What allopathic residencies is an average DO student competitive for?

[FlatIsJustice]

Say someone who is in the top 1/3 of their class with a 225 Step 1 and average evaluations.

Which specialties would this person be competitive for? Which would be a reach but possible? Which would be nearly impossible?

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[EmergDoc2B]

So many variables its just to hard to say.

 

[racerwad]

Man, if only there was a document that complied Match data statistics that you could consult...

 

[IslandStyle808]

Nope... Nope... Nope... I'm not telling you anything, search feature that question.

 

[FlatIsJustice]

If you guys aren't giving a straight answer maybe I'll have to ask @MeatTornado

 

[67552931811]

If you guys aren't giving a straight answer maybe I'll have to ask @MeatTornado

People just don't want to give you a handout. Don't be a lazy ass.

 

[costales]

.

 

[costales]

Man, if only there was a document that complied Match data statistics that you could consult...

Many have heard of it, but nobody has ever seen it.

If you guys aren't giving a straight answer maybe I'll have to ask @MeatTornado

1/10 troll.

 

[DetectiveAlonzo]

hahahaha I like this guy.

 

[NurWollen]

Say someone who is in the top 1/3 of their class with a 225 Step 1 and average evaluations.

Which specialties would this person be competitive for? Which would be a reach but possible? Which would be nearly impossible?

That's not even average. Someone with a 258 and top 3.37% might be able to score some low-tier university IM interviews if they audition well. But any lower than that you get might want to apply for a masters in janitorial services so you don't get stuck doing family medicine.

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[DetectiveAlonzo]

Say someone who is in the top 1/3 of their class with a 225 Step 1 and average evaluations.

Which specialties would this person be competitive for? Which would be a reach but possible? Which would be nearly impossible?

That person would be able to snag and take whatever the Caribbean IMGs get.... maybe add EM (depending on your SLOE and rotations) and PM&R to that list.

 

[SLC]

...But any lower than that you get might want to apply for a masters in janitorial services so you don't get stuck doing family medicine.

Watch it now, some of us aren't in it for the prestige of fields like janitorial services. Some of us actually chose FM, even with good stats, because we like it.

 

[IslandStyle808]

Watch it now, some of us aren't in it for the prestige of fields like janitorial services. Some of us actually chose FM, even with good stats, because we like it.

I think what he stated was sarcasm embedded within sarcasm.

 

[deleted564680]

A 225 as a DO means you're "competitive" for nothing ACGME but there are variations of what people consider the word "competitive" to mean.

A 225 will get you community IM, low-mid FM, low-mid Psych, low PM&R. Outside shot at neurology, EM, peds, and path if you apply broadly and maybe anesthesia since it's been shifting in recent years.

The fact is that a 225 is well below average now on Step 1 and as a DO you really are looking at 225 = ~210 for an MD applicant. So, think whatever a 210 can get you as an MD if those ACGME PDs consider all other things being equal (which they don't).

Yes, there are people with 225 that match better than what I've stated above but it's NOT the majority and X applicant will have less than coin flip odds to do better than above.

 

[Drrrrrr. Celty]

A 225 as a DO means you're "competitive" for nothing ACGME but there are variations of what people consider the word "competitive" to mean.

A 225 will get you community IM, low-mid FM, low-mid Psych, low PM&R. Outside shot at neurology, EM, peds, and path if you apply broadly and maybe anesthesia since it's been shifting in recent years.

The fact is that a 225 is well below average now on Step 1 and as a DO you really are looking at 225 = ~210 for an MD applicant. So, think whatever a 210 can get you as an MD if those ACGME PDs consider all other things being equal (which they don't).

Yes, there are people with 225 that match better than what I've stated above but it's NOT the majority and X applicant will have less than coin flip odds to do better than above.

Yeesh. Depressing.

 

[FlatIsJustice]

A 225 as a DO means you're "competitive" for nothing ACGME but there are variations of what people consider the word "competitive" to mean.

A 225 will get you community IM, low-mid FM, low-mid Psych, low PM&R. Outside shot at neurology, EM, peds, and path if you apply broadly and maybe anesthesia since it's been shifting in recent years.

The fact is that a 225 is well below average now on Step 1 and as a DO you really are looking at 225 = ~210 for an MD applicant. So, think whatever a 210 can get you as an MD if those ACGME PDs consider all other things being equal (which they don't).

Yes, there are people with 225 that match better than what I've stated above but it's NOT the majority and X applicant will have less than coin flip odds to do better than above.

Thanks for the honest answer. What additional options become available withh a 240 step score all else being equal?

Which specialties will remain exceedingly difficult regardless of step score?

 

[NurWollen]

A 225 as a DO means you're "competitive" for nothing ACGME but there are variations of what people consider the word "competitive" to mean.

A 225 will get you community IM, low-mid FM, low-mid Psych, low PM&R. Outside shot at neurology, EM, peds, and path if you apply broadly and maybe anesthesia since it's been shifting in recent years.

The fact is that a 225 is well below average now on Step 1 and as a DO you really are looking at 225 = ~210 for an MD applicant. So, think whatever a 210 can get you as an MD if those ACGME PDs consider all other things being equal (which they don't).

Yes, there are people with 225 that match better than what I've stated above but it's NOT the majority and X applicant will have less than coin flip odds to do better than above.

Your source? I mean I know it's hard to gauge numbers but yours seem a little extreme.

 

[dfib slim]

Your source? I mean I know it's hard to gauge numbers but yours seem a little extreme.

I think it actually looks pretty accurate.

 

[deleted564680]

Thanks for the honest answer. What additional options become available withh a 240 step score all else being equal?

Which specialties will remain exceedingly difficult regardless of step score?

Like others have stated, this information is available in many other threads. I just felt the need to give you an honest answer because I've seen way too many DOs have unrealistic expectations and then be upset when they didn't match or matched at places lower than they thought they would. Everyone likes a good story and hears about so and so who matched X place with a mediocre app, but it's just not the norm.

If there's one solid piece of advice I can give it is to not have unrealistic expectations and expect the worst case scenario.

As far as having a 240, you'd be good with all the ones I mentioned in my previous post and maybe get some interviews for gen. surg., diagnostic rads, ob/gyn.

Many fields are essentially off-limits to DOs (ACGME-wise) barring a special circumstance that no one should count on (research year, connections, luck, good audition rotation, etc.): NSG, derm, ortho, uro, rad onc, plastics, ophtho, ENT, vascular surg, interventional rads

Have DOs matched in those fields? Yes. But you're probably looking at a < 10% chance of doing so. I know NUMEROUS DOs with 250+/260+ that didn't even get more than a couple INTERVIEWS to those specialties, let alone match at them.

Another person asked about my source. Some of it comes from the Charting Outcome of the Match Data coupled with the yearly Match Data, while most of it comes from my personal experience and experience of my friends and DOs I know.

There's heavy DO propaganda out there and I want to give the realist point of view.

So again, If there's one solid piece of advice I can give it is to not have unrealistic expectations and expect the worst case scenario.

 

[SLC]

Like others have stated, this information is available in many other threads. I just felt the need to give you an honest answer because I've seen way too many DOs have unrealistic expectations and then be upset when they didn't match or matched at places lower than they thought they would. Everyone likes a good story and hears about so and so who matched X place with a mediocre app, but it's just not the norm.

If there's one solid piece of advice I can give it is to not have unrealistic expectations and expect the worst case scenario.

As far as having a 240, you'd be good with all the ones I mentioned in my previous post and maybe get some interviews for gen. surg., diagnostic rads, ob/gyn.

Many fields are essentially off-limits to DOs (ACGME-wise) barring a special circumstance that no one should count on (research year, connections, luck, good audition rotation, etc.): NSG, derm, ortho, uro, rad onc, plastics, ophtho, ENT, vascular surg, interventional rads

Have DOs matched in those fields? Yes. But you're probably looking at a < 10% chance of doing so. I know NUMEROUS DOs with 250+/260+ that didn't even get more than a couple INTERVIEWS to those specialties, let alone match at them.

Another person asked about my source. Some of it comes from the Charting Outcome of the Match Data coupled with the yearly Match Data, while most of it comes from my personal experience and experience of my friends and DOs I know.

There's heavy DO propaganda out there and I want to give the realist point of view.

So again, If there's one solid piece of advice I can give it is to not have unrealistic expectations and expect the worst case scenario.

Good advice for the most part.

But I know many people with average USMLE and middle or lower half class ranks who matched ACGME Gen-Surg, Rads, Gas, etc.

There is a significant difference between Matching at a solid University program and matching at a community hospital. Many on SDN seem to gloss over this difference and act like all ACGME programs are the same.

 

[deleted564680]

Good advice for the most part.

But I know many people with average USMLE and middle or lower half class ranks who matched ACGME Gen-Surg, Rads, Gas, etc.

There is a significant difference between Matching at a solid University program and matching at a community hospital. Many on SDN seem to gloss over this difference and act like all ACGME programs are the same.

Fair point. When I mentioned above about getting interviews in those fields (GS, Rads, Anesthesia) I meant they are mostly going to be community programs. I too forget that sometimes people don't remember there's a distinction and I should have stated that when I said low tier it meant community programs for the most part.

And, yes there are people who match in those fields with average or even below average scores, I just want people to realize it's not a lock for anything. It's not like oh I got my 230 so I'm all set for anesthesia and EM because that's the USMLE average for people who match.

The other point I want to make since you mentioned it is that no one I've ever come in contact with PD-wise gives a crap about class rank at all with DOs. The MD side has AOA so they care about that but on the DO side they don't care unless you've failed a course. You can be no. 1 in your class and they just think "oh, well it was a DO school so who cares." And, I'm not trying to spout hyperbole, I've seen this happen with my own eyes more than once.

 

[Petypet]

Thanks for the honest answer. What additional options become available withh a 240 step score all else being equal?

Which specialties will remain exceedingly difficult regardless of step score?

240 opens most doors at most places, save derm, plastics, neursurg, ortho, ent.

Your source? I mean I know it's hard to gauge numbers but yours seem a little extreme.

Those numbers are a bit extreme. If you stay in the midwest 225 is almost good enough for any IM program (save the ones where DO's struggle to match), certainly any FM (who knew their were FM tiers), many EM, some gas, rads, psych, path. People match at some of the top programs in FM and psych with comlex alone.

Go based on the charting outcomes and not anecdotal evidence.

If there's one solid piece of advice I can give it is to not have unrealistic expectations and expect the worst case scenario.

That's a bit negative. Tons of "average" DO's match just fine into solid programs with average scores. If you play the game right you don't need to expect the worst case scenario. Anecdotally, the classmates of mine that had the "worst case scenario" were ones that I would have predicted prior to the match due to not playing the game right.

Taking USMLE and getting 225, means you are in the door, hammer step 2 and get a few good letters and you will match confidently at a good program.

 

[hallowmann]

240 opens most doors at most places, save derm, plastics, neursurg, ortho, ent.


Those numbers are a bit extreme. If you stay in the midwest 225 is almost good enough for any IM program (save the ones where DO's struggle to match), certainly any FM (who knew their were FM tiers), many EM, some gas, rads, psych, path. People match at some of the top programs in FM and psych with comlex alone.

Go based on the charting outcomes and not anecdotal evidence.


That's a bit negative. Tons of "average" DO's match just fine into solid programs with average scores. If you play the game right you don't need to expect the worst case scenario. Anecdotally, the classmates of mine that had the "worst case scenario" were ones that I would have predicted prior to the match due to not playing the game right.

Taking USMLE and getting 225, means you are in the door, hammer step 2 and get a few good letters and you will match confidently at a good program.

This is the impression I have as well talking to 4th years, PDs, and residents. And obviously charting outcomes is more optimistic.

I think Cubsfan might be focusing on very specific program populations. Good University IM and competitive specialties, in primarily coastal regions/big cities might very well be like he describes, but that's certainly not all residency programs.

I really can't tell if FM has tiers. It seems more like there are just focuses in training. Certain programs are really good at giving certain types of training. In any given region some programs will be better well-known, but it's not necessarily in the same way that tiers matter in something like IM. Obviously there are stronger and more desirable programs, but that really seems to have to do with what kind of training you want.

 

[purva13]

This is the impression I have as well talking to 4th years, PDs, and residents. And obviously charting outcomes is more optimistic.

I think Cubsfan might be focusing on very specific program populations. Good University IM and competitive specialties, in primarily coastal regions/big cities might very well be like he describes, but that's certainly not all residency programs.

I really can't tell if FM has tiers. It seems more like there are just focuses in training. Certain programs are really good at giving certain types of training. In any given region some programs will be better well-known, but it's not necessarily in the same way that tiers matter in something like IM. Obviously there are stronger and more desirable programs, but that really seems to have to do with what kind of training you want.

I can name a few coastal IM residencies off the top of my head that are not "top tier" but still with fantastic training that could land you a fellowship AND are receptive to DOs. It's definitely changing.

 

[dfib slim]

I can name a few coastal IM residencies off the top of my head that are not "top tier" but still with fantastic training that could land you a fellowship AND are receptive to DOs. It's definitely changing.

Like?

 

[deleted564680]

I'm saying everyone should be cautious and a realist. It's all about odds.

 

[Sai111394]

I'm saying everyone should be cautious and a realist. It's all about odds.

I won't disagree with you on that. You should be realistic, but not so much that it turns to pessimism. If that happened you wouldn't have DOs matching every year to places that we previously thought were out of reach. Granted they must have had excellent apps but still, if they had simply just thought "oh there's no way they'll even glance at my app because I'm a DO" they wouldn't be where they are.

 

[NurWollen]

I'm saying everyone should be cautious and a realist. It's all about odds.

I agree. Nothing's worse than someone overestimating their chances and ending up getting screwed because of it. Reaching for the stars with an appropriate back up is where it's at.

I just think saying that someone with a 225 has "an outside chance" at peds (one of the specialties you listed) is a little much.

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[67552931811]

I agree. Nothing's worse than someone overestimating their chances and ending up getting screwed because of it. Reaching for the stars with an appropriate back up is where it's at.

I just think saying that someone with a 225 has "an outside chance" at peds (one of the specialties you listed) is a little much.

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Seriously.

 

[Drrrrrr. Celty]

Idk, if SDN the fact that someone basically equated being a DO to having 15 points subtracted off of your step 1 score is pretty harsh if not outright ridiculous.

 

[IslandStyle808]

This is the impression I have as well talking to 4th years, PDs, and residents. And obviously charting outcomes is more optimistic.

I think Cubsfan might be focusing on very specific program populations. Good University IM and competitive specialties, in primarily coastal regions/big cities might very well be like he describes, but that's certainly not all residency programs.

I really can't tell if FM has tiers. It seems more like there are just focuses in training. Certain programs are really good at giving certain types of training. In any given region some programs will be better well-known, but it's not necessarily in the same way that tiers matter in something like IM. Obviously there are stronger and more desirable programs, but that really seems to have to do with what kind of training you want.

The thing that a lot of residents tried to hammer into my head is that tiers are used usually in the context of competitive fellowships. In the case of family medicine, most of stated there are no competitive fellowships (@SLC you can correct me on this). So it doesn't really apply to family medicine. The thing that matter is whether it has a good training program or not (ex. factors such as opposed versus unopposed programs), whether this be at a community hospital or university hospital. You definitely know this aspect far better than I do.

 

[IslandStyle808]

I agree. Nothing's worse than someone overestimating their chances and ending up getting screwed because of it. Reaching for the stars with an appropriate back up is where it's at.

I just think saying that someone with a 225 has "an outside chance" at peds (one of the specialties you listed) is a little much.

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Classic example of what you are mentioning was the LECOM match in peds at Hopkins (residents on SDN have state it to be one of the top programs in peds). Shooting for the stars, but can still land on the moon (This analogy makes more sense to me than the original quote, I don't care if its wrong).

 

[deleted564680]

Idk, if SDN the fact that someone basically equated being a DO to having 15 points subtracted off of your step 1 score is pretty harsh if not outright ridiculous.

No...this pretty much happens. At least it did 3 years ago.

 

[Drrrrrr. Celty]

No...this pretty much happens. At least it did 3 years ago.

I mean if that were the case then my class last year who got a 224 average would have honestly had an awful match and only 10% would have gotten decent matches.

Idk, maybe I'm wrong, but hopefully it has gotten better since 3years ago.

 

[deleted564680]

Well it may be a situation more like this:
DO 260 = MD 245
DO 250 = MD 240
DO 240 = MD 230
DO 230 = MD 220
DO 220 = MD 215
DO 210 = MD 205


Most of what I know and what I saw was within the group of people 240+

 

[Drrrrrr. Celty]

Well it may be a situation more like this:
DO 260 = MD 245
DO 250 = MD 240
DO 240 = MD 230
DO 230 = MD 220
DO 220 = MD 215
DO 210 = MD 205


Most of what I know and what I saw was within the group of people 240+

That's more reasonable.

 

[Drrrrrr. Celty]

The thing that a lot of residents tried to hammer into my head is that tiers are used usually in the context of competitive fellowships. In the case of family medicine, most of stated there are no competitive fellowships (@SLC you can correct me on this). So it doesn't really apply to family medicine. The thing that matter is whether it has a good training program or not (ex. factors such as opposed versus unopposed programs), whether this be at a community hospital or university hospital. You definitely know this aspect far better than I do.

Well from what I comprehend tiers are established based on how many of a program's graduates go onto competitive fellowships. I mean If something is ACGME accredited then at the very least it satisfies the requirements to make you a competent physician.

 

[deleted564680]

Sometimes for fields like FM the tiers are based on geography and competitiveness due to that...at least that's what I meant when I first said low-mid FM. I meant in terms of how competitive they were to get, not necessarily that there is a quality ranking of FM programs.

 

[Drrrrrr. Celty]

Sometimes for fields like FM the tiers are based on geography and competitiveness due to that...at least that's what I meant when I first said low-mid FM. I meant in terms of how competitive they were to get, not necessarily that there is a quality ranking of FM programs.

This might be a bit specific, but what is the difference between low tier psych and mid tier psych?

Also I know community IM can match you into the least competitive IM subspecialties very well enough. How is the training at a decent community IM place?

And finally what does ACGME accreditation actually fundamentally mean? Like is it scientifically proven to at the minimal make you adequate for practice and not killing people? Or is it going to be somewhat poor training?

 

[Petypet]

This might be a bit specific, but what is the difference between low tier psych and mid tier psych? Its a hypothetical SDN issue. Real world is psych is generally very easy to match into

Also I know community IM can match you into the least competitive IM subspecialties very well enough. How is the training at a decent community IM place? Opportunities and connections. Maybe a bit more zebra pathology but the basic training is similar.

And finally what does ACGME accreditation actually fundamentally mean? Like is it scientifically proven to at the minimal make you adequate for practice and not killing people? Or is it going to be somewhat poor training? Means you met a set of standards to practice medicine in a certain speciality. Many AOA programs do not yet meed that accreditation standard, hence why some have failed, some have closed shop, etc.

 

[Drrrrrr. Celty]

This might be a bit specific, but what is the difference between low tier psych and mid tier psych? Its a hypothetical SDN issue. Real world is psych is generally very easy to match into

Also I know community IM can match you into the least competitive IM subspecialties very well enough. How is the training at a decent community IM place? Opportunities and connections. Maybe a bit more zebra pathology but the basic training is similar.

And finally what does ACGME accreditation actually fundamentally mean? Like is it scientifically proven to at the minimal make you adequate for practice and not killing people? Or is it going to be somewhat poor training? Means you met a set of standards to practice medicine in a certain speciality. Many AOA programs do not yet meed that accreditation standard, hence why some have failed, some have closed shop, etc.

The psych forum is pushing the notion that it's pretty competitive now, which kinda worries me, because I think Psych is probably one of my top choices.

 

[Petypet]

The psych forum is pushing the notion that it's pretty competitive now, which kinda worries me, because I think Psych is probably one of my top choices.

It's all relative. You do you not need usmle for a majority of programs.

Sent from my SM-G920V using Tapatalk

 

[DetectiveAlonzo]

The psych forum is pushing the notion that it's pretty competitive now, which kinda worries me, because I think Psych is probably one of my top choices.

You've dealt with competition your whole life to this point. You thought this was gonna get any easier? lol

All this means is your life just leveled up... grow a pair and go get what you want.

 

[MiaMia14]

Like others have stated, this information is available in many other threads. I just felt the need to give you an honest answer because I've seen way too many DOs have unrealistic expectations and then be upset when they didn't match or matched at places lower than they thought they would. Everyone likes a good story and hears about so and so who matched X place with a mediocre app, but it's just not the norm.

If there's one solid piece of advice I can give it is to not have unrealistic expectations and expect the worst case scenario.

As far as having a 240, you'd be good with all the ones I mentioned in my previous post and maybe get some interviews for gen. surg., diagnostic rads, ob/gyn.

Many fields are essentially off-limits to DOs (ACGME-wise) barring a special circumstance that no one should count on (research year, connections, luck, good audition rotation, etc.): NSG, derm, ortho, uro, rad onc, plastics, ophtho, ENT, vascular surg, interventional rads

Have DOs matched in those fields? Yes. But you're probably looking at a < 10% chance of doing so. I know NUMEROUS DOs with 250+/260+ that didn't even get more than a couple INTERVIEWS to those specialties, let alone match at them.

Another person asked about my source. Some of it comes from the Charting Outcome of the Match Data coupled with the yearly Match Data, while most of it comes from my personal experience and experience of my friends and DOs I know.

There's heavy DO propaganda out there and I want to give the realist point of view.

So again, If there's one solid piece of advice I can give it is to not have unrealistic expectations and expect the worst case scenario.

Just as someone with experience in the one field, think with even the 225 you would have a shot at Ob/Gyn provided you chose your programs wisely. I got 9 interviews and matched my top choice with only an average comlex score and no Usmle. Granted, it's not a top tier program, but I'm pretty happy with my training where I am.


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[LuluLovesMe]

Well it may be a situation more like this:
DO 260 = MD 245
DO 250 = MD 240
DO 240 = MD 230
DO 230 = MD 220
DO 220 = MD 215
DO 210 = MD 205


Most of what I know and what I saw was within the group of people 240+

I feel an MD 245 would have an easier time matching derm than a DO 260 though. I may be wrong

 

[Dharma]

This might be a bit specific, but what is the difference between low tier psych and mid tier psych? Its a hypothetical SDN issue. Real world is psych is generally very easy to match into

Not so easy this year. Interest in psych is on the rise. USMD matches on the increase (I believe 61% in psych this year). IMGs approaching a point of lock out. DOs feeling the crunch, on the coasts especially. I would expect it to become tougher for DOs matching into a good number of programs out there in years to come. A few years back, all but a few were fair game and totally reachable, even by an average DO student, but this is no longer the case. Those who aren't following the trends in psychiatry may not be in the know, but it is well on its way to no longer being an easy match.

As for USMLE scores and comparison to MD students, there is no comparison. The score simply keeps you in the game. Regardless of a score, the MD student (with a much lower score) will likely have a one-up (or more) on a DO student since your clinical education will likely be called into question. This is a reality, generally speaking.

 

[Drrrrrr. Celty]

You've dealt with competition your whole life to this point. You thought this was gonna get any easier? lol

All this means is your life just leveled up... grow a pair and go get what you want.

haha, it's not that I disagree with the sentiment.

 

[hallowmann]

The psych forum is pushing the notion that it's pretty competitive now, which kinda worries me, because I think Psych is probably one of my top choices.

Its more competitive than it was. Truth is the same phenomenon to some (probably lesser) degree is happening with FM. For the first time in decades for example FM in California went completely filled in the match last year. This doesn't mean that either have gotten particularly competitive, just more so than they've been in the past.

Competitive programs and competitive regions as always will be on the more competitive side. This doesn't mean you'll struggle to match at a program that'll give you good training. There are plenty of those around. You don't need a 240 to match a good psych program.

 

[Petypet]

You don't need a 240 to match a good psych program.

Or even a USMLE

 

[Blunt Dissection]

I feel an MD 245 would have an easier time matching derm than a DO 260 though. I may be wrong

This seems to be the case for ultra-competitive residencies and I can only assume it is a result of MD bias on the part of program directors (as most ultra-competitive residency PDs are MDs). A DO applicant applying for something like Derm/Plastics/Neurosrg needs to not only perform higher on the USMLE, they need to have outstanding everything else.