MD vs DO rotations

[RopingDoc]

I am currently in the application cycle and have applied to both MD and DO schools. After visiting with an MD, he raised the concern that DO rotations are probably lower quality and less organized around learning for the students. Is this true/relevant? What are the differences between attending an MD school with teaching hospital rotations vs a DO school with "community" rotations where the student simply joins a clinic etc? Do DO students get told to "sit in the corner and watch" as this MD suspects? Interested in hearing the pros/cons for both sides. I am interested in neurology, internal med, and emergency medicine at this point.


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[mimelim]

It is an ignorant/bias MD as DO rotations have no difference with MD rotations.

I disagree. I think that the answer needs to be much more nuanced.

Rotations for MD and DO students are setup in a similar fashion. Thus, there is no blanket, "MD students do stuff and DO students sit in the corner". However, I think that it is naive to think that clinical rotations are equal at each school. There is a tremendous variation between MD programs and there is a tremendous variation between DO and MD schools. You can have great preceptors at every different type of clinical location, whether it be large academic university teaching hospital or rural clinic. But, when it comes to averaging things out and the resources and locations generally available to students, your clinical education is going to be better served at most MD schools. I'm sure that there is plenty of overlap, but having seen the "best" of DO school's clinical offerings, they always fall well short of the MD schools I have spent time in and around.

 

[Lawpy]

I disagree. I think that the answer needs to be much more nuanced.

Rotations for MD and DO students are setup in a similar fashion. Thus, there is no blanket, "MD students do stuff and DO students sit in the corner". However, I think that it is naive to think that clinical rotations are equal at each school. There is a tremendous variation between MD programs and there is a tremendous variation between DO and MD schools. You can have great preceptors at every different type of clinical location, whether it be large academic university teaching hospital or rural clinic. But, when it comes to averaging things out and the resources and locations generally available to students, your clinical education is going to be better served at most MD schools. I'm sure that there is plenty of overlap, but having seen the "best" of DO school's clinical offerings, they always fall well short of the MD schools I have spent time in and around.

So MD schools have in general better quality of clinical education than DO schools. Could this be linked to the stricter LCME regulations and quality check or is it largely independent of that?

 

[SpartanWolverine]

My DO rotations are at a hospital with MD students from nearby universities (University of Michigan, University of Toledo) as well. So, there is absolutely zero difference in a good number of our rotations. Of course this will vary by school -- so do your due diligence in researching the rotations at schools you are applying to; I don't expect my N=1 experience is indicative of the wider picture.

What you get out of a rotation, however, will depend mostly on how proactive you are in the hospital and how interested your preceptors are in teaching. Sadly the second of these factors can vary widely.

 

[Lnsean]

So MD schools have in general better quality of clinical education than DO schools. Could this be linked to the stricter LCME regulations and quality check or is it largely independent of that?

Nah...I think it just boils down to the pure competition that these MD programs have with each other to be in the top spot and as such their is a progression or shift of the curve towards the right for all of them.

 

[libertyyne]

This is a legitimate question. Most newer DO schools will have poorer rotations compared to their MD brethern. Some DO schools may be blessed based on location and historical relationships with hospitals where rotations can take place such as Michigan State DO, others scramble to get enough sites. I am unsure if the quality of electives also changes due to the above states reasons. This may be another reason for placement gap in residencies between DO and MD schools especially for ultra-competitive specialties and inherent bias in the residency programs for MD applicants. This is probably the most defining characteristic and difference most MD and DO schools besides an almost sadistic obsession with OMM at some DO schools.

 

[Psai]

It is an ignorant/bias MD as DO rotations have no difference with MD rotations.

lol no it's not. There is a clear difference and you're doing applicants a disservice by misleading them

 

[Brorthopedic]

On average, MD schools are going to have better rotation sites than DO schools. At my DO school, there's a nearby MD school that's trying to share our rotation spots, but the vast majority of their students end up in a small, community hospital because it's a relatively new school. Again, this isn't the norm as my school has a long history with the surrounding area.

Obviously go with an MD school, statistically you're gonna end up with better rotations, but if you end up going the DO route, make sure the school has a history of an established presence in the area and you'll be fine.

 

[DrBowtie]

My DO rotations are at a hospital with MD students from nearby universities (University of Michigan, University of Toledo) as well. So, there is absolutely zero difference in a good number of our rotations. Of course this will vary by school -- so do your due diligence in researching the rotations at schools you are applying to; I don't expect my N=1 experience is indicative of the wider picture.

What you get out of a rotation, however, will depend mostly on how proactive you are in the hospital and how interested your preceptors are in teaching. Sadly the second of these factors can vary widely.

This is relatively common. At my med school this one rotation with overlap was our "community" health rotation with the remainder at our academic medical center. The site was a core for the DO students and made up the majority of their experience. Not exactly equal rotations.

 

[RogueUnicorn]

It is an ignorant/bias MD as DO rotations have no difference with MD rotations.

You're out of your depth here and incorrect.

DO schools on average absolutely have worse rotations, and the difference in my opinion/experience is not small. This is largely a function (again, opinion) of the fact that most DO schools are very new in relation to the MD schools and therefore most good rotations have been taken up, more or less permanently, by the old guards.

This is not a statement regarding DO/MD student's inherent or extrinsic qualities or abilities, but to me at least it's quite apparent that many DO schools (and some MDs too) are doing their students a huge disservice with their clinical education. No matter where you do your endocrine rotation, you'll see diabetes and hypothyroidism. But will you see Kallman's or MEN-2 or whatever else? Probably not unless you are rotating at a tertiary referral center. This shows when you're a resident.

 

[SpartanWolverine]

This is relatively common. At my med school this one rotation with overlap was our "community" health rotation with the remainder at our academic medical center. The site was a core for the DO students and made up the majority of their experience. Not exactly equal rotations.

Absolutely, that makes sense; what you describe sounds like a typical structure and I certainly understand the limits of a community hospital. I just want to clarify that at my site we share - at least from what I've done so far - core surgery, OB/Gyn, and EM rotations. Our school gives us the option to be based at level I trauma centers, if that's what interests us, or other hospitals that overlap all rotations with our MD counterparts that are based there (e.g., Wayne State at DMC or MSUCHM at Sparrow/McLaren). So, short of being at U of M and their academic medical center - which I place on a different tier - our DO rotations are just as good as any of the other MD schools in the state. Of course I don't pretend to think that all DO schools have a similar setup (but I am rather uneducated as to the structure and quality of other DO school rotations).

Basically, to the OPs point, being at a DO school does not necessarily mean that your rotations will be poorly organized or lower quality than your MD counterparts.

 

[username456789]

It is an ignorant/bias MD as DO rotations have no difference with MD rotations.

This isn't completely not true and exposes your ignorance.

 

[username456789]

Can we now frame these replies to the OP's original question: MD and DO rotations are essentially the same in structure, style and instruction. That is, you will have mentors/preceptors that expect you to actively engaged in the process equally in both MD and DO rotations. You will not be sitting in a corner and told to watch. In both cases you will actively learn medicine

As has been described above, the "quality" of the rotations can be different for several reasons.
1) MD schools tend to attract higher caliber instructors, students, etc, due to the selectivity in admission to the profession and this may lead generally to higher quality in both giving and receiving instruction. Conversely, DO instructors and students have slightly less selectivity to the profession.
2) MD schools tend to be better funded and associated with larger, more indepth teaching/university hospitals and thus more varied and indepth specialists as well as cases, thus having more opportunities for wide and varied rotation. Some DO schools, especially those in urban areas, are now approaching this level so the differences are minimal
3) Both MD and DO schools can vary across both types as individual institutions.
4) As the historical osteopathic hospitals are consumed by larger medical centers and residencies are merge, and the selectivity of DO schools continues to increase, it is likely that these differences will lessen over the next 10-20 years. BTW, this was the basis of "Physician 2015," a project started in the late 1990s to merger the MD, DO and DPM, which ultimately led to the merging of residency systems

In the end, both MD and DO students will receive similar general rotations instruction and will learn medicine at most institutions without significant difference in the structure or style.

A glaring difference is that many DO students complete their rotations at hospitals with little to no residency presence. That is, they are working with attending but not learning how to act, think, or function as a resident and ultimately as a physician.

I've used this analogy before, but it's like a pilot taking his 10 year old son into the cockpit. The kid will have a fun time pressing all the buttons and think he's acting like a pilot, but he is no more able to fly the plane after the experience.

 

[RogueUnicorn]

which is precisely what I said in my point #2.

However, to OP's question, the style, structure and general instruction are similar in both MD and DO. You are not just sitting in the corner and just watching.

Your post #2 is a poor paraphrase of mimelim's post that preceded it.

The style, structure and general instruction are similar in RN and MD programs, that's not at all what is being discussed here; please stop obfuscating the issue

 

[Goro]

Can you elaborate on this, colleague?

I'm sure that there is plenty of overlap, but having seen the "best" of DO school's clinical offerings, they always fall well short of the MD schools I have spent time in and around.

 

[Goro]

I have to agree with my learned colleague here and with username. The stereotypes mentioned above are real, and are sadly more common at the newer schools. This is why I can't recommended Wm Carey to anyone looking to attend DO schools. This will not go away until the AOA stops its mindless "more DOs good" mentality, and directs COCA to place an emphasis on the quality of clerkship training.

The days of the cult of Still are over, and the prejudices seen here against DO are now based more appropriately on the quality of training. Unfortunately, all DOs are tarred by the same brush, even if they come from good training programs. Pay attention, AOA.

N

No, it's not.



Actually there are plenty of reports of DO students doing exactly that. Doing their "Internal Medicine" rotation with an outpatient preceptor in a strip mall doctor's office. No core didactics, no consistency.

You're way out of your depth and giving blatantly misleading information here.