Fork in the road... Deciding between D.O. and M.D.

[meatie]

Case in point I watched a Fox News (I know, it was already playing on the TV) segment doing one of those sidewalk interviews of passersby with general trivia questions related to Christopher Columbus. Some of the answers to questions were just mindblowing.

What were the names of the ships that Columbus sailed on to get to America?

"The Mayflower... and..."

When did Columbus sail for the "New World"?

"Like.. 19-.. 19... 40's?"

What is Columbus famous for discovering?

"Africa." "No it was Mexico."


It went on and on. There were a couple smarties in the mix, but the majority were... disappointing.

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[meatie]

Well if OPs plans are primary care it's sort of moot point.

I see now that OP says "EM/Neurology". Emergency medicine you should be fine with either. Neuro might be a bit harder, but still okay. If you were thinking about things like plastics/derm/Neurosurg/ortho etc. I would seriously not even bother with DO. You could have a chance at a residency with a DO, but it would be hard.

What is your opinion about my interest in possibly doing academics / faculty administration type positions in the future? Would being an M.D. or D.O. have any bearing on a decision like that? @Goro and @gyngyn I would love your input on this!

 

[Mad Jack]

MD every time unless you will absolutely die not going to that DO school.

 

[jakeislove]

Based upon posts here and elsewhere, it's physically impossible to underestimate the intelligence of the American public.

True.

 

[DoctorSynthesis]

MD every time unless you will absolutely die not going to that DO school.

Mad jack you went to a DO school over MD though

 

[Eppur Si Muove]

In general, everyone should apply to both MD and DO.
And, if you get into an MD school you probably should take it... not because it's inherently better, but because although they're equal medically, there's still a questionable social stigma.
But you shouldn't turn down a DO acceptance and risk being a reapplicant the next year in the hopes of being an MD.

Just curious, why should everyone apply to both MD and DO, in general?

 

[Dr. Retractor]

Just curious, why should everyone apply to both MD and DO, in general?

Not everyone per se but people who are borderline applicants for MD usually have a good-very good shot at getting in to a DO school. Some people (it seems like the majority on SDN but it's really not) are very competitive applicants and have no need to apply DO because they're pretty much (though not entirely) guaranteed an acceptance to an MD school.

 

[Sc1entific]

Not everyone per se but people who are borderline applicants for MD usually have a good-very good shot at getting in to a DO school. Some people (it seems like the majority on SDN but it's really not) are very competitive applicants and have no need to apply DO because they're pretty much (though not entirely) guaranteed an acceptance to an MD school.

No need to apply DO, except perhaps for the appeal of the osteopathic perspective and honest desire to become an osteopathic physician.

 

[gyngyn]

What is your opinion about my interest in possibly doing academics / faculty administration type positions in the future? Would being an M.D. or D.O. have any bearing on a decision like that? @Goro and @gyngyn I would love your input on this!

I have seen DO's in hospital admin positions (at my MD school). I have seen relatively few in the medical school, but they do exist.
It's hard to say if they are represented at parity since I don't know the denominator....

 

[Instatewaiter]

It's a turn of phrase. Just don't make statements without supporting them. Also, people shouldn't instantly assume I totally disagree with them when I didn't even say so. Try to communicate properly.

Yes, MD matches "better" than DO both historically and right now. We don't know how that will change in the future and I'd wager the past isn't w good predictor seeing as there had never beem a merger like this in the past. It will most likely have an effect on the numbers we see for both degrees in terms of residency matching into the next decade, a decade into which most of us will graduating..

The merger is going to change essentially nothing. Realize that MD programs already get DO applications and already have the option to choose DO candidates. This isn't going to magically make ACGME residencies more open to DO candidates. It just means that DO residencies are now open to MDs.

 

[Doctor Bob]

Just curious, why should everyone apply to both MD and DO, in general?

Because med school is med school. And for people who want to be a doctor, being in med school is preferred to not being in med school.

Not everyone per se but people who are borderline applicants for MD usually have a good-very good shot at getting in to a DO school. Some people (it seems like the majority on SDN but it's really not) are very competitive applicants and have no need to apply DO because they're pretty much (though not entirely) guaranteed an acceptance to an MD school.

The failure to matriculate rate is fairly high. And as much as people think that they are limiting their options by going DO instead of MD, their options are even more limited by going MD and not matching.

No need to apply DO, except perhaps for the appeal of the osteopathic perspective and honest desire to become an osteopathic physician.

While those answers sound good at a DO school interview, the best reason to go to a DO school is a desire to be a doctor. The concept of the osteopathic perspective as a distinct and separate approach to the allopathic perspective is bunk.

 

[miszfifi820]

-

 

[miszfifi820]

lolll, don't worry, i completely got the reference, so it wasn't a total miss. sighhh i feel sorry for my generation sometimes..

 

[DoctorSynthesis]

The merger is going to change essentially nothing. Realize that MD programs already get DO applications and already have the option to choose DO candidates. This isn't going to magically make ACGME residencies more open to DO candidates. It just means that DO residencies are now open to MDs.

While that's a possibility its not the more likely one.

@Goro who has a lot of knowledge about this said:

"The upcoming merger should make things easier for DO grads....every DO I know who has ties to the upper echelons of the AOA believes this as well."

So this is what I believe as well

 

[Goro]

Must respectfully disagree...the AOA never would have agreed to the merger if it meant merely accommodating MD grads. It will be a two-way street.

Naturally, how things shake out will take a few years.

The merger is going to change essentially nothing. Realize that MD programs already get DO applications and already have the option to choose DO candidates. This isn't going to magically make ACGME residencies more open to DO candidates. It just means that DO residencies are now open to MDs.

 

[Eppur Si Muove]

Because med school is med school. And for people who want to be a doctor, being in med school is preferred to not being in med school.

Med school is not med school. Some people believe in the osteopathic philosophy and some the allopathic. I see what you are saying, but some of the responses on this thread show you that not everyone should apply to both. If you don't believe in the osteopathic philosophy or believe that one is inferior to the other from an education perspective, then you should not apply to that branch of medicine. If you are simply "settling" or are just applying for a backup plan, then you are taking away someone else's opportunity to go to that school that wants to actually be there. There are other ways into an MD or DO school than the traditional route.

 

[Doctor Bob]

Some people believe in the osteopathic philosophy and some the allopathic.

I would argue the philosophical differences are historical and only come into play during the interview process.
Having done clinical rotations at different hospitals where DO and MD students rotate together, done internship at a hospital with DOs and MDs, gone through residency at one, taught at two, and now doing fellowship at one... there's no clinical difference. No different approach, no "different way of thinking". It's all medicine. I have never seen DO residents approach the workup of a patient any differently than MD residents.

I see what you are saying, but some of the responses on this thread show you that not everyone should apply to both. If you don't believe in the osteopathic philosophy or believe that one is inferior to the other from an education perspective, then you should not apply to that branch of medicine. If you are simply "settling" or are just applying for a backup plan, then you are taking away someone else's opportunity to go to that school that wants to actually be there. There are other ways into an MD or DO school than the traditional route.

Sure... if you don't think you'll get a good education at a school then don't apply there. But if one thinks they would be a sub-par doc simply by going to a DO school then they would be wrong.

 

[Eppur Si Muove]

I would argue the philosophical differences are historical and only come into play during the interview process.
Having done clinical rotations at different hospitals where DO and MD students rotate together, done internship at a hospital with DOs and MDs, gone through residency at one, taught at two, and now doing fellowship at one... there's no clinical difference. No different approach, no "different way of thinking". It's all medicine. I have never seen DO residents approach the workup of a patient any differently than MD residents.

Again, I agree with what you are saying and I respect your experience, but we both know that not everyone feels this way, which is why some people have their opinions. But this fact alone tells you that not everyone should apply to both. All I'm saying is that I respectfully disagree that everyone should apply to both. The pre med stud with a 36MCAT and 4.0 gpa that apply's to a handful of DO schools as a backup when they believe they are superior candidates to their matriculants should not be applying there.

 

[Doctor Bob]

Ok. My opinion is just that... an opinion.

 

[meatie]

Med school is not med school. Some people believe in the osteopathic philosophy and some the allopathic. I see what you are saying, but some of the responses on this thread show you that not everyone should apply to both. If you don't believe in the osteopathic philosophy or believe that one is inferior to the other from an education perspective, then you should not apply to that branch of medicine. If you are simply "settling" or are just applying for a backup plan, then you are taking away someone else's opportunity to go to that school that wants to actually be there. There are other ways into an MD or DO school than the traditional route.

That is a valid point, but is based on an ideal, theoretical distinction between the two. Doctor Bob's point stands because of the reality of medical admissions and the majority of applicant intent.

How many applicants are applying to D.O. schools because they believe purely in the osteopathic philosophy? How many are applying simply because it awards a legitimate medical degree and an avenue to clinical practice? In reality, there really is little difference between most D.O. and M.D. physicians. I believe that that is what Doctor Bob meant when he said medical school is medical school. In the end, the distinction between the two is eroded by the same base intention that both M.D. and D.O. exist to serve -- to train doctors.

 

[DoctorSynthesis]

That is a valid point, but is based on an ideal, theoretical distinction between the two. Doctor Bob's point stands because of the reality of medical admissions and the majority of applicant intent.

How many applicants are applying to D.O. schools because they believe purely in the osteopathic philosophy? How many are applying simply because it awards a legitimate medical degree and an avenue to clinical practice? In reality, there really is little difference between most D.O. and M.D. physicians. I believe that that is what Doctor Bob meant when he said medical school is medical school. In the end, the distinction between the two is eroded by the same base intention that both M.D. and D.O. exist to serve -- to train doctors.

The biggest difference in clinical practice seems to be speciality dependent. Pm&r and primary care as well as doctors who do neuromusclar residencies there seems to be a difference as well as the location of practice.

If you're a nuero surgeon there is no difference.

 

[ems2doc]

What is your opinion about my interest in possibly doing academics / faculty administration type positions in the future? Would being an M.D. or D.O. have any bearing on a decision like that? @Goro and @gyngyn I would love your input on this!

I generally see fewer DO admins, but that's partly since there are fewer DO grads. Don't think that going DO will hurt your chances at academic medicine. You could always work/teach at a DO affiliated facility. I've seen plenty of DOs involved in research. One place I did rotations at the EMS medical control was managed by a DO.

A lot of people seem to neglect geography. Some states/regions have a higher prevalence of DOs than other places. If I wanted to become an EM doc in Michigan (where 15-25% of docs are DO) I could absolutely do either MD or DO. However, if I wanted to do plastic surgery in North Carolina (where <3% of docs are DO), I would need to do MD for sure.

Summary: MD is the better path (for now... things are starting to even out) especially for competitive specialties. However, do not discredit DO too much. It's still top tier education and you're still going to become a doctor. We're all talking about generalizations here. I've met DO neurosurgeons, orthopedic surgeons, dermatologists, and others just as not all MDs go into super competitive specialties.


^Disclaimer: It's 1:47 AM and I've been awake for the past 30 hours or so on 5 cups of coffee. Please excuse any grammatical erors or whatnot that you may encounter.

 

[Doctor Bob]

What is your opinion about my interest in possibly doing academics / faculty administration type positions in the future? Would being an M.D. or D.O. have any bearing on a decision like that?

(I missed this question before)

As a DO, who was faculty at an allopathic residency and worked in academics, I can say it's possible to do it with either.

 

[Instatewaiter]

Must respectfully disagree...the AOA never would have agreed to the merger if it meant merely accommodating MD grads. It will be a two-way street.

Naturally, how things shake out will take a few years.

Hmmm...
Since ACGME residencies are alreay open to DOs and this merger did little to change the divide between MD and DO schools, how is this going to change how residency directors feel about students from various schools?

This isn't going to make residency program directors magically take more DOs. I agree that it will make DO students not have to risk the ACGME match and forgo the AOA match, though.

 

[jakeislove]

Must respectfully disagree...the AOA never would have agreed to the merger if it meant merely accommodating MD grads. It will be a two-way street.

Naturally, how things shake out will take a few years.

Won't a lot of people who would have gone to the Caribbean simply end up in new DO schools?

 

[DermViser]

It's a pretty tried and true one. I agree with it whole heartedly.

As much as pre-meds would love to act like they know what's up, where you go to school is important. Those DOs that have gone throug the match, rarely come back to SDN talking with such confidence as pre-meds do. It is a eye-opening experience. Many residency programs outright say they will not even interview a DO. In 20 years will this improve- yearh. Will it resolve by the time you finish med school- probably not. Quite frankly, unless there are compelling reasons (like needing to be in a given location for family) it doesn't make a lot of professional sense.

THIS. Unless going to another school on the other side of the country and being away from your family for much longer periods of time would greatly affect you emotionally, mentally, and thus your medical school performance (nothing wrong with this as being close to family has a LOT of tangible benefits), where you go to medical school matters esp. if it's a DO vs. MD school, in terms of the match and in certain specialties.

Medical schools admissions do a lot of talking to entice students. They've played the game for years and there are always some premeds who fall for it. The reason the discussion is muddied up on SDN is bc people always get offended and take it a personal flaw or they bring up the lone exception without knowing background facts: http://forums.studentdoctor.net/thr...rogram-with-good-usmle-comlex-step-1.1102639/

 

[DermViser]

Mad jack you went to a DO school over MD though

Which is even a greater reason why you should listen to him. I realize you have a dog in this fight so I understand.

MD every time unless you will absolutely die not going to that DO school.

 

[el_duderino]

I don't see any real reason for this to change over time. There's zero tangible philosophical or practical difference, so the main distinguishing factor will continue to be that most DO students are in such programs because they failed to get into an MD school or the DO school was cheaper or more convenient.

 

[Mad Jack]

Which is even a greater reason why you should listen to him. I realize you have a dog in this fight so I understand.

Pretty much. It was an okay decision for me because I had a lot of reasons to go to med school both in the area and sooner rather than later. If I'd had an MD acceptance in one hand and a DO in the other, I'd have gone MD. But I had a definite acceptance in one hand I would have to discard and wait a year to reapply so that I could *maybe* get into an MD school in the region.

 

[Mad Jack]

Hmmm...
Since ACGME residencies are alreay open to DOs and this merger did little to change the divide between MD and DO schools, how is this going to change how residency directors feel about students from various schools?

This isn't going to make residency program directors magically take more DOs. I agree that it will make DO students not have to risk the ACGME match and forgo the AOA match, though.

The match isn't merging for several years after the accreditation merger.

 

[DermViser]

Pretty much. It was an okay decision for me because I had a lot of reasons to go to med school both in the area and sooner rather than later. If I'd had an MD acceptance in one hand and a DO in the other, I'd have gone MD. But I had a definite acceptance in one hand I would have to discard and wait a year to reapply so that I could *maybe* get into an MD school in the region.

Like almost anything in life, it's always a risk benefit ratio. For many people's purposes it fits quite well with their specific goals. Choosing a medical school doesn't always rely only on the characteristics of the medical school itself. I totally understand that. It is 4 very rigorous years of your life and taking into other factors is very important depending on your goal.

 

[deleted407021]

The biggest difference in clinical practice seems to be speciality dependent. Pm&r and primary care as well as doctors who do neuromusclar residencies there seems to be a difference as well as the location of practice.

If you're a nuero surgeon there is no difference.

I disagree on the grounds that I've actually held and interview with a DO spine surgeon (NS) and he was very much into the osteopathic philosophy. He used OMM regularly, managed patients diets and helped patients to quit smoking (he had data that suggested it caused spine density loss), did surgery only as a last resort and made good use of pm&r docs. He had little pamphlets in his office about "What's a DO", "The DO Difference", etc.

He applied to CCOM because he liked the concept of osteopathc medicine despite knowing he could have gotten into any number of MD schools. As a cool aside, he holds the patent for the first artificial disk developed in the US.

 

[DoctorSynthesis]

I disagree on the grounds that I've actually held and interview with a DO spine surgeon (NS) and he was very much into the osteopathic philosophy. He used OMM regularly, managed patients diets and helped patients to quit smoking (he had data that suggested it caused spine density loss), did surgery only as a last resort and made good use of pm&r docs. He had little pamphlets in his office about "What's a DO", "The DO Difference", etc.

He applied to CCOM because he liked the concept of osteopathc medicine despite knowing he could have gotten into any number of MD schools. As a cool aside, he holds the patent for the first artificial disk developed in the US.

I was speaking generally but ofcourse nothing is absolute.

Which is even a greater reason why you should listen to him. I realize you have a dog in this fight so I understand.

I agree with him for most people though. Just pointing something out.

 

[DermViser]

I was speaking generally but ofcourse nothing is absolute.

You're correct no rule is absolute in any circumstance. As a general rule, probably much easier to bank on the trend, rather than the most minute of exceptions don't you think?

 

[DermViser]

I disagree on the grounds that I've actually held and interview with a DO spine surgeon (NS) and he was very much into the osteopathic philosophy. He used OMM regularly, managed patients diets and helped patients to quit smoking (he had data that suggested it caused spine density loss), did surgery only as a last resort and made good use of pm&r docs. He had little pamphlets in his office about "What's a DO", "The DO Difference", etc.

He applied to CCOM because he liked the concept of osteopathc medicine despite knowing he could have gotten into any number of MD schools. As a cool aside, he holds the patent for the first artificial disk developed in the US.

Your example is VERY MUCH the exception. It is not the rule. These people have other things in their history that show they are very much to the head of the bell curve. Most medical students or premeds don't have the ability to come up with patent for something the first of its kind.

 

[Mad Jack]

That is a valid point, but is based on an ideal, theoretical distinction between the two. Doctor Bob's point stands because of the reality of medical admissions and the majority of applicant intent.

How many applicants are applying to D.O. schools because they believe purely in the osteopathic philosophy? How many are applying simply because it awards a legitimate medical degree and an avenue to clinical practice? In reality, there really is little difference between most D.O. and M.D. physicians. I believe that that is what Doctor Bob meant when he said medical school is medical school. In the end, the distinction between the two is eroded by the same base intention that both M.D. and D.O. exist to serve -- to train doctors.

The philosophical difference certainly comes into play, at least at my school. They do a very good job of selecting people who are down with the school's mission of preventative care, which is pretty core to osteopathic principles. It is less about the how of medical practice and more about the why, hence our class tends to lean mostly toward PCP/psych/general IM/PM&R/rural care.

 

[DoctorSynthesis]

You're correct no rule is absolute in any circumstance. As a general rule, probably much easier to bank on the trend, rather than the most minute of exceptions don't you think?

Ofcourse.

 

[Goro]

I doubt it. There appears to be two demographics of people who go to the Caribbean. One is a group that wouldn't make it into (or through) ANY medical school in the US. The other is a group that refuses to accept that being a DO means being a doctor. To them, it';s MD or nothing. I see little evidence that these people are going to Carib diploma mills because it's harder for DOs to get into competitive MD residencies.

Won't a lot of people who would have gone to the Caribbean simply end up in new DO schools?

 

[DermViser]

The upcoming merger should make things easier for DO grads....every DO I know who has ties to the upper echelons of the AOA believes this as well.

Do you truly think this will be the case?

 

[deleted407021]

Your example is VERY MUCH the exception. It is not the rule. These people have other things in their history that show they are very much to the head of the bell curve. Most medical students or premeds don't have the ability to come up with patent for something the first of its kind.

Obviously...I'm just citing an example of that exact exception in response to DocSynth's post.

 

[Goro]

Time will tell, although being from NY, I'm also a believer in the Law of Unintended Consequences. Hey, what happened to your old avatar?

Do you truly think this will be the case?

 

[Baron Samedi]

LOL @ "osteopathic perspective."

The ONLY people who say that are pre-meds and maybe a few self-righteous faculty. There is NO difference between the two.

The only differences between an MD school and a DO school are difficulties in the match and about 6 points on the MCAT.

 

[DermViser]

Time will tell, although being from NY, I'm also a believer in the Law of Unintended Consequences. Hey, what happened to your old avatar?

LOL! For some reason I absolutely LOVED the picture on the front SDN page (I forget which article it's with). Reminded me of medical students and their reams of different highlighters in studying.

 

[jakeislove]

I doubt it. There appears to be two demographics of people who go to the Caribbean. One is a group that wouldn't make it into (or through) ANY medical school in the US. The other is a group that refuses to accept that being a DO means being a doctor. To them, it';s MD or nothing. I see little evidence that these people are going to Carib diploma mills because it's harder for DOs to get into competitive MD residencies.

DO is looked down upon by certain parents, LOL! That being said, I still think newer DO schools may become attractive to non-traditionals and those seeking second careers.

I'm a little cynical and have a difficult time believing much will improve in the MD vs DO discussion. There will probably just be more stiff competition for MD admission once graduates exceed residency positions.

 

[DoctorSynthesis]

LOL! For some reason I absolutely LOVED the picture on the front SDN page (I forget which article it's with). Reminded me of medical students and their reams of different highlighters in studying.

I like your new avatar. Its appropriate but so was the old one.

LOL @ "osteopathic perspective."

The ONLY people who say that are pre-meds and maybe a few self-righteous faculty. There is NO difference between the two.

The only differences between an MD school and a DO school are difficulties in the match and about 6 points on the MCAT.

LOL @ "osteopathic perspective."

The ONLY people who say that are pre-meds and maybe a few self-righteous faculty. There is NO difference between the two.

The only differences between an MD school and a DO school are difficulties in the match and about 6 points on the MCAT.

4 points (average DO is 27 MD is 31) and with some schools its even less. Tons are in the 28-30 range which is 1-3 points difference.

 

[DoctorSynthesis]

DO is looked down upon by certain parents, LOL! That being said, I still think newer DO schools may become attractive to non-traditionals and those seeking second careers.

I'm a little cynical and have a difficult time believing much will improve in the MD vs DO discussion. There will probably just be more stiff competition for MD admission once graduates exceed residency positions.

No one knows for sure its all guesses but the most qualified person to do so is @Goro so im not sure why you guys are arguing with goro.

 

[DermViser]

I like your new avatar. Its appropriate but so was the old one.

It reminds me of those students who are hardcore studying with syllabus/course pack/powerpoints, with a huge table, with frumpy clothes (sweats, etc.) on, with index cards, highlighters of every color, white dry-erase board, dry-erase markers, etc. Their notes look like a rainbow farted on it.

 

[jakeislove]

No one knows for sure its all guesses but the most qualified person to do so is @Goro so im not sure why you guys are arguing with goro.

Goro is perfectly qualified. I'm just of a mind that Goro may be a little naive at how the customer base might change once the Caribbean is no longer a pathway for residency. Another thing no one's really asking is: With the number of schools opening every year, will there really be any difference in quality between someone from a new DO school and a well-established school like SGU?

 

[DoctorSynthesis]

Goro is perfectly qualified. I'm just of a mind that Goro may be a little naive at how the customer base might change once the Caribbean is no longer a pathway for residency. Another thing no one's really asking is: With the number of schools opening every year, will there really be any difference in quality between someone from a new DO school and a well-established school like SGU?

Some new schools have been pretty awesome actually. MUCOM for example. Others (like liberty) haven't been so hot. Those new schools won't affect the quality of the more established ones though.


Again goro isn't naive. He knows what he is doing. He has connections and knowledge about these things so what he says shouldn't be taken lightly.

 

[HoboCommander]

I would pick school based on location. Allopathic neurology programs have a ton of DO residents. You would just apply for the allopathic match. No point in applying AOA neurology with its mere 9 programs in bad locations. This is not a disadvantage, however.