HOD resolution on osteopathic student discrimination

[user3]

http://www.osteopathic.org/inside-aoa/events/annual-business-meeting/Documents/2015 Annual Business Meeting/2015 HOD Resolutions/H204-Prevention of Osteopathic Student Discrimination ACGME-OPSC.pdf

This is posted on http://www.osteopathic.org/inside-a...-meeting/house-resolutions/Pages/default.aspx .

"RESOLVED, that the American Osteopathic Association (AOA) request the Accreditation Council of Graduate Medical Education (ACGME) develop accreditation requirements that assure Commission of Osteopathic Colleges of Accreditation (COCA) accredited osteopathic medical students have the same access, protocols, and requirements to training opportunity for audition or elective rotations as a Liaison Council of Medical Education (LCME) allopathic medical student; and, be it further

RESOLVED, that the ACGME develop accreditation requirements to assure COCA accredited osteopathic medical students have equal consideration and opportunity as an LCME medical student for residency match participation and acceptance into an ACGME residency. "

I found this interesting-- has any resolution similar to this been presented in the past?

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[AlteredScale]

This is a great step forward.

Is this just a proposal?

 

[GUH]

It would have been better to present this before we gave up what little leverage we had by giving away all our residencies but better late than never!
And no, I am not familiar with any passed resolutions with the same meaning.

 

[sylvanthus]

This is a great step forward.

Is this just a proposal?

It is just a resolution, doesn't mean squat right now.

 

[sylvanthus]

Also, it hasnt even been passed as a resolution yet, so means even less.

 

[AlbinoHawk DO]

It would have been better to present this before we gave up what little leverage we had by giving away all our residencies but better late than never!
And no, I am not familiar with any passed resolutions with the same meaning.

We still own over 20% of GME vote, so plenty of "little leverage."

 

[deleted480308]

We still own over 20% of GME vote, so plenty of "little leverage."

Twenty percent is less than half what it takes to matter

 

[iwillnevergiveup]

Twenty percent is less than half what it takes to matter

Taking the proportion of MD vs DO physicians into account, I'd say that's pretty good representation within the ACGME.

 

[Darthberghen]

Meanwhile, as a matter of principles, DOs could try not to send business to graduates of programs that publicly discriminate against them. That is, if there is a choice between board-certified specialist #1 from a program that officially discriminates against DOs, and board-certified specialist #2 from a program that does not have such an official policy, the DOs should send referrals and consults to specialist #2.

 

[Mad Jack]

Meanwhile, as a matter of principles, DOs could try not to send business to graduates of programs that publicly discriminate against them. That is, if there is a choice between board-certified specialist #1 from a program that officially discriminates against DOs, and board-certified specialist #2 from a program that does not have such an official policy, the DOs should send referrals and consults to specialist #2.

You should pick the best person to care for your patients. Letting politics get in the way of that is how we ended up with MDs that literally wouldn't take referrals from DOs at all in the 60s and 70s. I heard a story of one woman who was diagnosed with breast cancer back in the day, but the only oncology group in the state at the time refused to take her because the physician that made the diagnosis was a DO. Her treatment was delayed substantially because of her choice in provider, all because people were picking and choosing their referrals like dinguses.

 

[JustPlainBill]

And now we look at the overt discrimination that's occurring in Ft. Worth -- in an overnight miracle, rotation spots have been found at local Ft. Worth hospitals for third year MD students in the new proposed TCU/UNT joint venture which will "be open" to third year D.O. students from TCOM -- GeeWhiz, Ringo Rangers, where were these spots BEFORE the MD school was proposed? When Ransom was the Prez, same thing -- no spots until the MD school and all of a sudden, why, we can accommodate medical students and oh, yes, we'll "reserve" some spots for D.O. students ---

 

[Darthberghen]

You should pick the best person to care for your patients. Letting politics get in the way of that is how we ended up with MDs that literally wouldn't take referrals from DOs at all in the 60s and 70s. I heard a story of one woman who was diagnosed with breast cancer back in the day, but the only oncology group in the state at the time refused to take her because the physician that made the diagnosis was a DO. Her treatment was delayed substantially because of her choice in provider, all because people were picking and choosing their referrals like dinguses.

Who was going to let her die?

I said if there is a choice. Usually there are multiple choices. A board-certified specialist is a board-certified specialist. There are no secret textbooks or protocols in surgery or medicine.

 

[RuralMedicine]

Meanwhile, as a matter of principles, DOs could try not to send business to graduates of programs that publicly discriminate against them. That is, if there is a choice between board-certified specialist #1 from a program that officially discriminates against DOs, and board-certified specialist #2 from a program that does not have such an official policy, the DOs should send referrals and consults to specialist #2.

This is a really bad approach! Referrals should be made to the most appropriate physician (with some compromising based on patient preference and/or insurance networks--which sometimes drives patient preference due to cost). To do anything else is at best putting your ego above your patients' needs and may actually constitute gross negligence for inappropriate referrals (yes, we've seen some malpractice cases brought on these grounds in recent years).

Additionally, I think "DO Discrimination" can be pretty nebulous at times. I got interviews at programs that SDN touts as "DO Discriminators". I even matched at one of those programs and I like to think I turned out ok. But I suppose that you wouldn't send patients to me just because of where I trained. Ok...

Who was going to let her die?

I said if there is a choice. Usually there are multiple choices. A board-certified specialist is a board-certified specialist. There are no secret textbooks or protocols in surgery or medicine.

I disagree with this. I can think of several board certified specialists in our community that I would never voluntarily allow to treat family members. I don't usually refer patients to them either unless the patient requests them specifically or they are the only in network provider and the patient is unwilling to go out of network. One of the physicians in question did train in a low volume/ poor quality program and I think that probably had some impact on what they took away from residency and where they are now. In another case I think it is really less of a fund of knowledge or clinical competency and more just personality issues that are significant enough to impair function.

 

[AlbinoHawk DO]

Twenty percent is less than half what it takes to matter

You're assuming the other 80% will always vote together. In any split decision, the minority has great influence of where things move.

 

[deleted480308]

You're assuming the other 80% will always vote together. In any split decision, the minority has great influence of where things move.

Side A 20% with a history of completely excluding side B
Side B 80% with a history of usually allowing side A

Side A wants a resolution to require equal access for side A...it's ridiculous. I wouldn't even vote for that one sided resolution. Propose one guaranteeing all students from either side have equal access across the board and we can talk about something that might make sense

 

[AlbinoHawk DO]

Side A 20% with a history of completely excluding side B
Side B 80% with a history of usually allowing side A

Side A wants a resolution to require equal access for side A...it's ridiculous. I wouldn't even vote for that one sided resolution. Propose one guaranteeing all students from either side have equal access across the board and we can talk about something that might make sense

The other side can propose that to be the case. You can't have the 80% always railroading the 20%. Honestly, this kind of stuff makes me think the end of "DO" is in a countdown. It's only a matter of time until they force COCA to meet LCME standards and infuse money into the Osteopathic schools. Together they are stronger against the IMG invasion that's ruining training sites in NY and other states.

 

[GUH]

Side A 20% with a history of completely excluding side B
Side B 80% with a history of usually allowing side A

Side A wants a resolution to require equal access for side A...it's ridiculous. I wouldn't even vote for that one sided resolution. Propose one guaranteeing all students from either side have equal access across the board and we can talk about something that might make sense

If by "Side A" you are referring to DO's, then you may wish to reconsider your statement in light of the fact that all DO residencies have agreed to take applications from MD's and have a very concrete deadline by which they must comply.

The other side, on the other hand, has made no such guarantee. So if you want "equal access across the board", it is time for Side B to step up.

Not to mention that the AOA HoD consists entirely of DOs, so of course they are likely to vote for resolutions which advocate for DOs.

 

[SurgeDO]

there is nothing wrong with residencies taking into consideration the school each applicant is applying from.

 

[GUH]

there is nothing wrong with residencies taking into consideration the school each applicant is applying from.

Unless it's Side A doing it. Then it's backwards and exclusive!

 

[user3]

there is nothing wrong with residencies taking into consideration the school each applicant is applying from.

then why shouldn't side A have been allowed to continue excluding side B's students from its GME under the agreement? I assume AOA wanted this, but it was ultimately not agreed upon.

 

[deleted480308]

then why shouldn't side A have been allowed to continue excluding side B's students from its GME under the agreement?

to be frank, the DO side was always the most exclusionary and we kept a very one sided deal for quite some time. Then when we were finally forced to play nice and link up, we put in OMM requirements for the MDs that end up in our programs. If we want open playing field both ways, our resolutions should reflect that (and so should our programming requirements)

 

[user3]

to be frank, the DO side was always the most exclusionary and we kept a very one sided deal for quite some time. Then when we were finally forced to play nice and link up, we put in OMM requirements for the MDs that end up in our programs. If we want open playing field both ways, our resolutions should reflect that (and so should our programming requirements)

FWIW, under the NRMP, DO students are still considered "independent" (or, outside/guest?) applicants to the match. To be more fair, the designation should change to "US Senior" or US Osteopathic Senior or similar. This would be a very simple change, but for some reason it has not taken place...

 

[SurgeDO]

i'm not really following this whole side A and side B thing. i'm assuming side A = osteopathic/AOA and side B = allopathic/ACGME.

it's been discussed many times on this site. technically, all ACGME programs are open to DOs with the overwhelming majority actually accepting DOs. when it comes time to apply for residency, you will have the ability to apply to any residency program you desire as a DO.

the AOA, on the other hand, refuses to even consider MDs as candidates for their residencies.

whenever discussions come up about DO biases in the match, i try to put myself in the program directors' shoes. let's take for example the PD of the IM program at MGH. this guy is zipping through 260s all day long. every applicant cured cancer with their research in one way or another. every applicant inherited a LOR from Osler. every applicant is ****ing insane.

so if it were me...and it came down to two applicants with the above mentioned qualifications...one from Harvopkins medical school and BFE COM...the choice is obvious. why would i choose an applicant who was taught about cancer curing back rubs and magical tapioca pudding points when i could choose an applicant with the same qualifications coming from a school with an excellent track record and lack of bull ****? why would i choose an applicant from a school whose parent organization (AOA) constantly preaches their superiority over my degree? why would i choose an applicant who has thousands of residencies set aside specifically for his or her degree that my same degree colleagues have no access to? i am sure there are more reasons.

with that said, the first DO (at least that i heard of) matched into a residency at MGH this year. MGH has been taking DOs into fellowship programs for decades now (fairly competitive ones, too).

i don't want to give the impression that i am a self-hating DO; i am very happy with my medical education thus far (except OMM obviously). i truly believe DOs can match strong as long as they put the effort into it. with each match, we are seeing DOs busting down more and more doors...but i have absolutely no confidence in anything the AOA decides on. the AOA leaders are incompetent as they have proven time after time after time after time after time after time again. nothing good will come of a bunch of AT Still worshipers knocking at the doors of the ACGME saying, "can you p-p-p-pllleaasseeeee be nicer to our poor osteopaths?". i'd rather keep my pride.

 

[dfib slim]

the first DO (at least that i heard of) matched into a residency at MGH this year

Which program?

 

[67552931811]

Which program?

Gas

 

[hallowmann]

Same conversation over and over. It doesn't mean anything until the ACGME looks at it and responds. Personally, at best the response would be a recommendation to programs. Rather than assume everyone is out to get us poor DOs, maybe we should wait and see what actually happens. Programs have already been on a trajectory to increasingly accept DOs. Why people assume it'll change overnight (one way or the other) is beyond me.

Also, to clarify, its actually more like 28% voting seats, which as it currently stands is a bit higher than the percentage of US grads that are DOs, and higher than the percentage of residents that are DOs.

 

[burritowithgreensauce]

You should pick the best person to care for your patients. Letting politics get in the way of that is how we ended up with MDs that literally wouldn't take referrals from DOs at all in the 60s and 70s. I heard a story of one woman who was diagnosed with breast cancer back in the day, but the only oncology group in the state at the time refused to take her because the physician that made the diagnosis was a DO. Her treatment was delayed substantially because of her choice in provider, all because people were picking and choosing their referrals like dinguses.

i heard about this one story of a woman who was diagnosed with lower back pain back in the day, but the only osteopathic group in the state at the time refused to take her because the physician that made the diagnosis was an MD. Her somatic dysfunction was aggravated substantially because of her choice in provider, all because people were picking and chosing their referrals like dinguses.

 

[GUH]

i'm not really following this whole side A and side B thing. i'm assuming side A = osteopathic/AOA and side B = allopathic/ACGME.

it's been discussed many times on this site. technically, all ACGME programs are open to DOs with the overwhelming majority actually accepting DOs. when it comes time to apply for residency, you will have the ability to apply to any residency program you desire as a DO.

the AOA, on the other hand, refuses to even consider MDs as candidates for their residencies.

whenever discussions come up about DO biases in the match, i try to put myself in the program directors' shoes. let's take for example the PD of the IM program at MGH. this guy is zipping through 260s all day long. every applicant cured cancer with their research in one way or another. every applicant inherited a LOR from Osler. every applicant is ****ing insane.

so if it were me...and it came down to two applicants with the above mentioned qualifications...one from Harvopkins medical school and BFE COM...the choice is obvious. why would i choose an applicant who was taught about cancer curing back rubs and magical tapioca pudding points when i could choose an applicant with the same qualifications coming from a school with an excellent track record and lack of bull ****? why would i choose an applicant from a school whose parent organization (AOA) constantly preaches their superiority over my degree? why would i choose an applicant who has thousands of residencies set aside specifically for his or her degree that my same degree colleagues have no access to? i am sure there are more reasons.

with that said, the first DO (at least that i heard of) matched into a residency at MGH this year. MGH has been taking DOs into fellowship programs for decades now (fairly competitive ones, too).

i don't want to give the impression that i am a self-hating DO; i am very happy with my medical education thus far (except OMM obviously). i truly believe DOs can match strong as long as they put the effort into it. with each match, we are seeing DOs busting down more and more doors...but i have absolutely no confidence in anything the AOA decides on. the AOA leaders are incompetent as they have proven time after time after time after time after time after time again. nothing good will come of a bunch of AT Still worshipers knocking at the doors of the ACGME saying, "can you p-p-p-pllleaasseeeee be nicer to our poor osteopaths?". i'd rather keep my pride.

It's not like the bias against DOs is imaginary, or only based on the prestige of the school. Read the NRMP PD Survey. Or at least look through one or two sections. The fact of bias towards allopathic graduates is well-documented. And I have not seen a shred of evidence that all current allopathic programs will consider DOs equally after the GME takeover. It is merely hopeful speculation.

And if you think it's okay for MDs to exclusive consider MDs, then it is hypocritical to slam DOs for exclusively considering DOs.

 

[GUH]

i heard about this one story of a woman who was diagnosed with lower back pain back in the day, but the only osteopathic group in the state at the time refused to take her because the physician that made the diagnosis was an MD. Her somatic dysfunction was aggravated substantially because of her choice in provider, all because people were picking and chosing their referrals like dinguses.

Name? Any actual evidence at all that this happened?
EDIT: whoops fell for it

 

[GUH]

Same conversation over and over. It doesn't mean anything until the ACGME looks at it and responds. Personally, at best the response would be a recommendation to programs. Rather than assume everyone is out to get us poor DOs, maybe we should wait and see what actually happens. Programs have already been on a trajectory to increasingly accept DOs. Why people assume it'll change overnight (one way or the other) is beyond me.

Also, to clarify, its actually more like 28% voting seats, which as it currently stands is a bit higher than the percentage of US grads that are DOs, and higher than the percentage of residents that are DOs.

Nothing wrong with DOs advocating for DOs. Worst case scenario is that if passed, the resolution will be ignored. But if DOs don't advocate for DOs, then nobody else will. A wait-silently-and-see approach seems even more likely to be ignored.

 

[Dharma]

i heard about this one story of a woman who was diagnosed with lower back pain back in the day, but the only osteopathic group in the state at the time refused to take her because the physician that made the diagnosis was an MD. Her somatic dysfunction was aggravated substantially because of her choice in provider, all because people were picking and chosing their referrals like dinguses.

An attempt at humor that fell obviously short of its target. I would say nice try but the effort appears mediocre at best.

 

[burritowithgreensauce]

An attempt at humor that fell obviously short of its target. I would say nice try but the effort appears mediocre at best.

i'm hilarious bro.

 

[jw3600]

there is nothing wrong with residencies taking into consideration the school each applicant is applying from.

Neither do I. But if PDs are taking applicants from MD schools over applicants from DO schools who are objectively worse in every possible criterion (this obviously happens) just because one applicant is from a DO school, that becomes a slightly more slippery slope. If the school is accredited and some external body has deemed the school adequate, then PDs are using a single criterion that should hold minimal weight and using it disproportionately. The only difference between this and not hiring someone because of their gender, disability, or ethnicity, is that DOs are not a protected class. I have no problem with including quality of school has a tangible factor in selection, but right now many programs use it as their crutch to just not bother with DOs.

That being said, I don't even necessarily think they are doing anything wrong. Certainly not illegal, and at worst, maybe somewhat shaky ethically. I was just responding to your post as it stood.

I do not think DOs should be a protected class. I do not think that classification was made for this kind of issue.

 

[user3]

But if PDs are taking applicants from MD schools over applicants from DO schools who are objectively worse in every possible criterion (this obviously happens) just because one applicant is from a DO school, that becomes a slightly more slippery slope. If the school is accredited and some external body has deemed the school adequate, then PDs are using a single criterion that should hold minimal weight and using it disproportionately.

spot on.

 

[hallowmann]

Nothing wrong with DOs advocating for DOs. Worst case scenario is that if passed, the resolution will be ignored. But if DOs don't advocate for DOs, then nobody else will. A wait-silently-and-see approach seems even more likely to be ignored.

When did I say there was something wrong with this? What I meant is that there's no point bickering back and forth in this thread until something actually happens. I have no problem with the resolution, I'm just saying, maybe we should hold off on saying its the "best" or "worst" thing that ever happened to the profession since AT Still until we actually see the outcome.

My "wait-silently-and-see-approach" was in reference to those in this thread that have already judged every action ever taken (including this resolution) as either a terrible mistake or the best thing since sliced bread. Again, no problem with advocating for the profession, but this thread isn't really doing that.

 

[235009]

Neither do I. But if PDs are taking applicants from MD schools over applicants from DO schools who are objectively worse in every possible criterion (this obviously happens) just because one applicant is from a DO school, that becomes a slightly more slippery slope. If the school is accredited and some external body has deemed the school adequate, then PDs are using a single criterion that should hold minimal weight and using it disproportionately. The only difference between this and not hiring someone because of their gender, disability, or ethnicity, is that DOs are not a protected class. I have no problem with including quality of school has a tangible factor in selection, but right now many programs use it as their crutch to just not bother with DOs.

That being said, I don't even necessarily think they are doing anything wrong. Certainly not illegal, and at worst, maybe somewhat shaky ethically. I was just responding to your post as it stood.

I do not think DOs should be a protected class. I do not think that classification was made for this kind of issue.

So many gaps in this logic ...it's absolutely dizzying.

Not all accreditation is created equal. You need not go any further than this forum to understand how lax COCA accreditation standards are. The fact that these DO schools are held to a different (and significantly less stringent) standard, particularly with regards to clinical training, is highly problematic and makes the fact that an applicant hails from a DO school anything but trivial. It means you don't know what you're going to get or what training/knowledge/background this applicant will have when they show up on day 1 seeing patients and writing orders or how much catching up they'll need to do. Medicine isn't the only place where there is a group of accredited programs (in this case LCME accredited) and another group of unaccredited programs (in this case DO schools that are not LCME accredited). Public health is a good example. No one would argue that it is "discrimination" for an employer in a field with this educational setup to require that his applicants come from an accredited program and refuse to consider applicants from unaccredited programs. No one has time to do the legwork and look into every single rotation you did to verify whether it was rigorous or a purely outpatient surgery rotation or an IM rotation where you shadowed some community PCP in their office so they rely on accrediting bodies like the LCME to regulate these things.

So comparing being a DO to protected classes is absolutely absurd. You weren't born a DO. It's part of your CV and is open to scrutiny and judgement as much as every other part of your CV/application. If a PD thinks it's a deal breaker (as many do) they're not being unreasonable nor are they "discriminating" against you. It's your educational background not your sexuality. Nothing unethical about that.

 

[jw3600]

So many gaps in this logic ...it's absolutely dizzying.

Not all accreditation is created equal. You need not go any further than this forum to understand how lax COCA accreditation standards are. The fact that these DO schools are held to a different (and significantly less stringent) standard, particularly with regards to clinical training, is highly problematic and makes the fact that an applicant hails from a DO school anything but trivial. It means you don't know what you're going to get or what training/knowledge/background this applicant will have when they show up on day 1 seeing patients and writing orders or how much catching up they'll need to do. Medicine isn't the only place where there is a group of accredited programs (in this case LCME accredited) and another group of unaccredited programs (in this case DO schools that are not LCME accredited). Public health is a good example. No one would argue that it is "discrimination" for an employer in a field with this educational setup to require that his applicants come from an accredited program and refuse to consider applicants from unaccredited programs. No one has time to do the legwork and look into every single rotation you did to verify whether it was rigorous or a purely outpatient surgery rotation or an IM rotation where you shadowed some community PCP in their office so they rely on accrediting bodies like the LCME to regulate these things.

So comparing being a DO to protected classes is absolutely absurd. You weren't born a DO. It's part of your CV and is open to scrutiny and judgement as much as every other part of your CV/application. If a PD thinks it's a deal breaker (as many do) they're not being unreasonable nor are they "discriminating" against you. It's your educational background not your sexuality. Nothing unethical about that.

It's almost like....you didn't read my whole post.

 

[jordansetron]

So many gaps in this logic ...it's absolutely dizzying.

Not all accreditation is created equal. You need not go any further than this forum to understand how lax COCA accreditation standards are. The fact that these DO schools are held to a different (and significantly less stringent) standard, particularly with regards to clinical training, is highly problematic and makes the fact that an applicant hails from a DO school anything but trivial. It means you don't know what you're going to get or what training/knowledge/background this applicant will have when they show up on day 1 seeing patients and writing orders or how much catching up they'll need to do. Medicine isn't the only place where there is a group of accredited programs (in this case LCME accredited) and another group of unaccredited programs (in this case DO schools that are not LCME accredited). Public health is a good example. No one would argue that it is "discrimination" for an employer in a field with this educational setup to require that his applicants come from an accredited program and refuse to consider applicants from unaccredited programs. No one has time to do the legwork and look into every single rotation you did to verify whether it was rigorous or a purely outpatient surgery rotation or an IM rotation where you shadowed some community PCP in their office so they rely on accrediting bodies like the LCME to regulate these things.

So comparing being a DO to protected classes is absolutely absurd. You weren't born a DO. It's part of your CV and is open to scrutiny and judgement as much as every other part of your CV/application. If a PD thinks it's a deal breaker (as many do) they're not being unreasonable nor are they "discriminating" against you. It's your educational background not your sexuality. Nothing unethical about that.

Are you asserting that all MD rotations are of the same quality? That there is no difference between rotations at Florida State and those at University of Miami? Or are you saying that all 30 something osteopathic schools rotate their students at walgreens clinics? And even if the rotations were of such measurable quality, it doesn't ensure that the student is any better prepared for residency. Giving someone a good car doesn't make them a good driver. (does that analogy make sense?) People go to all sorts of schools in all sorts of places for all sorts of reasons. It seems the education in the pre-clinical years is just about the same with the exception that DO's take 1 additional class (OMM) but the rotations vary wildly according to a schools mission and location. Rotation quality should and does matter significantly. Sure. But the USMLE is supposed to be the standard for residency just like the MCAT was for med school and the SAT was for undergraduate. The point of these periodical exams is to assess a students CURRENT aptitude.

Seeing how many PDs won't even consider a DO is like seeing people at thanksgiving dinner only eating turkey. Turkey is great and there's plenty to go around, but don't you want to at least try something else? The green bean casserole? Mashed potatoes? Cranberry sauce? It just might make the meal better.

 

[235009]

Are you asserting that all MD rotations are of the same quality? That there is no difference between rotations at Florida State and those at University of Miami? Or are you saying that all 30 something osteopathic schools rotate their students at walgreens clinics? And even if the rotations were of such measurable quality, it doesn't ensure that the student is any better prepared for residency. Giving someone a good car doesn't make them a good driver. (does that analogy make sense?) People go to all sorts of schools in all sorts of places for all sorts of reasons. It seems the education in the pre-clinical years is just about the same with the exception that DO's take 1 additional class (OMM) but the rotations vary wildly according to a schools mission and location. Rotation quality should and does matter significantly. Sure. But the USMLE is supposed to be the standard for residency just like the MCAT was for med school and the SAT was for undergraduate. The point of these periodical exams is to assess a students CURRENT aptitude.

Seeing how many PDs won't even consider a DO is like seeing people at thanksgiving dinner only eating turkey. Turkey is great and there's plenty to go around, but don't you want to at least try something else? The green bean casserole? Mashed potatoes? Cranberry sauce? It just might make the meal better.

A couple of quick points:

The USMLE is not meant to be used the same way as the MCAT or SAT. Passing vs not passing is meaningful. Beyond that who knows. It doesn't level the playing field, it never will and shouldn't.

Your Thanksgiving analogy is absurd. A more apt analogy is choosing between two turkeys at Thanksgiving dinner: one was cooked using a method passed down for generations and known to produce tasty juicy evenly cooked turkey with some minor variation and the other turkey was cooked by a novice using God knows what method... Some parts may be tender and juicy while others are simply raw... There is tremendous intra and inter turkey variation. The LCME provides a minimum standard. Of course there will be variability but there is in any education. All u can ask for is good thorough oversight. The LCME provides this, COCA doesn't.

 

[NontradCA]

A couple of quick points:

The USMLE is not meant to be used the same way as the MCAT or SAT. Passing vs not passing is meaningful. Beyond that who knows. It doesn't level the playing field, it never will and shouldn't.

Your Thanksgiving analogy is absurd. A more apt analogy is choosing between two turkeys at Thanksgiving dinner: one was cooked using a method passed down for generations and known to produce tasty juicy evenly cooked turkey with some minor variation and the other turkey was cooked by a novice using God knows what method... Some parts may be tender and juicy while others are simply raw... There is tremendous intra and inter turkey variation. The LCME provides a minimum standard. Of course there will be variability but there is in any education. All u can ask for is good thorough oversight. The LCME provides this, COCA doesn't.

I don't think PDs base their choice of candidates from this perspective at all. It's simply not how the world works. The reason that they choose MD applicants is simply because they know the people who come from those schools and reputation. The long winded post about standards and etc is not really needed.

 

[GUH]

I don't think PDs base their choice of candidates from this perspective at all. It's simply not how the world works. The reason that they choose MD applicants is simply because they know the people who come from those schools and reputation. The long winded post about standards and etc is not really needed.

I very much doubt that any PD knows people who come from every MD school.

 

[GUH]

A couple of quick points:

The USMLE is not meant to be used the same way as the MCAT or SAT.

Regardless of its intended purpose, the USMLE is used as a quick and lazy means to rank candidates or disregard their applications entirely.
Similarly, the DO degree is used by some PD's as a quick and lazy means to rank candidates or disregard their applications entirely. This goes beyond the quality of the school. Again, this is a documented fact.

 

[NontradCA]

I very much doubt that any PD knows people who come from every MD school.

At the very least they will know the name. If they don't, yea, they might be seeking outside legitimization of the applicant just like they would a DO. Source: PD

 

[jordansetron]

A couple of quick points:

The USMLE is not meant to be used the same way as the MCAT or SAT. Passing vs not passing is meaningful. Beyond that who knows. It doesn't level the playing field, it never will and shouldn't.

Your Thanksgiving analogy is absurd. A more apt analogy is choosing between two turkeys at Thanksgiving dinner: one was cooked using a method passed down for generations and known to produce tasty juicy evenly cooked turkey with some minor variation and the other turkey was cooked by a novice using God knows what method... Some parts may be tender and juicy while others are simply raw... There is tremendous intra and inter turkey variation. The LCME provides a minimum standard. Of course there will be variability but there is in any education. All u can ask for is good thorough oversight. The LCME provides this, COCA doesn't.

It seems like you're advocating for the use of stereotypes to actively discriminate against professionals and limit their career opportunities. I agree that the LCME standards are more stringent than COCA. However, its not like those that go to state schools and those that go to private schools are dramatically different despite they're different standards. One might have more resources and long standing traditions, but a students success is really up to the student and not the school. I ask if that is the same logic PDs used to not interview women doctors because "they didn't know what they were getting" or because of simple prejudice. The differences between COCA and LCME are there, but they aren't different enough to justify the overt discrimination in some programs.

It just seems like bad business for PDs to forgo the opportunity to cherry pick some of the best medical students in the country that happen to be DOs because they supposedly "don't know what they're getting". I think it would be better to take at least a couple residents for a few years and see if the lax COCA standards actually manifest in the competency of the physician.

MDs make up the vast majority of physicians so the voices exclaiming how much better MD is than DO will always be louder and more numerous. But c'mon, shouldn't we strive for a meritocracy and not a caste system? 30% of PDs in EM not even considering DOs is what is absurd. I'd at least TRY the other turkey. amirite?

 

[IslandStyle808]

It seems like you're advocating for the use of stereotypes to actively discriminate against professionals and limit their career opportunities. I agree that the LCME standards are more stringent than COCA. However, its not like those that go to state schools and those that go to private schools are dramatically different despite they're different standards. One might have more resources and long standing traditions, but a students success is really up to the student and not the school. I ask if that is the same logic PDs used to not interview women doctors because "they didn't know what they were getting" or because of simple prejudice. The differences between COCA and LCME are there, but they aren't different enough to justify the overt discrimination in some programs.

It just seems like bad business for PDs to forgo the opportunity to cherry pick some of the best medical students in the country that happen to be DOs because they supposedly "don't know what they're getting". I think it would be better to take at least a couple residents for a few years and see if the lax COCA standards actually manifest in the competency of the physician.

MDs make up the vast majority of physicians so the voices exclaiming how much better MD is than DO will always be louder and more numerous. But c'mon, shouldn't we strive for a meritocracy and not a caste system? 30% of PDs in EM not even considering DOs is what is absurd. I'd at least TRY the other turkey. amirite?

Actually from 2012 to 2014, EM ACGME program interviewing DOs has went up 8-9% (in 2014 77% of programs interview DOs). So they have been, as you have put it, trying the DO turkey.

 

[jordansetron]

Actually from 2012 to 2014, EM ACGME program interviewing DOs has went up 8-9% (in 2014 77% of programs interview DOs). So they have been, as you have put it, trying the DO turkey.

Well thats good to know. Can we make "DO Turkey" a thing now?

 

[DrEnderW]

Well thats good to know. Can we make "DO Turkey" a thing now?

With all the myofascial, you know that meat would be more tender.

 

[235009]

It seems like you're advocating for the use of stereotypes to actively discriminate against professionals and limit their career opportunities. I agree that the LCME standards are more stringent than COCA. However, its not like those that go to state schools and those that go to private schools are dramatically different despite they're different standards. One might have more resources and long standing traditions, but a students success is really up to the student and not the school. I ask if that is the same logic PDs used to not interview women doctors because "they didn't know what they were getting" or because of simple prejudice. The differences between COCA and LCME are there, but they aren't different enough to justify the overt discrimination in some programs.

It just seems like bad business for PDs to forgo the opportunity to cherry pick some of the best medical students in the country that happen to be DOs because they supposedly "don't know what they're getting". I think it would be better to take at least a couple residents for a few years and see if the lax COCA standards actually manifest in the competency of the physician.

MDs make up the vast majority of physicians so the voices exclaiming how much better MD is than DO will always be louder and more numerous. But c'mon, shouldn't we strive for a meritocracy and not a caste system? 30% of PDs in EM not even considering DOs is what is absurd. I'd at least TRY the other turkey. amirite?

I feel like I keep having to rehash the same simple concepts in response to pre-meds these days.... this generation with their buzz words is the worst....

You are not being discriminated against for your qualifications!

The rest of your post makes absolutely no sense. States schools and private schools are't "dramatically different" precisely because of stringent LCME standards! I'll ignore the fact that you are "stereotyping" all state schools as being inferior to private schools by lumping them together despite the fact that you are whining that PDs lump all DOs. I'd like to see you try to argue that Albany/Drexel/RF are superior to and have more resources than UCSF because they're private schools.

Let me put it in simpler terms that you'll understand.... There are two colleges. College A known to have tough courses with rigorous coursework.. you have to write papers take tough exams and attend labs, etc. College B is an online school where you just watch videos, take at-home multiple choice tests, and do online labs. At college B you're more than welcome to take courses at college A and they'll gladly give you credit for them. Some students choose to go through the hassle of doing this. Would you fault a grad school or employer from avoiding any and all graduates from college B because they don't know what kind of education these students got and don't want to go through the trouble of trying to figure it out when they have dozens/hundreds/thousands of perfectly qualified applicants from college A where the quality of education is known to be up to par? Is it really up to the student in this case or will they just simply be under-qualified and unprepared because of the inferior experience they were afforded?

Finally, I realize you haven't even stepped into a med school classroom or are a first year at best so you have no idea what clinical undergraduate medical education is like (i.e. third and fourth year) but the differences between the LCME and COCA standards are real, significant and very important. For PDs these difference can mean life or death for patients or calamity in your program. So, no they're not at liberty to just "try the other turkey" and hope for the best. This is real life.

 

[GUH]

I feel like I keep having to rehash the same simple concepts in response to pre-meds these days.... this generation with their buzz words is the worst....

You are not being discriminated against for your qualifications!

The rest of your post makes absolutely no sense. States schools and private schools are't "dramatically different" precisely because of stringent LCME standards! I'll ignore the fact that you are "stereotyping" all state schools as being inferior to private schools by lumping them together despite the fact that you are whining that PDs lump all DOs. I'd like to see you try to argue that Albany/Drexel/RF are superior to and have more resources than UCSF because they're private schools.

Let me put it in simpler terms that you'll understand.... There are two colleges. College A known to have tough courses with rigorous coursework.. you have to write papers take tough exams and attend labs, etc. College B is an online school where you just watch videos, take at-home multiple choice tests, and do online labs. At college B you're more than welcome to take courses at college A and they'll gladly give you credit for them. Some students choose to go through the hassle of doing this. Would you fault a grad school or employer from avoiding any and all graduates from college B because they don't know what kind of education these students got and don't want to go through the trouble of trying to figure it out when they have dozens/hundreds/thousands of perfectly qualified applicants from college A where the quality of education is known to be up to par? Is it really up to the student in this case or will they just simply be under-qualified and unprepared because of the inferior experience they were afforded?

Finally, I realize you haven't even stepped into a med school classroom or are a first year at best so you have no idea what clinical undergraduate medical education is like (i.e. third and fourth year) but the differences between the LCME and COCA standards are real, significant and very important. For PDs these difference can mean life or death for patients or calamity in your program. So, no they're not at liberty to just "try the other turkey" and hope for the best. This is real life.

I am not aware of any evidence at all that graduates of osteopathic medical schools have inferior patient outcomes compared to graduates of MD-granting colleges. Unless there is evidence then what you describe is baseless discrimination, not some noble attempt to keep their patients safe from reckless, unqualified osteopathic physicians.

 

[PatsyStone]

Programs don't want to waste away rotation spots on students who are not capable of matching at their program. It's not uncommon for ortho and derm aways to request Step scores as part of your VSAS application (some even post Step cutoffs for away rotations). If a program states they don't take DO students, at least they are being honest.

For residency, you have to be kidding yourself if you think programs will place an applicant from Penn and Drexel on the same level. "Discrimination" exists in the MD match, and it is based on the quality of applicants, which is not only limited to ones step scores, AOA status, clinical grades, LORs, and research, but also the quality of the school they attended. As @MeatTornado mentioned above, there is a huge difference in the quality of the average DO vs MD school, and this "discrimination" is nothing new. Rather, it is a continuation of the stratification of quality amongst MD schools.