M.D and D.O Merger ?

[CAK2012]

I have always considered applying to both M.D and D.O schools. Never thought it really matter which one I hopefully get accepted into, as long as I get accepted. But I've always read that a lot of D.O's are limited to primary care. As of right now, that's not where my interest lie.

So with the merger will D.O's start attending more specialties like Emergency Medicine, Cardiology, General Surgery and etc. rather than being limited to primary care ?

Thanks,
Cody K.

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[md-2020]

If anything I'd expect the new Match to make it even harder for DO grads, as MD applicants now have access to desirable DO residency programs. I think this is a rather pessimistic and minority opinion, but just my 2c.

 

[deleted407021]

It makes no sense to me that previously DO only residencies will all-of-a-sudden be creaming for MD grads.

OP, it's hard to tell, but from what @Goro says, the clinical faculty at his school are all optimistic with the merger.

EM is not hard for DOs. Neither is GS, really. Cardiology isn't terribly off-limits so long as one has a decent IM residency under his/her belt that has a history of placing well into that fellowship. DOs are by no means "limited to primary care".

 

[Dr.Smexy]

It makes no sense to me that previously DO only residencies will all-of-a-sudden be creaming for MD grads.

OP, it's hard to tell, but from what @Goro says, the clinical faculty at his school are all optimistic with the merger.

EM is not hard for DOs. Neither is GS, really. Cardiology isn't terribly off-limits so long as one has a decent IM residency under his/her belt that has a history of placing well into that fellowship. DOs are by no means "limited to primary care".

If that is the case, it will also work both way in the sense that the PD of md residencies won't be too enthusiastic about taking more DO than what they have been used to.

 

[deleted407021]

If that is the case, it will also work both way in the sense that the PD of md residencies won't be too enthusiastic about taking more DO than what they have been used to.

That may be the case.

 

[Mad Jack]

 

[Mad Jack]

I have always considered applying to both M.D and D.O schools. Never thought it really matter which one I hopefully get accepted into, as long as I get accepted. But I've always read that a lot of D.O's are limited to primary care. As of right now, that's not where my interest lie.

So with the merger will D.O's start attending more specialties like Emergency Medicine, Cardiology, General Surgery and etc. rather than being limited to primary care ?

Thanks,
Cody K.

So here's the serious answer:

DOs have always matched well to EM. Roughly 10% of my school's class matches EM each year. If you look at my school, 47% of graduates entered "primary care" specialties which is after both school selection and self-selection. Many of those that entered "primary care" will end up specializing via specialty-27% of that 47% were in IM or peds, both fields which tend to lend themselves to specialty. And many of those that don't specialize end up becoming hospitalists or going into urgent care nowadays, so realistically I'd venture that only a quarter to a third of my very primary care focused DO school's students actually end up in primary care.

 

[GrapesofRath]

Theory I've seen floated around is that the merger will help DO's with lower tier residencies in terms of competitiveness but make things somewhat even more difficult for those gunning for the higher end of competitive residencies. Not sure how it affects the middle group of specialties that DO's have a track record of matching into but where there are still disadvantages DO's can face such as neurology, pathology, EM etc.

Waiting for MeatTornado to come in and bust this thread wide open btw

 

[CAK2012]

I appreciate all the responses from everyone.
Cody K.

 

[Law2Doc]

It makes no sense to me that previously DO only residencies will all-of-a-sudden be creaming for MD grads...

Makes total sense. There are many more allo students, so there are now simply going to be more applicants with higher test scores in the pile for programs to consider. Plus more allo students do research and publish (because more allo programs focus on that) so CVs can be pretty impressive in terms of this kind of accomplishment.

So interview offers won't be about MD student vs DO student. It's rather going to be "here's the pile of best scorers/best CVs -- lets bring them in for a look." And the osteo students will get diluted out.

Eg previously say 100 osteo students were considered for a given competitive osteo residency, but now you add in 300 equivalent allo applicants who also want that spot and suddenly odds for osteo drop to 25%. And that's assuming they all are equivalent. As noted some allo grads look even better on paper if things like research are valued.

 

[hopefulERdoc251]

Theory I've seen floated around is that the merger will help DO's with lower tier residencies in terms of competitiveness but make things somewhat even more difficult for those gunning for the higher end of competitive residencies. Not sure how it affects the middle group of specialties that DO's have a track record of matching into but where there are still disadvantages DO's can face such as neurology, pathology, EM etc.

Waiting for MeatTornado to come in and bust this thread wide open btw

EM is surprisingly a common residency for many DO's to go to! Most of the DO's I work with at my hospital are DO's (I'd say the group has 20ish people, >755 are DO's!). The current resident class that just started year 1 is mostly DO as well!

 

[Law2Doc]

not to mention all the new osteopathic schools opening like wildfire.

I'm not sure that really impacts the competitive fields, where the issue is about letting in allo grads to compete with the top osteo grads for osteo residencies. Osteo growth has been impressive but we still aren't talking about a merger of equals by any stretch of the imagination.

 

[hopefulERdoc251]

I'm also interested to see how match will work once it's combined residencies. Hypothetically, just using random numbers, if you have 10,000 slots for MD residencies, 10,000 for DO residencies, once the merger happens, since they say that the DO residencies will decrease (so 10k --> 7k but now these 7k are "allopathic" residencies), the total residency slots become 17k. Now in theory, that jacks up the competition, yes. But I do think that the IMG's will get the worst of the deal. There's almost an undoubted hierarchy where MD>DO>IMG (carrib + other international). DO's will still get preference over IMG's, and at places where there were the PD is a DO or if the practice is a majority DO, I'm sure those residencies will gravitate more for DO's as well. If this is true, then majority of the residencies will go to MD's, DO's from US schools, with a fewer amount going to the IMG's which is why there is such a strong push nowadays (even moreso than it was 2-3 years ago) to NOT go to an IMG school.

 

[md-2020]

I'm also interested to see how match will work once it's combined residencies.

This has literally been the topic of conversation for the entire thread.

 

[hopefulERdoc251]

This has literally been the topic of conversation for the entire thread.

haha sorry for the redundancy of that post. Long night in the ER has my brain all fried.

 

[hopefulERdoc251]

it's more competition in general and the lax requirements for accreditation e.g., Burrells, LUCOMs, and LECOMs, depreciate the value of the field of osteopathic medicine tragically.

But then you have the KCU's, AT-Stills, PCOM's, Rowan's, AZCOM/CCOM's, MSUCOM's, NOVA's, Western's which are the top that *hopefully* make up for the others

 

[CAK2012]

Makes total sense. There are many more allo students, so there are now simply going to be more applicants with higher test scores in the pile for programs to consider. Plus more allo students do research and publish (because more allo programs focus on that) so CVs can be pretty impressive in terms of this kind of accomplishment.

So interview offers won't be about MD student vs DO student. It's rather going to be "here's the pile of best scorers/best CVs -- lets bring them in for a look." And the osteo students will get diluted out.

Eg previously say 100 osteo students were considered for a given competitive osteo residency, but now you add in 300 equivalent allo applicants who also want that spot and suddenly odds for osteo drop to 25%. And that's assuming they all are equivalent. As noted some allo grads look even better on paper if things like research are valued.

This may be a dumb question but, why have a D.O if they will become almost obsolete. Why not just have one type of med school instead of two ?

 

[Law2Doc]

This may be a dumb question but, why have a D.O if they will become almost obsolete. Why not just have one type of med school instead of two ?

Baby steps. Allo couldn't just merge osteo into allo in one shot and fire all the osteo guys they were negotiating with. But over time the standards will become the same, the distinctions will blur. In law the JD basically supplanted LLB which is now just an historical footnote and on some parchment hanging up on some old guys walls. Same will happen to DO over time IMHO.

 

[hopefulERdoc251]

This may be a dumb question but, why have a D.O if they will become almost obsolete. Why not just have one type of med school instead of two ?

Because DO's still want to be considered individual and unique from their allopathic partners!

 

[deleted407021]

Makes total sense. There are many more allo students, so there are now simply going to be more applicants with higher test scores in the pile for programs to consider. Plus more allo students do research and publish (because more allo programs focus on that) so CVs can be pretty impressive in terms of this kind of accomplishment.

So interview offers won't be about MD student vs DO student. It's rather going to be "here's the pile of best scorers/best CVs -- lets bring them in for a look." And the osteo students will get diluted out.

Eg previously say 100 osteo students were considered for a given competitive osteo residency, but now you add in 300 equivalent allo applicants who also want that spot and suddenly odds for osteo drop to 25%. And that's assuming they all are equivalent. As noted some allo grads look even better on paper if things like research are valued.

Won't all those hypothetical MD applicants have to have OMM training to be accepted to an AOA merged residency? You don't think that such programs might have some kind of "loyalty" to osteopathic graduates?

 

[deleted407021]

Because DO's still want to be considered individual and unique from their allopathic partners!

Just like DMDs are individual and unique from their DDS partners? This is more the direction I see it going in.

 

[ChillDawg]

Using the word 'merger' is considered offensive according to an AOA rep who I heard from indirectly. I guess it has a negative connotation in this case?

 

[Law2Doc]

Won't all those hypothetical MD applicants have to have OMM training to be accepted to an AOA merged residency? You don't think that such programs might have some kind of "loyalty" to osteopathic graduates?

OMM will ultimately become a quick summer course you do before you start, like ACLS.

As for loyalty-- It's more about keeping up with the Joneses. They'll want to be able to boast high board scores and residents presenting at the major conferences, not that they are staying true to their heritage. Programs will want to move up in the pecking order. You do that by bringing in the best and brightest , which means osteo folks will be diluted by the more numerous allos.

 

[Law2Doc]

Using the word 'merger' is considered offensive according to an AOA rep who I heard from indirectly. I guess it has a negative connotation in this case?

It really should be viewed as a hostile takeover...

 

[Tommyguns89]

If anything I'd expect the new Match to make it even harder for DO grads, as MD applicants now have access to desirable DO residency programs. I think this is a rather pessimistic and minority opinion, but just my 2c.

Honestly I see this a lot here and it doesnt make sense to me. MD and DO both have their own biases(which are decreasing). I doubt MD programs that didnt take DOs before are going to start. And I would imagine DO programs would have an OMM requirement, and would be biased in favor of DO candidates even if they dont. Also I doubt MD students are going to be falling all over themselves to apply to the former DO programs.

 

[RurouniKarly]

true, but the more of the other ones I listed there are, the worse it is. the Do school accreditation board has tragically lax standards.

Which COCA standards do you consider lax, and what do you think the standards should be?

 

[RurouniKarly]

This may be a dumb question but, why have a D.O if they will become almost obsolete. Why not just have one type of med school instead of two ?

There have been multiple attempts in the past by MDs to absorb the DOs, but the DOs have managed to maintain their autonomy each time. The DOs were especially keen to keep their independence after they saw what happened to the DOs in California after the California amalgamation. What it comes down to is that osteopathic medicine was created as an alternate approach to medicine, and while there are now more similarities than differences, osteopathic medicine still has it's own identity and way of doing things. Allopaths make the mistake of thinking that osteopaths are sad, lesser medical practitioners who wish they could have the MD initials, but really it's a very close knit community with a specific identity and tenets that are different from allopathic medicine.

 

[Law2Doc]

...but really it's a very close knit community with a specific identity and tenets that are different from allopathic medicine.

It certainly was once like this but if you speak to most of the current generation, they'll tell you they'd actually prefer to be regarded as indistinguishable from MDs, and don't really share the different identity or ideology.

 

[Law2Doc]

...Also I doubt MD students are going to be falling all over themselves to apply to the former DO programs.

For the uber competitive things, like ortho and derm, where applicants outnumber spots, and every spot is gold, of course they will. For IM and other less competitive things, you are correct.

 

[hopefulERdoc251]

For the uber competitive things, like ortho and derm, where applicants outnumber spots, and every spot is gold, of course they will. For IM and other less competitive things, you are correct.

I don't think allopaths will take an entire course to learn OMM just to get into a ortho/derm residency lol. Like this one statement is the big problem with medicine as it is.

 

[Law2Doc]

I don't think allopaths will take an entire course to learn OMM just to get into a ortho/derm residency lol. Like this one statement is the big problem with medicine as it is.

As I said above, OMM post merger will likely ultimately become something short one can take in the summer before residency, like ACLS. Otherwise that would thwart the idea of opening osteo slots to allo, which was something bargained for /fought over in this merger.

 

[deleted407021]

As I said above, OMM post merger will likely ultimately become something short one can take in the summer before residency, like ACLS. Otherwise that would thwart the idea of opening osteo slots to allo, which was something bargained for /fought over in this merger.

How does a summer of OMM training stand-up to the 2+ years that DO students get? Certainly, the standard would be set at being proficient enough to pass the OMM portion of COMLEX--would a summer couse be adequate, you think? Anything less would be an unlevel field, in favor of the MDs who can skirt by with just piddling OMM training.

 

[Scumbag_Steve]

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[ChrisMack390]

Honestly I see this a lot here and it doesnt make sense to me. MD and DO both have their own biases(which are decreasing). I doubt MD programs that didnt take DOs before are going to start. And I would imagine DO programs would have an OMM requirement, and would be biased in favor of DO candidates even if they dont. Also I doubt MD students are going to be falling all over themselves to apply to the former DO programs.

They will for neurosurgery, derm, ortho, etc.

 

[AlteredScale]

They will for neurosurgery, derm, ortho, etc.

Perhaps, but if you are fellowship hungry going to a community neurosurgery program with a lack of research opps due to a lack of university oversight would be absoluteley detrimental for their career. MDs gunning for these programs are looking for the best and to be frank, AOA sub speciality programs are not those when compared to ACGME programs at university medical centers.

 

[allantois]

DMD and DDS are equivalent degrees and the only difference between them is the state in which they are issued. For example, California and New York schools award DDS degrees while Pennsylvania and Massachusetts schools award a DMD. I admit I'm not quite sure about the history of how this came to be, and if they used to be different degrees, but it's been this way for awhile. See, dentists do know at least something!

Maryland was the first dental college, and they awarded DDS. Then came Harvard which issued DMD as DDS doesn't sound well in Latin on their diplomas. Both degrees are regulated by the same accrediting body and it is up to individual school to decide which they want to issue. Schools that opened before Harvard are all DDS, while post Harvard are typically DMD. It's quite different for DO and MD, where you have two independent bodies licensing each type of school.

As for the topic of this thread: if you are going DO and wanting to match derm (and the like), good luck to you. First of all, all programs will have to be ACGME accredited. A lot of residencies will not meet their requirements and are closing already, and I can imagine it won't be very hard for ACGME to prevent residencies from discriminating against MD applicants just for the OMM requirement. And let me tell you, there are derm applicants taking multiple research years in the hopes of matching anywhere. So don't think that taking an OMM course for them will be such a great barrier if it opens the door for a few more programs to apply to.

 

[Med Ed]

If anything I'd expect the new Match to make it even harder for DO grads, as MD applicants now have access to desirable DO residency programs. I think this is a rather pessimistic and minority opinion, but just my 2c.

I happen to agree with you. When osteopathic residency programs are brought to ACGME standards, some of them will invariably shrink or close. That means fewer positions traditionally reserved for DO graduates. When the surviving programs become open to allopathic graduates, that means more competition. Ultimately this will improve the quality of graduate medical education for residents in osteopathic residency programs, which is a good thing, but it can only further squeeze the pool of DO medical students.

 

[ChrisMack390]

Perhaps, but if you are fellowship hungry going to a community neurosurgery program with a lack of research opps due to a lack of university oversight would be absoluteley detrimental for their career. MDs gunning for these programs are looking for the best and to be frank, AOA sub speciality programs are not those when compared to ACGME programs at university medical centers.

If you want to do neurosurg and are not quite qualified or are borderline for an MD residency, you wouldn't throw in a couple of DO ones, even just as safeties?

 

[Goro]

Historical context, dating to over 120 years ago, when most treatments were palliative. keep in mind at at one point surgeons weren't considered physicians, a distinction that still exists in the name of Columbia's medical school.

This may be a dumb question but, why have a D.O if they will become almost obsolete. Why not just have one type of med school instead of two ?

Concur with my learned colleague. Medicine is an evolving field, and this merger is a part of the evolutionary process.

Baby steps. Allo couldn't just merge osteo into allo in one shot and fire all the osteo guys they were negotiating with. But over time the standards will become the same, the distinctions will blur. In law the JD basically supplanted LLB which is now just an historical footnote and on some parchment hanging up on some old guys walls. Same will happen to DO over time IMHO.

 

[medic86]

If you want to do neurosurg and are not quite qualified or are borderline for an MD residency, you wouldn't throw in a couple of DO ones, even just as safeties?

I would hope that I realized earlier that I wasn't competitive for neurosurgery and decided on another field.

 

[Donald Juan]

If you want to do neurosurg and are not quite qualified or are borderline for an MD residency, you wouldn't throw in a couple of DO ones, even just as safeties?

Yes, you are right. It's tough for some SDNers to imagine being worried about simply matching as opposed to not matching at a "top 10." On top of that, you will have thousands of FMGs flooding the DO applicant pool as well for all specialties. Also, many USMD applicants care about matching into a particular city/region over anything else, and you can be certain they will be applying to these previously DO specialties if they are in the right location.

We can sit here and debate how much the DO residencies will be favorable to MD students or how many MD students will apply to them, but without a doubt at least SOME previously DO only spots will be taken by MD students. The MD residencies that don't take DO students on the other hand have been getting DO applications for years and this merger won't change their minds on rejecting them.

 

[gyngyn]

I don't think allopaths will take an entire course to learn OMM just to get into a ortho/derm residency lol.

You clearly have not met an Ortho applicant!
They'd give you a brain biopsy if it would get them a residency spot.

 

[RurouniKarly]

Any and all of their lax standards that allow DO schools such as LECOM, LUCOM, and Burrell to be set up quickly, no questions asked. If the LCME was in charge, all of those places would have been struck down instantly because the LCME is far more conscientious about the future of medicine. The biggest issue the LCME has is northstate, which is one compared to all of those.

That didn't answer my question. You say there are lax standards. Which standards are lax and what should they be instead?

 

[RurouniKarly]

It answered it just fine. It's the way COCA operates and the way they abide by the rules that makes it such a huge issue. It's not hard to read behind the lines by comparing the way they operate and approve medical schools relative to LCME. As someone accepted to medical school, you should think way more critically about the way COCA operates as it may significantly impact your future career.

Monster_cat, there is no reason to start behaving defensively or to attack me. You made an assertion, and I am asking you to elaborate on that assertion. It does no good to just state that COCA has poor accediting standards if you can't demonstrate that you know what the accediting process entails or what parts of the process may need improvement. You're refusal to offer specifics demonstrates that you are likely only parroting statements about COCA and have not actually done your own analysis or comparison of the accreditation criteria.

 

[Psai]

I don't think allopaths will take an entire course to learn OMM just to get into a ortho/derm residency lol. Like this one statement is the big problem with medicine as it is.

With the number of hoops they need to jump through to get into derm or ortho, an omm course is the least of their worries

 

[RurouniKarly]

I'm neither behaving defensively nor attacking you . I'm not parroting anything, this is my word based off of my research and firsthand experience. You should do some analysis of the questionable quality of the schools recently COCA approved (I've experienced the quality of those institutions) instead of blindly defending them as you are accepted at one of them, which I know is the real reason why you keep trying to say this stuff about me. There are a huge number of redflags at each of those places (LUCOM - most of it is a red flag, LECOM - independent study pathway, the way they handle PBL, how they don't pay rotation sites, sketchy business models Burrell - huge redflags all over the place), yet they are approved.

Tell me the LCME would approve any of those places. They wouldn't.

I would PM you so we can continue this discussion without cluttering the thread, but you seem to have disabled that functionality.

 

[Dral]

I don't think allopaths will take an entire course to learn OMM just to get into a ortho/derm residency lol. Like this one statement is the big problem with medicine as it is.

Some Derm candidates toil in research labs/pre-residency fellowship positions for years for a chance to get a residency spot. I think about 25% of 4th year students don't match into it yearly. I'm guessing many would jump at the chance to take an OMM course to land a Derm spot.

 

[ChrisMack390]

I just don't see this as any different than the fact that my GPA is on the low side so I might put an app in to a few DO schools just to make sure I get in somewhere.

 

[Med Ed]

That didn't answer my question. You say there are lax standards. Which standards are lax and what should they be instead?

6.9 should be much more rigid.

 

[Moose A Moose]

I've talked to many a PD. The bias will remain. The end.