that does not mean it did not happen elsewhere. There are different type of patients and I was merely pointing out the fact I witnessed. Additionally, not all people visit ER for emergency reasons...

As for the international rights, I am originally from Singapore. I would very much love to go there for some international rotations and electives. However, Singapore Medical Council does not recognize DO degree and in fact it only recognizes 39 MD schools in the states (it does not even recognize Jefferson ). With the abundance of learning opportunities in Singapore as it becomes the medical hub of the region, it is to our disadvantage that our administrative status prevents those who interested in int'l exp from going there and learning to better help patients. I am sorry, I just think learning is not limited to one country. I had my education all over different places and it just prompts me to diversify my medical educational experience too.

As to AOA, why can't we get people who can accurately represent us in the first place? Then, under the leadership of progressive execs, we can start working on areas that have been held back because of previous old school thoughts? This country wants a change, so do many DOs.

http://forums.studentdoctor.net/showthread.php?t=592566

Never seen this in any type of practice ... let alone an ER where people wait 4 hours to see a physician. I'm pretty sure in the ER you could send in ANY physician and the person will be thrilled to finally see someone.

it is at a relatively small hospital where patients do not have to wait that long during most of the time of the day.... well I am not saying this is common, just something happened along with my other experiences.... the DO I shadowed is an attending and being the only DO there he is well respected by his co-workers. He also guides MD residents. The experience was rather awkward because the patient and his family just felt very uneasy with him...


Anywayz, my apologies to those who were offended..... However, after reading the other thread posted by Dr.Mom above, I really have no idea what is AOA doing with expanded enrollment but no similar increase in residency capacity.... on another note, the thread is a rather weird one; it is packed with arguments that why podiatrists are not physicians....

 

[JaggerPlate]

it is at a relatively small hospital where patients do not have to wait that long during most of the time of the day.... well I am not saying this is common, just something happened along with my other experiences.... the DO I shadowed is an attending and being the only DO there he is well respected by his co-workers. He also guides MD residents. The experience was rather awkward because the patient and his family just felt very uneasy with him...


Anywayz, my apologies to those who were offended..... However, after reading the other thread posted by Dr.Mom above, I really have no idea what is AOA doing with expanded enrollment but no similar increase in residency capacity.... on another note, the thread is a rather weird one; it is packed with arguments that why podiatrists are not physicians....

Bah. You aren't offending anyone ... it's just that a lot of people try to footnote their claims on this site with 'one time in an ER I saw ____,' or 'my uncle, who is an MD radiologist said ____.'

It sounds like your situation was more of an urgent care type center. I've worked at 2 ERs and gone to 3-4 in my life for various things, I've never seen one where there wasn't always a wait to get in, and I've never seen anyone utter one word about the letters behind a doc's name. Most people sit in a room or the lobby for hours anyway, I seriously think you could send anyone in there and they would be happy.

Plus, if these people were using the ER as their PCP for their kid's cold or getting shots or whatever ... hopefully they were squimish and just left. I seriously hate when people abuse the ER like this. I've witness people scream at nurses because they have been waiting 45 minutes to get their cold checked out, but that guy on the stretcher with the bag over his face and team of EMTs working on him just got here 2 minutes ago. One of my biggest pet peeves.

 

[TexasTriathlete]

Most pts in the average ED just want dilaudid and a boxed lunch. It doesn't matter who gives it to them. At least that's my experience.

These posts seem logical when you first think about it, but then when you really think about it, you realize that they are ******ed.

1. As far as RVU goes, some people think that they will be the worst thing ever to happen to this planet, and that it is only a matter of time before they cause the downfall of humanity. Other people think that they will be just fine, and that they will be a top-flight medical school.

So far, they seem to be doing everything right, but really, it will probably be 10+ years before we can tell if they were a success or not.

2. When I first applied, I knew tons of DOs, in many specialties, and this was not a concern of mine. Then I came on here, and everyone started to freak me out about how I'd be locked into family med in Arzamas-16 if I went to a DO school. Then I calmed down and realized that most people on here don't know ****.

3. If you go to RVU and completely **** the bed, then you will not get a competitive specialty. The same is true if you go to CU and do the same. If you do well, you will be in good shape.

4. Nothing is certain, no matter where you go. Just do your best, and if that isn't good enough, you have nobody to blame but yourself.

 

[Semicolon]

Bah. You aren't offending anyone ... it's just that a lot of people try to footnote their claims on this site with 'one time in an ER I saw ____,' or 'my uncle, who is an MD radiologist said ____.'

It sounds like your situation was more of an urgent care type center. I've worked at 2 ERs and gone to 3-4 in my life for various things, I've never seen one where there wasn't always a wait to get in, and I've never seen anyone utter one word about the letters behind a doc's name. Most people sit in a room or the lobby for hours anyway, I seriously think you could send anyone in there and they would be happy.

Plus, if these people were using the ER as their PCP for their kid's cold or getting shots or whatever ... hopefully they were squimish and just left. I seriously hate when people abuse the ER like this. I've witness people scream at nurses because they have been waiting 45 minutes to get their cold checked out, but that guy on the stretcher with the bag over his face and team of EMTs working on him just got here 2 minutes ago. One of my biggest pet peeves.

Or when they're just there to get some drugs (opioids). Saw lots of those in NYC...

 

[PipiChen]

Or when they're just there to get some drugs (opioids). Saw lots of those in NYC...

how about skin rashes or sore throat, I have seen plenty of those

 

[JaggerPlate]

Or when they're just there to get some drugs (opioids). Saw lots of those in NYC...

For sure ... oh man wayyy to much. It's funny how it takes an ER RN or Doc about 35 seconds to peg these people, and their dead on like 90% of the time.

I worked in big city too ... another thing I just couldn't turn around with out seeing were people in the ER, with a cop, in cuffs, waiting to get their blood drawn to confirm their DUI.

 

[JaggerPlate]

Then I calmed down and realized that most people on here don't know ****.

This is a huge one to get over, but it's soooo true.

 

[TexasTriathlete]

A lot of times with the drug seekers, the er docs/nurses know the pt, or they can tell by pulling up their chart and seeing reasons for other ED visits.

 

[PipiChen]

A lot of times with the drug seekers, the er docs/nurses know the pt, or they can tell by pulling up their chart and seeing reasons for other ED visits.

experienced that at Grady Memorial... when on duty as a EMT-I

Patient: Doc, my back hurts! An air-con unit fell on my back on the walkway~~~

Doc: Sure, but Mr XXX I don't see any evident bruise on you back? Does it hurt here?

Patient: I think so, I ain't no idea of bruise but an air-con fell on me!! I need some morphines... this one is killing me

Doc: ..... u need to go home....

 

[MossPoh]

Tex, I think they'd make you do family medicine or obgyn in Oklahoma. They know how much you love Oklahoma. Probably a place with all sooners fans too. You'd get to drive past a dozen "boomer sooner" signs every day to work.

 

[TexasTriathlete]

**** oklahoma.

 

[MossPoh]

I knew you'd like that.

 

[DrMom]

**** oklahoma.

Hey!

 

[MossPoh]

A lot of times with the drug seekers, the er docs/nurses know the pt, or they can tell by pulling up their chart and seeing reasons for other ED visits.

My favorite is when they can't remember what they had for lunch that day or what they did yesterday but they can remember the exact drug name, dosage, amount of pills and what it looks like.

This was a good one too..
"Someone stole all of your pills?"

"Yea, that aint right is it?!"

"You said they left the bottle to these pills?"

"I KNOW. How messed up is that?"

"Ma'am, I can see the other bottle of painkillers in your purse and I know you are not a Mr. Johnson. "

"Uh....they're a friend's."

"Right..."

 

[Semicolon]

My favorite is when they can't remember what they had for lunch that day or what they did yesterday but they can remember the exact drug name, dosage, amount of pills and what it looks like.

This was a good one too..
"Someone stole all of your pills?"

"Yea, that aint right is it?!"

"You said they left the bottle to these pills?"

"I KNOW. How messed up is that?"

"Ma'am, I can see the other bottle of painkillers in your purse and I know you are not a Mr. Johnson. "

"Uh....they're a friend's."

"Right..."

Wow, that is IDENTICAL to the stuff I experienced before. The most amusing part of these situations is when they realize they can't win and they start getting angry, more often than not yelling at the doctor. One even came up to the area where all the docs were and threatened to sue him; after the guy left, the doc just started laughing and said "that's the third time I heard that today".

 

[TexasTriathlete]

We had a guy who would check himself in with a different name each time he came in. He did it a couple days in a row, and we recognized him, and the nurse called him on it. His explanation was that he was in the CIA, and could not risk using his real name. He could, however, tell us he was in the CIA.

 

[JaggerPlate]

We had a guy who would check himself in with a different name each time he came in. He did it a couple days in a row, and we recognized him, and the nurse called him on it. His explanation was that he was in the CIA, and could not risk using his real name. He could, however, tell us he was in the CIA.

We had a lady come in seeking multiple times and eventually she freaked out so bad when she couldn't get anything that she had to be restrained to a bed and - I kid you not- screamed at the top of her lungs ranting (insanely) for probably 3 hours. Eventually her 'boyfriend' came and the nurses let him to in to see her, watching the entire time through a camera that was in this one room (that I never knew about until that day). The boyfriend took a pill out of his pocket and gave it to her ... RN stormed in, screamed at him, he denied it etc. But here is the best part ... he wouldn't leave so the cops came and searched him and he was wearing multiple pairs of pants (3-4) over one another. The cops found the drugs and said that the pants thing was a way that they hide them b/c they figure the searches won't work as well ... I think this test proved fail.

 

[Semicolon]

We had a lady come in seeking multiple times and eventually she freaked out so bad when she couldn't get anything that she had to be restrained to a bed and - I kid you not- screamed at the top of her lungs ranting (insanely) for probably 3 hours. Eventually her 'boyfriend' came and the nurses let him to in to see her, watching the entire time through a camera that was in this one room (that I never knew about until that day). The boyfriend took a pill out of his pocket and gave it to her ... RN stormed in, screamed at him, he denied it etc. But here is the best part ... he wouldn't leave so the cops came and searched him and he was wearing multiple pairs of pants (3-4) over one another. The cops found the drugs and said that the pants thing was a way that they hide them b/c they figure the searches won't work as well ... I think this test proved fail.

At least it's good to know that, as a doctor, there's a chance for some unique entertainment.

 

[JaggerPlate]

At least it's good to know that, as a doctor, there's a chance for some unique entertainment.

Definitely in ER. Go check out some of the threads in the ER forums ... they are unreal.