Two things before I go down this road
1) Please be aware that I know what I am. I am hysterically well informed on the matter thanks to a lot of involvement with the AMA on matters of medical education (I guess more tangentally involved in this specific issue, but still), but all that does is make me a comical online know-it-all. I can get annoying, but I also have no horse in this race as my entire medical career has been basically devoured by the AMA and I am their stats boy. So I like the numbers of it all. This is something where there are rarely hard numbers, but I can quantify trends in a broad sense. But please, don't take me too seriously. I'm just here to make sure there is some moderation of extreme thoughts, but never to actually anger people. Please imagine me this ridiculous, because I imagine myself this way when I get this dorked out in a conversation:
2) IDK who pooped in your cheerios today, but dont mistake me responding to you (because I enjoy the debate) with me agreeing that *anyone* has said any of the things youre suggesting. They havent. You applied your own bias to not-even-all-that-ambiguous comments and came away with an impression that I dont think anyone else did. IDK why you got so cranky over it, but you did. It might be more appropriate to step away at this point, as nothing said here will scratch whatever itch is driving you nuts. It will only make you more aware of that itch that drove you to take a normal comment and see something angering in it. And you'll start seeing similar comments everywhere as the itch that is not scratched is irritated more and more with each comment where people disagree with you because you're the one out in left field here, but maybe 'we all just cant see it'.
Perhaps in the pre-med frame of mind, but elsewhere on SDN, including the osteo forum, it's all about DO discrimination and skepticism.
This is the only appropriate response to that. If i were to select a forum between pre-osteo and osteo where there is more negativity... it would be pre-osteo. By a mile. By two miles. By 3.2 kilometers for the canadians and europeans out there. The osteo forum is, again, an overwhelming number of people blowing smoke up each others butts and a lot of loss-of-touch-with-reality. Just go to the match thread (oh wait its this one) and read the responses to every match list. One or two are "above average" most are mediocre. One or two are downright bad. None are "Solid". What am I comparing it to? I'm comparing it to the last 3 years. This was somewhat of a letdown year. Looking at the match lists as a whole (I dont get stars in my eyes from a tiny number of people being outliers. They kicked ass, but 'they' are not the match list), this was a plateua year for DOs, didnt really gain much footing, though the percent in ACGME rose a bit, the raw data doesnt make me feel that the rise represents anything more than a shift in where the applications are going.
There are tons of reasons to be optimisitc. But this place is *too* optimistic. They ignore the facts in favor of potential futures. They dont celebrate what is occurring and instead fantasize about what could occur. At least the pre-osteo knows well enough to focus on the present.
I could not disagree more strongly with your assessment.
This sentence is an example of why people like me get annoyed. Instead of accepting that I fully understand and appreciate the issue and just simply disagree with you, you assume that any disagreement is due to lack of understanding or experience.
I specifically said that I didnt think you appreciated FULLY the subtley of it. I was well aware of who you are and knew you understood how match process works. I was arguing that you
heavily oversimplified the argument by saying that the only thing that is suggested is that a place that hasnt had DOs never will. I was fleshing out how it can take decades for a program that has never had DOs to re-evaluate considering to interview them. How a decision made in the early 2000's with the advent of the ERAS system allowing for automatic filters to be put up can lead to never seeing a DO applicant for since then. If they get more applicants from MDs then they can ever possibly see and have no issues filling their program early in their rank list, they have no reason to expand their applicant pool. This was literally described to me by the program director at my program when he was commenting that when he took over for the old director they had some filters that prevented any DO from having their application even seen, but it was a drop in how far down their rank list they went that lead to them changng that filter and now they take a DO (on average) every year, but if they didnt have a tough year in 2009, they still would interview exactly 0 DO's.
I didnt even disagree with you on your comment. Anyone who *does* feel the way you accused people of feeling is objectively an idiot. But outside of trolls like the guy whose avatar was sheldon from Big Bang Theory, I've never seen ANYONE here suggest anything even CLOSE to that. Everyone here is all about how if youre the best candidate you'll get an interview because no one can ignore a damn good USMLE score. Excep everyone says that ad nauseum no one actually remembers that most places that have never had DOs don't have them because they filter their applications out... not because they are waiting for some "super DO" applicant to show up. They wouldnt see that application. They need a *reason* to re-evaluate their filters befre the take the DO filter off. That is the overlooked caveat. Directors who made a poor/biased decision 13 years ago dont need to change it today if it has yet to cause any problems with their ability to get the candidates they feel they deserve.
Please list specific programs.
Lets get urology out of the way in one smooth move: There are 123 AUA approved urology programs for a grand total of ~270 spots in the US. This is a list of programs that have EVER interviewed a DO in the last 10 years: Brookdale, Brooklyn Hospital, North Shore-LIJ, NEOMed, Georgia HSU, University of Kansas, UTGalveston, Wayne State, Virginia Commonwealth, Southern Illinois, Mayo Clinic, Brown, Indiana, Minnesota, U of South Carolina. 15 programs have ever interviewed a DO. only 10 of them have ever taken one. So 108 programs have never even seen a DO. and 113 have never taken one. And 3 of those sites only ever interviewed the same DO (who was beyond belief spectacular and is a fellow now. I met him. Blown away.)
I would like to think 108 hospitals already eliminates your veryx4 few. But lets just throw a few more in there off of the top of my head:
Any program not named ObGyn, PM&R or Anesthesia at Columbia, Cornell, NYU-Langone, or Mt. Sinai (main campus, not SLR). Its to the point where NYU came to my school for a resiency fair and flat out said that their IM, Surgery, and EM departments will not look at any DO applicants on principle and to save our application money as we wont make it past the ERAS filter (the first time anyone ever taught me about the filter); but his job was to sell PM&R and to convince us that their refusal to *train* DOs doesnt mean they wont *hire* them post-training. He was not unclear with his words. He straight up said it.
So that brings the total to probably about 140 programs. And thats just urology + programs in manhattan (aka the smallest county in the US)
Where are the stats for interviews? I'm unaware that those exist.
It exists for urology. DOs applying for urology number between 50 an 65 every year. We are a very smallgroup and we always find each other. I am personal friends or correspondance-buddies with 30 applicants (not all successful) from the 2011 class. all 61 applicants from the 2012 class. All 67 applicants from the 2013 class. 49 of the 57 applicants from the 2014 class. And I know 13 highly serious candidates from the 2015 graduating class. Plus the various older residents (so 9 or 10) from the classes of 2008-2010 and one fellow from 2007. They've kept a conglomeration of information from years ago that they keep passing on to each following year about who has interviewed ever and how many times theyve interviewed DOs. Since the group is so small each year, and since the competition is so high (the 50-65 people compete for 17-20 DO spots and 2-3 MD spots per year. As said before, those 2-3 are always at the same 10 places), we can track that info to apply smarter.
It doesnt exist, I would assume, for any other field. But it is realistic to assume that 90% of all IM programs have taken a DO at some point, or at the least have seriously ranked one at some point. But fields like urology are exactly the opposite.
Also, I said "outwardly," as in they have a policy to never take DOs. Very, very, very, very, very few programs come out and say they won't take a DO.
You havent bothered to ask the programs have you? I did. For both urology and EM. They are VERY forthcoming about not ranking DOs if you ask them. They honestly want you to save the money because the program doesnt get the application money anyway, and the filter auto-trashcans it. So it doesnt hurt them at all to tell you the truth. They dont post it on their website, but they do outwardly admit it. NYU straight up says it at residency fairs held at osteopathic schools (theyve said the same thing at NYITCOM/NYCOM too, circa 2009/2010).
And for the record, I ran into 7-8 EM programs who said they absolutely will not even look at DOs. Out of about 50 I contacted. It wasnt even the 'elite' programs. It was just ones that you sort of 'knew' had no problems filling because they had some catch (usually being the only program worth its salt in the state, or they paid exceptionally well).
Now some of you look at the ones who haven't taken DOs in the past to mean they don't take DOs.
Don't worry I'm not.
What you fail to understand is that that's conjecture. You can make an argument that it's conjecture based on past behavior and therefore, valid, but regardless, it's still conjecture. I'm certain JH has never taken a DO for derm before.
I would not disagree with you. I would say that in the absence of actually asking the program or sitting outside of their interview sessions and polling the candidates on where they came from, conjecture is all you have. But I also think that anyplace that interviews DOs will eventually get one. Using past match data has limitations and it only takes one "positive" to prove the point, but requires years of negative to support the null hypothesis... but in a large enough sample size, you will eventually assume it approximates the truth.
Obviously, if someone matched derm there this year, that means that JH had no policy/filter/whatever against DOs.
We literally have no proof or reason to believe someone matched derm there. Someone DID match ACGME derm. Everyone agrees with that. The comment that followed was that *no one* seems to agree
where at and ONE of the theorized locations was JH.
Yet, using your logic, one should have assumed that before this year.
Sort of need to actually have a person there before you use a theoretical person there to argue against my point. But I also never said JH definitely had a filter. JH is a unique situation where its main campus never takes DOs for anything except some of the "DO-friendly" field, but their afffiliate hospitals are full of DO residents in all fields. Its one of those places where you wonder if the affiliate hospital trend will leak over to the main campus at some point soon. So I wouldnt expect the filter to be there, but also wouldnt be shocked if it was for many main campus programs.
No, it's really not. At least not once you leave pre-osteo and especially not on the allo side.
I should have said osteo on SDN. But you sortof proved my point. Later on I said if you thought osteo was bad (its not) you'd end up on suicide watch in the allo thread (I see you're familiar). But I cannot wrap my head around how you think pre-osteo is optimistic. That forum makes me depressed and I already graduated.
What makes you think I haven't?
Because if you have visited the allo forums and think it is pessimistic here, then you live in a bizarro world from my point of view.
What delusional optimism is that?
That everything will change overnight and be better. There are people, which I admitted to, who follow in the great internet trend of anonymous negativity and venting. But they are MASSIVELY outnumbered in this forum. The only explination I have for how you dont see that is you must have a sensitivity for the negativity, because objectively looking at it, the pessimists are a very small minority here. But if ever pesimisstic comment stings you in the heart and every optimistic comment seems innocuous to you, I can see how you'd see it differently. Those negative people sya it will never change. That the problems of DO world are intractable. There are probably met one-for-one by people who say it is a process that takes time but is consistently moving forward, and outnumbered 5 or 6 to 1 by people who are just farting rainbows and optimism about how its all going to change *tomorrow*.
IDK who is right. But I clearly identify with the middle so both the pessimists and the optimists annoy me with their cynicism despite evidence/optimism despite evidence. I can tell you the blind optimists MASSIVELY outnumber the pessimists or middle-grounders. You wont see that in the other forums where its a more even split (and negativity is always a bit more visible because its a bit more abbraisive)
Thread after thread about the degree change, threads saying that certain programs won't ever take a DO, threads complaining about the COMLEX for the umpteenth time, etc don't seem nauseatingly optimistic to me. And when it's reported that someone dared to match derm at a good program, it's met with skepticism as if it can't possibly true because there's no way that would happen.
Go and read the threads. The degree change thread is two optimists fighting each other. The "we will succeed as we are" group and the "We can succeed even quicker with this change" group. No one ever says they want to do it because DO is failing. They say it because they feel DO has been such a dramatic success that it needs to distance itself from the less-successful past.
Threads complaining about programs that wont take DOs are drowned out by the chorus of "just be the best candidate and no one will overlook you". Which is poppycock. It might apply to *most* programs, but as long as certain things like the filter exists (or the general opinion of 90% of all urology programs) that above comment is a phrase people say but isnt actually true. "Be the best candidate you can be and you'll get the program you deserve" is the truth. If you are unhappy with what you get, then you misjudged what you actually deserve in nearly all cases.
Maybe read the thread again? The person who initially heard it, laughed thinking it was a joke. The person who replied to it also said they thought it was a joke. Maybe it was and maybe it wasn't. Who knows? But my point is, why assume it's a joke? Because of the misconception that Hopkins would never ever take a DO?
I know exactly where it came from. Had to re-read it before my first comment to make sure I wasnt mispeaking. So, the same comment back at you. Re-read it. No one said it was a match at JH. They said it was a match at an unknown place and someone heard, among other options, that it might be JH. They thought it was a joke because every year there are 2-3 of these per school that are massively misunderstood. We got excited just last year for not one but two matches to Yale IM. one of them was an Yale affiliate and the other was a damn AOA spot near new haven. For probably a week we were all excited over these two shocking matches. They were both misunderstandings. Dont even get me started with how many people are currently practicing surgery and IM at Columbia ('s Connecticut affiliate). It gets confusing with that one because the match says "Columbia University Hospital, Stamford CT) and people either dont read to the end, or the location gets parsed and just Columbia University Hospital makes it onto the listing that gets posted here.
If there is a total lack of information and there is only a rumor that it might be something hard to believe, I'd always assume that its the yearly allotment of misinformation per school rather then its a mind-blowing match that ocurred to someone and they immediatly deleted Facebook and lost the ability to talk or text since no one knows who it happened to or can confirm it actually did happen at all. Unless you guys have a autistic loner in your class who refuses to join facebook, doesn't have friends, and is REALLY into skin. Then I'd buy that they matched there and told no one.
Look, the point is that it's been proven time and time again that DOs can match into any specialty and at the vast majority of programs and when someone does break the ceiling, it's disheartening that people think it's a joke.
You use "proven" very lightly. Also "can" as in "can match into any specialty". Does one person per year prove something? Two people? Whats the 'n' needed for something to be proven for >5,250 people per year? And is the burden of proof that it can be done reliable by a lot of people per year? Reliably by a few people per year? Reliably by one person per year? Every few years by a person? Once or twice ever by anyone? At what point does something go from an outlier, and we all know from week 1 who the outliers are in our classes, to being something "proven".
For me, I can understand if someone says something is proven that it can be done the second the first person ever does it. But that is such a low threshold for success that I feel like that can only be applied to an individual program. E.G. a DO can match to derm at JH because x did it. Not... a DO can match to Derm becaus x matched to JHs.
And mind you, I do believe DOs can match to allo derm. ~3-4 do it every year last time I checked. Same way 2-3 match to urology every year. But to me those people are ridiculous outliers that even "competitive applicants" cant come close to. The DOs matching to allopathic urology all had insane board scores and two of them took an entire year off just to do research with a major allopathic program betwen 3rd and 4th year. Let me reiterate *insane* USMLE scores. 98th or 99th percentile in america scores (not 2 point score. Percentile score.). You *know* if youre that kind of person. 5,230 of us are not the 20 of us who will get these insane residencies. I dont consider their accomplishments indicative of anyone else's potential until I start seeing a trend or unless you are only framing it as "it is not impossible to match here as a DO." which really.... you should put
impossible in italics in that sentence, if we're using the cases I'm referencing. IDK anything about the characteristics of potential JH derm person, but to be fair... no one seems to know either.
This goes back to my first point that you assume those who disagree with what you say are either clueless or don't have the experience you do.
Not really. I'm here to simply make sure the 1st years reading along have a moderate voice that (tries to) remains grounded in the stats of it all. I found that the extremes on this board, especially the extreme optimism, overstated the realities. I never assume anyone is wrong. I assume they are letting emotion or anecdote make them realize that the plural of 'anecdote' is not 'proof', and the abundance of emotion does not mask a void of evidence. Evidence no one (myself included) has. Emotion makes for a better story, and more firey argument, but it does not make proof for any side. This isnt necessarily event pointed at you. Its just how I always function. I try to bring the facts to the table and anyone who seems to be leaning heavily on anecdote or flaring up with emotion draws a response out of me the way peanut butter on a snap trap draws interest and immediate death to the mice in my basement. Its an irresistable stimulus of interest to me.
No one said there aren't false match results floating around. In fact, I said EXACTLY the opposite. I said there ARE false match results, which is why no one knows what's real until the official match lists come out.
But thats *not* what you said. That what you think you said. What you said was equating someone mentioning a rumor floating around with no proof at all with data released on the unofficial match list. Even if a match list is unofficial, it carries more weight than hearsay that didnt even make it onto the list. You commented that nothing is known until its official, but why do we doubt the heresay but believe the unofficial list. The answer being, the unofficial list probably came from either students self-adding or the admin themselves (as my old schools unofficial list came from the admin themselves). The heresay came from nowhere until someone can confirm any part of it.
Yet another case in point.
This was fun... but idk what to do now.
) ACGME hospitals. Its even so bad that there is an entire PGY-2 prelim system in surgery for people who still have no programs and havent figured it out that surgery is not as bright and sunny as medicine is for its prelims. Obviously there are success stories, but surgery is a field where pedigree is everything, and its hard to compete with Ivy league prelims who leave after doing an intern year and B&W, AND a research year (oh yea... harvards prelim program is two years. year 2 is a research year. This is not uncommon at the super-top-teir surgical programs)
