Emergency Medicine in Florida – Caribbean (MD) or DO?

[thomasfx10]

This is not a post of which is a better doctor MD or DO (I am not opening that can of worms). I am looking for advice on practicing in EM in Florida.

I am one of those people who try to plan way in advance, and always has backup plan. However, I am having some doubt between Plan B & C. The plans that I have are:

Plan A: US MD school
Plan B: DO School
Plan C: Caribbean (SGU, ROSS, AUC)
Plan D: PA School
Plan E: Move to Australian Outback and live among the Aborigines.

I was originally looking at the DO route for Plan B, but I having second thoughts. I found out the EM is four years for an AOA residency. The only way around it is to take the USMLE Steps to get a MD residency. In addition, in states PA, MI, and FL require the "DO internship" for ALL residencies. From what I understand, you can get Resolution 42 approval from the AOA for your 1st year in an ACGME residency in most circumstances, allowing you to skip the AOA internship requirements. Not sure how hard this is to get.

It seems like a lot of hoops to jump through, including taking both the Comlex and USMLE.

In addition, I have been shadowing at DO for a while and I am not sure about Osteopathic Manipulative Medicine (OMM). The doctor I shadow who has been in practice for 37 years says he hardly uses it. Depending on the DO medical school, you have to take a few semester of this training.

So here is the question … looking only at the Big Three MD medical schools in the Caribbean (SGU, Ross, AUC) and the DO route, which would appear to be the better route for practicing EM in Florida without doing a four year residency, which I read somewhere as the 250K mistake.

About myself, I am in my forties (look and feel much younger), and I have 3.5 CGPA, 3.7 SGPA. I am taking the MCAT in May.

Thanks!

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[ChE04]

No, Carib MD schools would not be better for matching into anything, EM is no exception. You will have a much better chance at an MD residency with a DO than with a carib MD (though it can certainly be done).

I know a bunch of EM residents, several of them DO's. They are all in MD residencies. One of those DO's is in FL, and she did not do a DO internship. Incidentally, there are MD programs for EM that are 4 year residencies, usually the more academic ones.

For further clarification you might want to run this by the EM or General Residency forums.

 

[andrewsmack05]

If plan A or B doesnt work out, I would seriously consider plan E. How could you go wrong with that, go out play a didgeridoo and fight off crocodiles all day.

 

[MLT2MT2DO]

Personally, the only two plans I would think about switching would be Plan "C" and Plan "D".

You should research into Resolution 42, as it is basically a "work around" for DOs doing an ACGME residency and pertains to all the states (excluding PA) that require a DO intern year. I'd go NSU or LECOM-Bradenton and not look back. The hoops you'll have to jump through going the DO route pale in comparison to the hoops you'll have to jump through going the carib route.

Regardless with a solid MCAT score you probably won't have to budge from Plan A.

 

[0919mmk]

Sorry, I'm totally being a broken record here, but I agree with the "switch 3&4" opinion expressed above. Read these:

http://6medschool.blogspot.com/
http://4medschool.blogspot.com/

Apologies to those who saw me most these like a day ago on another thread, but the lessons in these blogs are invaluable, and anybody considering carrib needs to read them.

 

[Law2Doc]

This is not a post of which is a better doctor MD or DO (I am not opening that can of worms). I am looking for advice on practicing in EM in Florida.

I am one of those people who try to plan way in advance, and always has backup plan. However, I am having some doubt between Plan B & C. The plans that I have are:

Plan A: US MD school
Plan B: DO School
Plan C: Caribbean (SGU, ROSS, AUC)
Plan D: PA School
Plan E: Move to Australian Outback and live among the Aborigines.

I was originally looking at the DO route for Plan B, but I having second thoughts. I found out the EM is four years for an AOA residency. The only way around it is to take the USMLE Steps to get a MD residency. In addition, in states PA, MI, and FL require the "DO internship" for ALL residencies. From what I understand, you can get Resolution 42 approval from the AOA for your 1st year in an ACGME residency in most circumstances, allowing you to skip the AOA internship requirements. Not sure how hard this is to get.

It seems like a lot of hoops to jump through, including taking both the Comlex and USMLE.

In addition, I have been shadowing at DO for a while and I am not sure about Osteopathic Manipulative Medicine (OMM). The doctor I shadow who has been in practice for 37 years says he hardly uses it. Depending on the DO medical school, you have to take a few semester of this training.

So here is the question … looking only at the Big Three MD medical schools in the Caribbean (SGU, Ross, AUC) and the DO route, which would appear to be the better route for practicing EM in Florida without doing a four year residency, which I read somewhere as the 250K mistake.

About myself, I am in my forties (look and feel much younger), and I have 3.5 CGPA, 3.7 SGPA. I am taking the MCAT in May.

Thanks!

First, I think you have to realize that a 4 year path from DO is better than no path from caribbean. The attrition rate of offshore schools is huge, and fewer than half of the people who start med school in the caribbean actually find their way into US residencies in 4 years. And the number of places that will entertain offshore grads for EM is certainly smaller than those that will consider DO grads; I think it's safe to assume that EM slots will be tighter as the ranks of US MD schools continue to grow, and as EM becomes seen as more lifestyle friendly. But also bear in mind that a handful of the EM programs most friendly to caribbean grads now "require" a prelim year before their "3 year" residencies (and no, these aren't academic places). This gives them a year of quality control and might be a model for more programs (that take offshore grads) in the future. So you may find that through either of these routes, your residency is going to be 4 years.

I think you have to not focus so much on a single year of training though and look at the big picture. During residency you are not in school -- you are working in your chosen profession. You are receiving a paycheck. It's really no different than being entry level at any job -- you have bosses and work long hours and act professionally, and try to learn the tricks that will make your life easier and get you out the door on time. And you may find 3 years only scratches the surface at what you need to know anyhow, and may still be reading like a maniac for another few years after that. Maybe even toy with a fellowship. It's really only the size of the paycheck that changes over time. So if you keep things in perspective, whether it's 3 years or 4 isn't going to change your life a whole lot. You will still be doing what you are interested in, learning what you are interested in, and spending a whole lot of time in the hospital/books for the first handful of years of your professional career. So take the path that gets you there, regardless of whether we are talking 3 years or 4. Heck, some of the specialty surgery types are going to have a decade of residency/research/fellowship before they reach their ultimate job title. And I guarantee even they aren't going to feel it was enough training to feel comfortable doing a lot of what they will be expected to do/know.

I also would note that time flies by when you are doing things that interest/challenge you. And when you are working a mix of days/nights, the weeks seem to fly by faster. Before you can blink an eye, a couple of years of residency will be gone, and you will start to realize that you are running out of time to learn what you need before you will be expected to work without a net.