Plastics and Dermatology

[labqi]

Hey guys
I hope all is going well in your respected careers and school. I am planning to apply to MD and The DO program this upcoming cycle. I was wondering if DO students have a similar or a competitive chance in achieving residencies in dermatology and/or plastic surgery.

Thank you in advance

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[SLC]

Hey guys
I hope all is going well in your respected careers and school. I am planning to apply to MD and The DO program this upcoming cycle. I was wondering if DO students have a similar or a competitive chance in achieving residencies in dermatology and/or plastic surgery.

Thank you in advance

I'm rotating in Plastics right now at a community hospital. There are two surgeons, and two dermatologists in the office.

Both the plastics guys are telling me to do Anesthesia, saying that Plastics (at least integrated plastics) is virtually impossible as a DO. Which is sad because they both say I'm far better than any other med-student they've taught (and they regularly teach students from the local state MD).

They also say Derm would be good, but Derm isn't something you just decide to do at the beginning of your 4th year so I wouldn't be getting into that anyway.

So to answer your questions:

1. Integrated Plastics is probably futile as a DO grad. Unless there are AOA integrated plastics residencies, I don't know if there are. But you can forget matching integrated plastics in an ACGME program.

2. Plastics fellowship after general surgery: I can't say for sure but I'd assume this is doable. No idea how doable exactly though.

3. Dermatology: Highly unlikely as a DO in an ACGME program. Though there are one or two most years who do it it seems. However, Derm is a pipe dream for all but the a particular subset of highly motivated MD students too. Derm in the DO world is sort of like a fellowship that I think can be completed after a FM residency; but the training isn't good and you'd be best served to forget it even exists.

If you're certain you'd like to be in one of these fields, you'll be smart to go to the best MD program you can get into. And even then, you're going to have to busy your ass way more than the rest of us to have a shot.

 

[deleted480308]

http://thedo.osteopathic.org/2012/0...e-pays-in-highly-competitive-lucrative-field/

 

[BestDoctorEver]

@SLC ... It is crazy ACGME PDs can't get away with discriminating against a degree... Are you telling me the bottom MD schools (like Howard, Meharry, PR schools) would do better than a top DO school when applying ACGME integrated plastics?... assuming everything else is equal..

 

[SLC]

@SLC ... It is crazy ACGME PDs can't get away with discriminating against a degree... Are you telling me the bottom MD schools (like Howard, Meharry, PR schools) would do better than a top DO school when applying ACGME integrated plastics?... assuming everything else is equal..

Yes, that's correct.

I used to get upset about stuff like this. Especially when I realized that there were IM programs I was looking at that required higher board scores from DO's than MD's. It's one thing to have those expectations privately; quite another to state it publicly on your website.

But I got over it. When you think about it, the ACGME currently exists to accredit GME for MD students. Us DO's have our own AOA programs and right now we don't even allow MD students to apply. Knowing that, I can't get too worked up when an MD program has a preference for an MD graduate, that should be their focus after all. They don't exist to provide DO's with GME opportunities; it just so happens that they allow it, and there are enough spots for many of us to train with them. We should be grateful we are even allowed into ACGME programs in the first place; they don't have to have it that way.

If and when the GME merger gets finalized, my opinion will change. Until then, it's fair IMO.

 

[BestDoctorEver]

Yes, that's correct.

I used to get upset about stuff like this. Especially when I realized that there were IM programs I was looking at that required higher board scores from DO's than MD's. It's one thing to have those expectations privately; quite another to state it publicly on your website.

But I got over it. When you think about it, the ACGME currently exists to accredit GME for MD students. Us DO's have our own AOA programs and right now we don't even allow MD students to apply. Knowing that, I can't get too worked up when an MD program has a preference for an MD graduate, that should be their focus after all. They don't exist to provide DO's with GME opportunities; it just so happens that they allow it, and there are enough spots for many of us to train with them. We should be grateful we are even allowed into ACGME programs in the first place; they don't have to have it that way.

If and when the GME merger gets finalized, my opinion will change. Until then, it's fair IMO.

I was furious too when I saw an IM program in NY (not 100% sure) that stated on their website that they DON'T accept DO applicants... I never thought it was so crazy like that and PDs won't even be discrete about it... I had acceptances from both MD/DO and chose MD due to COA only, and I did not think the DO degree would limit me on anything even if I saw stories in SDN that said otherwise because I thought people in here exaggerate stuff most of the time...

 

[DermViser]

@SLC ... It is crazy ACGME PDs can't get away with discriminating against a degree... Are you telling me the bottom MD schools (like Howard, Meharry, PR schools) would do better than a top DO school when applying ACGME integrated plastics?... assuming everything else is equal..

Yes.

 

[BestDoctorEver]

@DermViser ... There is no basis for a nonsense like that. If ACGME PDs think DO are good to be IM/FM/Psych/EM/Ortho physicians etc..., they should not limit them in other specialties as long as they are qualified for them... Something must be done about stuff like that...

 

[SLC]

@DermViser ... There is no basis for a nonsense like that. If ACGME PDs think DO are good to be IM/FM/Psych/EM/Ortho physicians etc..., they should not limit them in other specialties as long as they qualified for them... Something must be done about stuff like that...

Something is being done. Our GME is slated to merge soon; meaning there won't be DO residency or MD residency, there will just be "residency".

If the ACGME is going to represent DO's, then I fully expect DO's to be given equal "access" to residency programs. Meaning there better be a requirement that programs can't refuse to interview DO's (or MD's in the case of former AOA programs). And there better be rules against requiring different stats or CV items of DO's and MD's at a program.

That won't fix PD bias, but I expect policies against one type of grad to become against the rules.

 

[ChEMD]

@SLC ... It is crazy ACGME PDs can't get away with discriminating against a degree... Are you telling me the bottom MD schools (like Howard, Meharry, PR schools) would do better than a top DO school when applying ACGME integrated plastics?... assuming everything else is equal..

The thing is, neither of those groups are going to be successful in getting integrated plastics.

 

[DermViser]

@DermViser ... There is no basis for a nonsense like that. If ACGME PDs think DO are good to be IM/FM/Psych/EM/Ortho physicians etc..., they should not limit them in other specialties as long as they are qualified for them... Something must be done about stuff like that...

Why would ACGME PDs in Derm or Plastics care what PDs in other specialties do? It's irrelevant. No specialty's PDs care what PDs in other specialties do.

 

[BestDoctorEver]

The thing is, neither of those groups are going to be successful in getting integrated plastics.

Not sure about that cause I know someone from a PR school that got into Neurosurgery in the mainland, which I heard can be as competitive as integrated plastics... Would that be impossible for a DO to match into an ACGME neurosurg?

 

[DermViser]

If the ACGME is going to represent DO's, then I fully expect DO's to be given equal "access" to residency programs. Meaning there better be a requirement that programs can't refuse to interview DO's (or MD's in the case of former AOA programs). And there better be rules against requiring different stats or CV items of DO's and MD's at a program.

That won't fix PD bias, but I expect policies against one type of grad to become against the rules.

The merger does absolutely nothing to fix Program Director preferences. You are fully free to submit your application. It doesn't mean the PD will choose it for interview, regardless of merger or not. PDs can require anything they want of their applicants, whether that be class rank, Step score, etc.

 

[BestDoctorEver]

Why would ACGME PDs in Derm or Plastics care what PDs in other specialties do? It's irrelevant. No specialty's PDs care what PDs in other specialties do.

I understand that but my point was that there should not be stuff like that at all...

I guess I am a little bit upset about it because I almost chose a DO school and I did not think it was going to limit in anything, though I am not interested in any of these competitive specialties...

 

[SLC]

The merger does absolutely nothing to fix Program Director preferences. You are fully free to submit your application. It doesn't mean the PD will choose it for interview, regardless of merger or not. PDs can require anything they want of their applicants, whether that be class rank, Step score, etc.

I already addressed this...and acknowledged it as fact.

I simply expect the merger to prevent programs from having formal institutional policies against interviewing candidates based solely on their degree. PD's may still have preference, but NYU IM (for example) had better not be allowed to continue to have an official "No DO" policy. And formerly AOA programs had better not be allowed to have rules preventing MD's from being considered for interview.

 

[DermViser]

I already addressed this...and acknowledged it as fact.

I simply expect the merger to prevent programs from having formal institutional policies against interviewing candidates based solely on their degree. PD's may still have preference, but NYU IM (for example) had better not be allowed to continue to have an official "No DO" policy. And formerly AOA programs had better not be allowed to have rules preventing MD's from being considered for interview.

It's not formal and it's never been. It's mainly been informal. NYU will probably take it off their website, but they will still practice the same policy. At least now, D.O.s know not to waste their money on NYU bc it's stated directly.

 

[ChEMD]

Not sure about that cause I know someone from a PR school that got into Neurosurgery in the mainland, which I heard can be as competitive as integrated plastics... Would that be impossible for a DO to match into an ACGME neurosurg?

Integrated plastics is a unique beast in a league of its own. Neurosurgery, while competitive as well, is not on the same level for whatever reason.

 

[labqi]

Something is being done. Our GME is slated to merge soon; meaning there won't be DO residency or MD residency, there will just be "residency".

If the ACGME is going to represent DO's, then I fully expect DO's to be given equal "access" to residency programs. Meaning there better be a requirement that programs can't refuse to interview DO's (or MD's in the case of former AOA programs). And there better be rules against requiring different stats or CV items of DO's and MD's at a program.

That won't fix PD bias, but I expect policies against one type of grad to become against the rules.

Thank you all for your responses. I didn't think it was this messy when it came down to residencies. How soon is the merger supposed to happen? Is it beneficial to apply when the merger has occurred so we have more opportunities?

 

[SLC]

Thank you all for your responses. I didn't think it was this messy when it came down to residencies. How soon is the merger supposed to happen? Is it beneficial to apply when the merger has occurred so we have more opportunities?

If you are just applying for medical school now. The merger will either have taken complete effect by the time you apply for residency, or it will be scrapped completely.

That still doesn't mean you're suddenly going to have an equal chance at Integrated Plastics as the Columbia Grad with a stellar application. But you won't have that at a lower tier MD school either.

 

[SLC]

It's not formal and it's never been. It's mainly been informal. NYU will probably take it off their website, but they will still practice the same policy. At least now, D.O.s know not to waste their money on NYU bc it's stated directly.

If it's on the website, it's a formalized policy.

 

[DopaDO]

There are some DOs who have matched integrated plastics. It's just a ridiculously competitive field no matter what your degree is in. If you get a high 250s step 1 you def have a shot. A guy in my class is gunning for plastics, he has a 260 + Step 1

 

[hallowmann]

It's not formal and it's never been. It's mainly been informal. NYU will probably take it off their website, but they will still practice the same policy. At least now, D.O.s know not to waste their money on NYU bc it's stated directly.

Yeah, but when it is a stated formal policy, there's no chance of changing it. Its culture and law. Culture can change over time, law is much harder to. When they take it off the website, that opens the door just a crack. All you need is the right confluence of factors (a particularly high stat DO candidate, with the right connections, etc.) to bust the door open. After that, making a trend is much easier because they've already had to justify interviewing and taking one DO. I've seen it happen before.

 

[DrEnderW]

I agree with most of the comments above.

Integrated plastics is essentially 0% chance for DO students and it's not worth being a part of the plan. AOA residencies for ENT also have the label facial plastics so that is a viable route with an additional fellowship afterwards.

It's reasonable for DOs to match ACGME general surgery and if you're at a university program and compile a competitive CV, a plastics fellowship is possible.

I don't know much about AOA derm aside from the fact that some positions have horrible funding and are in private practices. I would not gamble a career on that route. I'm sure there are decent programs though but the spots are extremely, extremely limited.

@DermViser is dead on about the merger. This should not change anything in the near term (in my opinion) and should not weigh in your decision. Long term impact is another conversation for a different thread.

 

[SurgeDO]

plastics fellowships--even top programs--are open to DOs. they have been for years.

integrated programs are hard to match for anyone regardless of the degree. there are multiple DOs in integrated programs--even academic programs--around the country. i will not mention the programs for my own selfish reasons.

 

[DrEnderW]

i will not mention the programs for my own selfish reasons.

Don't shy away from sending me a PM tho...

 

[BurghStudent]

I believe there are some AOA-accredited plastic surgery residencies/fellowships, PCOM seems to have a plastics residency:

http://opportunities.osteopathic.or...program_id=126227&hosp_id=118562&returnPage=1

 

[cliquesh]

I believe there are some AOA-accredited plastic surgery residencies/fellowships, PCOM seems to have a plastics residency:

http://opportunities.osteopathic.or...program_id=126227&hosp_id=118562&returnPage=1

That's a fellowship. There are 8 DO plastic surgery fellowship programs. Most offer one or two spots per year.

There are 29 AOA derm residencies and there were 45 AOA derm spots offered in the 2014 match.

 

[BurghStudent]

That's a fellowship. There are 8 DO plastic surgery fellowship programs. Most offer one or two spots per year.

There are 29 AOA derm residencies and there were 45 AOA derm spots offered in the 2014 match.

In that case, I guest the best route for a DO to become a plastic surgeon is to enter an academic general surgery residency, and apply for an AOA/ACGME plastics fellowship. It's still possible I guess.

 

[Mass Effect]

There are some DOs who have matched integrated plastics. It's just a ridiculously competitive field no matter what your degree is in. If you get a high 250s step 1 you def have a shot. A guy in my class is gunning for plastics, he has a 260 + Step 1

This. If you're an extremely competitive applicant, it is possible. It's been done before by DOs.

 

[username456789]

I guess I am a little bit upset about it because I almost chose a DO school and I did not think it was going to limit in anything,

Haha, why in god's name would you think something like this?

 

[Instatewaiter]

@DermViser ... There is no basis for a nonsense like that. If ACGME PDs think DO are good to be IM/FM/Psych/EM/Ortho physicians etc..., they should not limit them in other specialties as long as they are qualified for them... Something must be done about stuff like that...

It's not nonsense. It is a way to screen the hundreds/thousands of applicants a program gets. Just like low board scores, no honors in the clerkship associated with the specialty, poor LORs- school and degree are ways. It is similar to MGH IM interviewing everyone from Duke with a 250 step 1 score and only 1 guy from Rosalind Franklin with a 250 (despite there being 5 who applied). The strength of the school/student population and its clinical education are important when you are running a clinical residency. Just because you can memorize some facts for step 1, doesn't mean your clinical education was good enough to be a reasonable clinician.

Were the clinical education actually the same between schools, this would be a moot point. A lot of DO schools don't have their own hospital, send their students all across the country to tiny community program, have minimal in patient rotations and expect to put out a similarly respected clinical product. Were residency about sitting in a classroom and taking standardized tests all day, this wouldn't matter... but it's not.

This is about competition for programs, not about being nasty toward DOs. Those programs that don't have a lot of competition (mediocre IM, FM, psych, EM, anesthesia) consider everyone- FMGs, DOs, etc. Those programs that are very competitive, will consider only the most competitive applicants (ie those with strong board scores, strong LORs, strong grades from a school that they have experience with or is known to produce strong clinicians and researchers).

The onus is on you (not them) to set yourself up well to get a strong residency. Let's not act like people who go to DO schools didn't realize the fact that they couldn't get into the MD schools they applied to and did get into DO schools didn't mean something. In the end , from whatever school you come, all you can do is do well on step 1/clinical grades and get strong LORs and apply smartly.

 

[SurgeDO]

It's not nonsense. It is a way to screen the hundreds/thousands of applicants a program gets. Just like low board scores, no honors in the clerkship associated with the specialty, poor LORs- school and degree are ways. It is similar to MGH IM interviewing everyone from Duke with a 250 step 1 score and only 1 guy from Rosalind Franklin with a 250 (despite there being 5 who applied). The strength of the school/student population and its clinical education are important when you are running a clinical residency. Just because you can memorize some facts for step 1, doesn't mean your clinical education was good enough to be a reasonable clinician.

Were the clinical education actually the same between schools, this would be a moot point. A lot of DO schools don't have their own hospital, send their students all across the country to tiny community program, have minimal in patient rotations and expect to put out a similarly respected clinical product. Were residency about sitting in a classroom and taking standardized tests all day, this wouldn't matter... but it's not.

This is about competition for programs, not about being nasty toward DOs. Those programs that don't have a lot of competition (mediocre IM, FM, psych, EM, anesthesia) consider everyone- FMGs, DOs, etc. Those programs that are very competitive, will consider only the most competitive applicants (ie those with strong board scores, strong LORs, strong grades from a school that they have experience with or is known to produce strong clinicians and researchers).

The onus is on you (not them) to set yourself up well to get a strong residency. Let's not act like people who go to DO schools didn't realize the fact that they couldn't get into the MD schools they applied to and did get into DO schools didn't mean something. In the end , from whatever school you come, all you can do is do well on step 1/clinical grades and get strong LORs and apply smartly.

meh, i agree with some of the things in this post, but i disagree with it overall.

it seems that this post is trying to state that DOs receive an inferior education because of 3rd year rotations. i agree that there are a good amount of DO schools with garbage 3rd year rotations, but there are also DO schools with just as good if not better rotations than MD schools.

the point being made about DO schools not having their own hospitals, while valid, fails to consider that a fair amount of MD schools do not have their own hospitals either. i would even argue that my DO school has stronger affiliations with stronger hospitals than a lot of MD schools.

by the end of 3rd year, all of my rotations will have been done with MD students from respectable, name-brand MD schools. i do not consider this something that makes my education more valuable--just countering the above post.

also, what is with bashing community hospitals? you seem to be so eager to point out the "realities" DOs face without facing the realities of your own. chances are, you will be practicing in a community hospital. i embrace this reality and believe learning at a community (communiversity-esque) hospital is beneficial. my time would be much better spent mastering appendectomies and lap choles than spending my time learning how to perfect a Whipple or some other **** i will see less than 5 or 6 times in my life. mastering bread and butter diseases/procedures is way too often underrated on these forums by those who fail to realize that this is exactly what they will be doing for the rest of their lives.

to add, i recently attended a surgical conference where one of the lectures was dedicated to "choosing the right residency". the lecturer was a surgical director of a large community hospital and was responsible for hiring/granting privileges to new surgery grads at his hospital. he told us a story where he was unable to hire a grad from an ivory tower program simply because the grad did not log enough operations. this grad looked awesome on paper, and despite how much this director wanted to hire him, he simply could not because of hospital policy. who knows how often this happens, but it is something to consider.

 

[hallowmann]

meh, i agree with some of the things in this post, but i disagree with it overall.

it seems that this post is trying to state that DOs receive an inferior education because of 3rd year rotations. i agree that there are a good amount of DO schools with garbage 3rd year rotations, but there are also DO schools with just as good if not better rotations than MD schools.

the point being made about DO schools not having their own hospitals, while valid, fails to consider that a fair amount of MD schools do not have their own hospitals either. i would even argue that my DO school has stronger affiliations with stronger hospitals than a lot of MD schools.

by the end of 3rd year, all of my rotations will have been done with MD students from respectable, name-brand MD schools. i do not consider this something that makes my education more valuable--just countering the above post.

also, what is with bashing community hospitals? you seem to be so eager to point out the "realities" DOs face without facing the realities of your own. chances are, you will be practicing in a community hospital. i embrace this reality and believe learning at a community (communiversity-esque) hospital is beneficial. my time would be much better spent mastering appendectomies and lap choles than spending my time learning how to perfect a Whipple or some other **** i will see less than 5 or 6 times in my life. mastering bread and butter diseases/procedures is way too often underrated on these forums by those who fail to realize that this is exactly what they will be doing for the rest of their lives.

to add, i recently attended a surgical conference where one of the lectures was dedicated to "choosing the right residency". the lecturer was a surgical director of a large community hospital and was responsible for hiring/granting privileges to new surgery grads at his hospital. he told us a story where he was unable to hire a grad from an ivory tower program simply because the grad did not log enough operations. this grad looked awesome on paper, and despite how much this director wanted to hire him, he simply could not because of hospital policy. who knows how often this happens, but it is something to consider.

I generally agree, but MD schools are required to have an affiliate academic hospital for accreditation purposes, so there shouldn't be any LCME accredited MD schools that don't. DO schools don't have that requirement (although now they are required to be a part of an OPTI - so its kind of similar). Whether those hospitals are better across the board than hospitals affiliated with DO schools is obviously not clear, and there certainly are plenty of DO schools with affiliations with very strong university hospitals.

 

[SurgeDO]

I generally agree, but MD schools are required to have an affiliate academic hospital for accreditation purposes, so there shouldn't be any LCME accredited MD schools that don't. DO schools don't have that requirement (although now they are required to be a part of an OPTI - so its kind of similar). Whether those hospitals are better across the board than hospitals affiliated with DO schools is obviously not clear, and there certainly are plenty of DO schools with affiliations with very strong university hospitals.

university of central michigan
georgia medical college
florida state university
university of central florida
florida international university
rosalind franklin
eastern virginia medical school

 

[hallowmann]

university of central michigan
georgia medical college
florida state university
university of central florida
florida international university
rosalind franklin
eastern virginia medical school

university of central michigan - Covenant Medical Center & St. Mary's of Michigan
georgia medical college - Georgia Regents Health System
florida state university
university of central florida
florida international university
rosalind franklin - Rosalind Franklin University Health System
eastern virginia medical school - Sentara Norfolk General Hospital & Children's Hospital of the King's Daughters

The rest (all FL schools, weird?) seem to have what is essentially an OPTI without the O, hence my statement that requiring an OPTI affiliation is kind of similar.

 

[SurgeDO]

university of central michigan - Covenant Medical Center & St. Mary's of Michigan
georgia medical college - Georgia Regents Health System
florida state university
university of central florida
florida international university
rosalind franklin - Rosalind Franklin University Health System
eastern virginia medical school - Sentara Norfolk General Hospital & Children's Hospital of the King's Daughters

The rest (all FL schools, weird?) seem to have what is essentially an OPTI without the O, hence my statement that requiring an OPTI affiliation is kind of similar.

ok. i guess i am failing to see the difference you are making between the affiliations DO schools have with their hospitals and the affiliation central michigan has with covenant medical center, a community hospital located an hour away, for example.

 

[hallowmann]

ok. i guess i am failing to see the difference you are making between the affiliations DO schools have with their hospitals and the affiliation central michigan has with covenant medical center, a community hospital located an hour away, for example.

That's because, I'm not really making a distinction . I agree with you, but one line in your post made it seem like there are MD schools without academic affiliates. The new requirement for DO schools to be affiliated with an OPTI kind of eliminates the difference.

 

[Mass Effect]

I generally agree, but MD schools are required to have an affiliate academic hospital for accreditation purposes

Several MD schools don't have their own teaching hospital.

 

[Instatewaiter]

the point being made about DO schools not having their own hospitals, while valid, fails to consider that a fair amount of MD schools do not have their own hospitals either. i would even argue that my DO school has stronger affiliations with stronger hospitals than a lot of MD schools.

MDs that don't have their own teaching hospitals are the exception rather than the rule. Also, of those schools you listed, EVMS and MCG both have teaching hospitals (sentara and MCG hospital) and i don;t know anything about the other programs.

also, what is with bashing community hospitals? you seem to be so eager to point out the "realities" DOs face without facing the realities of your own. chances are, you will be practicing in a community hospital. i embrace this reality and believe learning at a community (communiversity-esque) hospital is beneficial. my time would be much better spent mastering appendectomies and lap choles than spending my time learning how to perfect a Whipple or some other **** i will see less than 5 or 6 times in my life. mastering bread and butter diseases/procedures is way too often underrated on these forums by those who fail to realize that this is exactly what they will be doing for the rest of their lives.

Getting trained at 300 bed community hospital and practicing there are separate things. You want to be exposed to everything possible you can during your training. Getting training at a tiny hospital is going to leave you at a disadvantage when you are practicing. Any schmuck can take care of bread and butter cases. You will be exposed to this up the wazoo at any program- community or not. Also, the crap I see from community trained docs is appalling.

A potted plant could learn to do an appendectomy and a lap chole.

 

[BestDoctorEver]

A potted plant could learn to do an appendectomy and a lap chole.

No wonder that I saw some NPs in 'all nurses.com' claimed they can do 'minor' surgeries with 1-year surgical training... and they are gonna to petition ANA to start lobbying on that front...

 

[Instatewaiter]

No wonder that I saw some NPs in 'all nurses.com' claimed they can do 'minor' surgeries with 1-year surgical training... and they are gonna to petition ANA to start lobbying on that front...

And unless you know what to do and can turn it into a larger surgery if there are complications, you shouldn't be doing minor surgeries. Let them petition. Who is going to want to have their surgery done by an NP?

 

[BestDoctorEver]

And unless you know what to do and can turn it into a larger surgery if there are complications, you shouldn't be doing minor surgeries. Let them petition. Who is going to want to have their surgery done by an NP?

I am sure 30+ years ago people thought they would never let nurses practice medicine... Look at where we are now.