Does becoming a DO really limit your decisions for specialty?

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Scrambles

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SDNers,

Got a whole lot of good advice on my last thread and I'm hoping this one goes over just as well. I've seen and been interested in General Surgery for years. Lately, I've been beginning to think of more primary care roles (IM and FM with particular focus). I've seen a lot of different threads on here about DO bias and how it limits your options, but I've also seen a lot of contradictory information. Since the Merger took place earlier this year wouldn't that bias dissipate a bit? To be clear my question is: Does going DO limit yourself and disable you from going into specialties such as pulmonology, nephrology, general surgery, and ENT. These new three mentioned are ones I've considered for different reasons but am still unsure. I've seen older posts about some of these but nothing really recent (after the merger), but if I'm at fault please let me know (providing a link would be helpful) and I'll gladly remove this post.

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SDNers,

Got a whole lot of good advice on my last thread and I'm hoping this one goes over just as well. I've seen and been interested in General Surgery for years. Lately, I've been beginning to think of more primary care roles (IM and FM with particular focus). I've seen a lot of different threads on here about DO bias and how it limits your options, but I've also seen a lot of contradictory information. Since the Merger took place earlier this year wouldn't that bias dissipate a bit? To be clear my question is: Does going DO limit yourself and disable you from going into specialties such as pulmonology, nephrology, general surgery, and ENT. These new three mentioned are ones I've considered for different reasons but am still unsure. I've seen older posts about some of these but nothing really recent (after the merger), but if I'm at fault please let me know (providing a link would be helpful) and I'll gladly remove this post.

Go look at a DO match list and judge for yourself.

But be aware that its the mission of DOs to do primary care. While some do other specialties that isn't the objective of DO schools.
 
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The merger has been agreed upon but the single match won't happen for a couple of years (2017-18, my guess). It'll be fully in place by 2020.
 
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ENT is tough. Very low to nonexistent chances of matching on the historically ACGME programs.

Nephro is a dead field, don't do it.

Pulm is a definite posibility.

General surgery is doable, but your upper limit is going to likely be mid-tier programs. A superstar might land something better every now and again, but don't ever plan on being a superstar.
 
Overall sure it makes it a little harder. Some programs just dont bring in DOs, but from what I hear this is mostly from top tier university/research hospitals.

However, does it specifically disable you from being able to getting into them? Absolutely not. A lot of your residency application will come down to how hard you are willing to work (board scores) and then the connections you can make outside of the school, for research.

For those specialties, pulm and neph are fellowships after IM so I imagine they will be just about equal to MD in competitiveness. General surgery is definitely opening up for DOs. ENT is pretty freaking hard to get in to no matter if you are an MD or DO, thats a really competitive field to try and go in to. With naturally the MDs having a slight boost simply because it is their (ACGME) programs that you would be applying to for the most part, though there are AOA ENT programs as well, just not nearly as many.

No one knows what the merger will do, you will likely be going to residency riggggght when the merger is finally enacted and put into place. It is going to take a few years to get this whole thing in place.
 
This is a common question. Does it limit you as in you can't get there? Absolutely not.

Might you have to work harder to get exactly what you want, exactly where you want it, than someone with an MD? Maybe. Maybe not.

I know two DO trained ENT surgeons, at least one DO trained optho, and several DO trained anesthesia providers, off the top of my head. I'm sure that there are more, but my high-tier research / teaching facility doesn't really make a big deal out of MD vs DO, so I only know people's degree if I went out of my way to find it out because I was considering asking them for letters.

If you want it, and you want to put in the work to get it, you can specialize in anything you want as a DO. If you don't want to put in the work, well, having an MD wouldn't save you.
 
Recent discussions on being a DO and matching ACMGE (osteopathic student forum)
http://forums.studentdoctor.net/threads/matching-acgme-em.1099800/
http://forums.studentdoctor.net/threads/applying-to-competitive-acgme-im-programs.1097212/
http://forums.studentdoctor.net/threads/obstacles-as-an-osteopathic-student.1096058/
http://forums.studentdoctor.net/threads/interview-offers-to-acgme-programs.1099328/

2014 NRMP Survey Data on Program Directors
http://forums.studentdoctor.net/threads/2014-nrmp-pd-survey-results.1096743/

I guess my opinion on the matter is that there are difficulties, but definitely not impossible. A lot of the reasons I have read that DOs don't match into the more competitive programs are as follows 1) Not doing research or enough of it (in part due to not having much access to research through the school) 2) Not getting letters or recommendations from people in high places (meaning not getting letters from department chairs in ACGME programs) 3) opting out of competitive places due to the feeling of not being good enough. What I am stating here are within the power of the student and of course there are other factors that are out of the power of the student (some programs don't interview or rank DO students at all). Again this is what I have observed and it is better to hear it from a medical student who has matched or a resident.
 
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I have some DO friends that matched ENT/Plastics, as well as Derm. Pretty much every field is currently accessible except for OMFS. The merger actually makes it harder to enter competitive fields like Plastics, Neurosurgery, Ortho, etc. because you would have to compete with the MD folks.

In the long run, DOs would cease to exist due to the merger taking away all our residencies, except for a small handful of OMM specialists. But in the meantime our situation is real good.
 
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Courtesy of cliquesh:

It's realistic, as a DO, to match at:

A top tier pyschiatry, family medicine, anesthesia, PM&R or pathology program.

A mid-tier internal medicine, neurology, pediatric, Ob/gyn or emergency medicine program

A mid to low tier general surgery or radiology program.

It's also realistic to match AOA orthopedics and general surgery, as well as emergency medicine, family medicine, pediatrics, internal medicine, psych and Ob/gyn.

It's unrealistic to match Acgme orthopedics, neurosurgery, urology, ENT, derm, radiation oncology and plastic surgery. Ophthamology may or may not be unrealistic (not enough data to determine).

It's unrealistic to match aoa surgical subspecialities, except for aoa general surgery and orthopedics, because there are so few spots ( 14 neurosurgery, 24 ENT, 17 urology, and 15 opthamology). This is in contrast to the 135 general surgery spots and 100 orthopedic spots offered last year.

Similar there are few AOA anesthesia, radiology, and derm spots (about 30 for each speciality). However, acgme anesthesia is very DO friendly and acgme radiology is pretty DO friendly. AOA derm is weird because you don't apply as a 4th year, you apply as an intern, so I don't know how realistic aoa derm is.
 
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ENT is tough. Very low to nonexistent chances of matching on the historically ACGME programs.

Nephro is a dead field, don't do it.

Pulm is a definite posibility.

General surgery is doable, but your upper limit is going to likely be mid-tier programs. A superstar might land something better every now and again, but don't ever plan on being a superstar.
Why is that?
 
Why is that?
Go to the nephro subforum and check it out. Basically you make less money in nephro than you do as a FP because reimbursements have been cut so much and the dialysis companies basically own the entire market. It's cool science, but you spend 3 extra years learning something that 1: can't land you a job, and 2: makes you take a pay cut.
 
Go to the nephro subforum and check it out. Basically you make less money in nephro than you do as a FP because reimbursements have been cut so much and the dialysis companies basically own the entire market. It's cool science, but you spend 3 extra years learning something that 1: can't land you a job, and 2: makes you take a pay cut.
Hmm... I had no idea that was the way that specialty had gone. That's unfortunate cause it is a very cool field
 
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Yes it does but that is life. You have to make the best of it and work hard
 
I think as a DO you would have a very difficult time, if not impossible time, landing an ENT residency.

My brother was in the top 10% of his class with a 26x USMLE and got his ninth, and last choice, for residency.....and he's an MD.
 
In before a bunch of premeds jump in saying that you can specialize in anything and all it takes is some hard work!

Oh wait, too late.
 
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No. You might have to work a little harder.

SDNers,

Got a whole lot of good advice on my last thread and I'm hoping this one goes over just as well. I've seen and been interested in General Surgery for years. Lately, I've been beginning to think of more primary care roles (IM and FM with particular focus). I've seen a lot of different threads on here about DO bias and how it limits your options, but I've also seen a lot of contradictory information. Since the Merger took place earlier this year wouldn't that bias dissipate a bit? To be clear my question is: Does going DO limit yourself and disable you from going into specialties such as pulmonology, nephrology, general surgery, and ENT. These new three mentioned are ones I've considered for different reasons but am still unsure. I've seen older posts about some of these but nothing really recent (after the merger), but if I'm at fault please let me know (providing a link would be helpful) and I'll gladly remove this post.
 
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I have some DO friends that matched ENT/Plastics, as well as Derm. Pretty much every field is currently accessible except for OMFS. The merger actually makes it harder to enter competitive fields like Plastics, Neurosurgery, Ortho, etc. because you would have to compete with the MD folks.

In the long run, DOs would cease to exist due to the merger taking away all our residencies, except for a small handful of OMM specialists. But in the meantime our situation is real good.
You can apply to OMFS residencies after Dental school.
 
If you think you'd ever want an IM subspecialty or surgical subspecialty (except maybe ortho), and can get in US MD, go there. Not all IM subspecialties are competitive, but some are. If US MD is not an option, then DO is the way to go. Sure some things are harder as a DO (see pattr's quote from cliquesh), but most are still possible and its a great option.
 
There is almost 100 DO ortho spots, almost as much as general surgery! That means 3-4 students from every class can get into ortho, and some schools there's no interest in ortho at all.
 
There is almost 100 DO ortho spots, almost as much as general surgery! That means 3-4 students from every class can get into ortho, and some schools there's no interest in ortho at all.
Exactly... some schools wouldnt even have the opportunities (rotation wise) to even get people into Ortho anyways...

Some schools are pumping out 5-10 a year.
 
If you want to do orthosurgery or neurosurgery, it's easier through the DO route. Instead of competing against A+ applicants, you compete against A- applicants.

An additional advantage is if you specialize in spine surgery, with OMM you can offer a comprehensive solution to back pain with OMM, pain pumps, and surgery all at one place. You'll find spine anatomy very easy since you learn about it in OMM. You can locate T5 or the PSIS super easy and start marking and cutting, while even your chief resident will have trouble locating.

That said, with the merger coming, some osteopathic residencies will be closing so now might not be the best time to enter the profession.
 
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The ironic thing is, for the less competitive fields that DOs are actually interested in, like pediatrics or neurology, the allopathic route is way better. While highly competitive surgical subspecialties are easier to get into osteopathically. Reality is opposite of stereotypes sometimes. You don't know this kind of stuff until you find out for yourself as a 4th year med student.
 
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The ironic thing is, for the less competitive fields that DOs are actually interested in, like pediatrics or neurology, the allopathic route is way better. While highly competitive surgical subspecialties are easier to get into osteopathically. Reality is opposite of stereotypes sometimes. You don't know this kind of stuff until you find out for yourself as a 4th year med student.
I'm not sure I'm following either.
Do you mean, coming out of an osteo school, going to an allopathic residency is way better when applying for less competitive fields? I get that neuro/ortho-surgery osteo residencies are currently marginally easier to get into than allopathic ones. For residency programs such as neuro and peds, there seem to always be plenty of allo spots that go to DOs and IMGs, and definitely way more ACGME across the country than AOA ones.
 
I'm not sure I'm following either.
Do you mean, coming out of an osteo school, going to an allopathic residency is way better when applying for less competitive fields? I get that neuro/ortho-surgery osteo residencies are currently marginally easier to get into than allopathic ones. For residency programs such as neuro and peds, there seem to always be plenty of allo spots that go to DOs and IMGs, and definitely way more ACGME across the country than AOA ones.

I meant if you were a DO student applying to AOA ortho, ENT, or neurosurgery, it's easier to get spots as compared to an MD applying ACGME for the same specialties. Meanwhile if you are a DO student wanting pediatrics in california, your only options are ACGME as AOA options are scarce. My point is, relatively speaking, going DO is better for the more competitive specialties and the disadvantage of DO comes in for the less competitive specialties. The common thinking is that going DO is better for primary care while going MD is better for the competitive specialties. But looking at the distribution of AOA residences, it's not the case.
 
I meant if you were a DO student applying to AOA ortho, ENT, or neurosurgery, it's easier to get spots as compared to an MD applying ACGME for the same specialties. Meanwhile if you are a DO student wanting pediatrics in california, your only options are ACGME as AOA options are scarce. My point is, relatively speaking, going DO is better for the more competitive specialties and the disadvantage of DO comes in for the less competitive specialties. The common thinking is that going DO is better for primary care while going MD is better for the competitive specialties. But looking at the distribution of AOA residences, it's not the case.

What?? I've never heard one person ever present this argument.

There's something like 12 NS positions and 20 ENT positions. That is incredibly scarce and the match rate for all AOA surgical sub-specialties is lower than the equivalent ACGME match rate. Let's not even begin to talk about the location of these programs...

Many of those programs demand rotations and only take 1-2 residents. That is a serious crapshoot. I'm not in any way saying it's easy to match as an MD, but the sheer numbers for DO make it incredibly difficult.
 
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What?? I've never heard one person ever present this argument.

There's something like 12 NS positions and 20 ENT positions. That is incredibly scarce and the match rate for all AOA surgical sub-specialties is lower than the equivalent ACGME match rate. Let's not even begin to talk about the location of these programs...

Many of those programs demand rotations and only take 1-2 residents. That is a serious crapshoot. I'm not in any way saying it's easy to match as an MD, but the sheer numbers for DO make it incredibly difficult.

This is absolutely right. Maybe you can make the case that ortho might be "easier" because of the sheer number of spots on the AOA side vs. DO interest, but that is not the case in the other surgical subspecialties.
 
What?? I've never heard one person ever present this argument.

There's something like 12 NS positions and 20 ENT positions. That is incredibly scarce and the match rate for all AOA surgical sub-specialties is lower than the equivalent ACGME match rate. Let's not even begin to talk about the location of these programs...

Many of those programs demand rotations and only take 1-2 residents. That is a serious crapshoot. I'm not in any way saying it's easy to match as an MD, but the sheer numbers for DO make it incredibly difficult.

there's not nearly as much competition for those few spots compared to the MD side. MD applicants are a tier above in terms of grades, board scores, research, and overall medical knowledge. you ask a DO applicant to draw out a rostral midbrain section, they can't even do it. whereas MD applicant has already published 12 cutting edge research papers in the field. this is actual research, not just looking at some medical records. i'm glad i'm a DO and don't have to compete against these monsters.
 
I meant if you were a DO student applying to AOA ortho, ENT, or neurosurgery, it's easier to get spots as compared to an MD applying ACGME for the same specialties. Meanwhile if you are a DO student wanting pediatrics in california, your only options are ACGME as AOA options are scarce. My point is, relatively speaking, going DO is better for the more competitive specialties and the disadvantage of DO comes in for the less competitive specialties. The common thinking is that going DO is better for primary care while going MD is better for the competitive specialties. But looking at the distribution of AOA residences, it's not the case.
Ok, I see what you're saying.
Ultimately, I think there is only so much stuff that is in the control of the individual. Most students (MD or DO) that perform fairly well, and make the appropriate connections should be fine so long as they remain realistic and flexible. If you were meant to be a neurosurgeon or orthopedic surgeon, I have a feeling going to a DO school won't keep you from becoming one.
 
What?? I've never heard one person ever present this argument.

There's something like 12 NS positions and 20 ENT positions. That is incredibly scarce and the match rate for all AOA surgical sub-specialties is lower than the equivalent ACGME match rate. Let's not even begin to talk about the location of these programs...

Many of those programs demand rotations and only take 1-2 residents. That is a serious crapshoot. I'm not in any way saying it's easy to match as an MD, but the sheer numbers for DO make it incredibly difficult.


I have heard the argument before. Its tough to say though as it is tough to compare DO applicants to MD applicants. There might be some truth to it though. This could also help explain the discrepancies in matching. Besides the fact that DOs mission is primary care
 
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there's not nearly as much competition for those few spots compared to the MD side. MD applicants are a tier above in terms of grades, board scores, research, and overall medical knowledge. you ask a DO applicant to draw out a rostral midbrain section, they can't even do it. whereas MD applicant has already published 12 cutting edge research papers in the field. this is actual research, not just looking at some medical records. i'm glad i'm a DO and don't have to compete against these monsters.
This stimulated my area postrema. I need a new laptop now, thanks.
 
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