How many SDNers are electing DO as #1 choice

DoktorB said:

IL?

Illinois is not the DO capitol of the country..

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Chicago is where the AOA is headquartered. At the very least, it's very DO friendly.

skinMD said:

it's so frustrating how people always pretend like all that matters is that you match somewhere and totally ignore the fact that you have a much better chance of matching where you want or in a more reputable residency if you're an MD....even if you want to go into something less competitive.

there's a huge difference between being at a no-name psych program at a random community hospital somewhere you wouldn't want to drive through let alone live in for 4 years vs. matching at a top psych residency program and being on track to becoming a leader in the field.

if you read SDN you'd think that MD vs. DO only makes a difference for the hyper-competitive specialties (ENT, derm, plastics, ortho, radonc, etc) but everyone conveniently overlooks the fact that the road will be much easier and you will be much more likely to match where you want or end up at a quality residency program if you go MD even if you decide on a less competitive specialty.

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I agree with this. I only applied to DO schools and, although I am happy with my education, if I could do it again, I would have probably applied to some MD schools. I don't think there is much difference between MD and DO schools in terms of education, but life is much easier as an MD in terms of post-graduate training.

DO Anes said:

Although there are a lot of variables in a person's decisions and reasons, there are forces at play beyond anyone's control that will greatly affect your life. The economy, increasing patient load, decreasing resources and various "reform" plans are going to put an heretofore unseen stress on the US health care system. Additionally, new changes in the ACGME regarding internship and fellowship will increase the crush on their residencies. The Carib and IMG grads are basically done for at this point, but the DO's are not far behind. Over expansion of class sizes and schools with no regard to GME, lower accreditation standards and the AOA's continued territorial ostracism of ACGME grads are all combining into a perfect storm that will shake this profession to its core. I expect a progression: first, CMS stops funding AOA residencies; second, the USDE mandates that any school graduating physicians, MD or DO, be accredited by the LCME, rather than COCA. Finally, grads of LCME-accredited DO schools who completed ACGME residencies are converted to MD, while the others are limited to manipulation only, like British DO's. No amount of wishing or "proud to be a DO" chest thumping will change this. It is sad, as I do love the profession, but the storm is coming, sad or not. This may not have been the case 10 years ago, but in 2012, MD>DO>>>>>>>>IMG>>>>>>>>>>>>>>>>>>>>>>>Carib IMG.

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This seems a bit extreme to me. I could see the osteopathic residencies that are considered very bad, losing their funding like you say. But a conversion of ACGME trained DOs to MDs and changing of AOA trained DOs to manual medicine specialists does not seem rational with the physician shortage that we will be experiencing when many retire in the coming years.

I know I am a pre-med and I don't have any medical experience though, do any DO attendings or residents have any thoughts about this proposed idea?

DO Anes said:

I expect a progression: first, CMS stops funding AOA residencies; second, the USDE mandates that any school graduating physicians, MD or DO, be accredited by the LCME, rather than COCA. Finally, grads of LCME-accredited DO schools who completed ACGME residencies are converted to MD, while the others are limited to manipulation only, like British DO's.

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Yeah, this seems a bit on the doom & gloom end of things and more often than not, extremes rarely manifest outside the realm of imagination. No disrespect (because you are certainly more in-the-know that a lowly about-to-be med student such as myself), but what are you basing your speculation off of? Are these just the ideas bouncing around your head or do you have connections with those in higher places who have alluded to these drastic shifts in the status quo that you mentioned?

KPride said:

I am a nontraditional premed with a family. If admitted to both MD and DO, I would choose DO because I would prefer to be around classmates in my same situation. Also, having worked with both DOs and MDs, I've seen first hand the difference in personalities and the way they interact with and treat their patients. Yep, DO is my preference but MD is my back-up. Quite opposite of what most SDNers seem to say.

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Totally agree.. I was faced with the same situation and chose DO.. I almost withdrew my MD app actually. I do know two other people which are my close friends which have near perfect statistics(4.0, good mcat, internships, research, etc.), and want nothing more than DO. In fact they didn't even apply to MD. At first people didn't know what was wrong with them, and I kinda thought that way too. But now after going through the whole process myself and visiting places, I took a strong liking to the DO environment. perhaps it was the individual schools I was to, but MD just seemed more cocky, and less community. I am not looking to offend anyone, just my personal experiences.

I can not speak to what its ACTUALLY like. Once I go through with DO, perhaps I will have a different view. I give props to the people in medical school right now because you can give us insight which is impossible for me and my fellow premeds(accepted or not) to know right now.

skinMD said:

At a certain DO school in NY there are 40+ clinical sites scattered throughout a 100+ mile radius with zero standardization and what seems like complete decentralization. This is clearly a byproduct of not having your own hospital. I was also told by a DO resident at my US MD school that the clinical rotations were far less rigorous at his school.

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This is one of the reasons why I ended up choosing UMDNJ over NSU, even though the latter was my #1 choice coming into the app process. While being able to rotate wherever one wants is good, but wouldn't it be better to have that option in addition to being able to rotate in the school's own university/academic teaching hospital system?

Was this requirement deliberately overlooked by COCA early on?

poopyhead said:

This is one of the reasons why I ended up choosing UMDNJ over NSU, even though the latter was my #1 choice coming into the app process. While being able to rotate wherever one wants is good, but wouldn't it be better to have that option in addition to being able to rotate in the school's own university/academic teaching hospital system?

Was this requirement deliberately overlooked by COCA early on?

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It's the biggest difference in accreditation standards between MD and DO and why so many crappy DO schools are popping up like weeds. For MD you need to have your med students doing clinicals in hospitals with GME programs with supervision from interns and residents with all the academic things that come along with that. Really helps you prepare for intern year and why so many osteo students come out unprepared

"
* The LCME document contains six standards under the title Academic Environment. These standards include requirements that (1) medical students should learn in clinical environments where graduate and continuing medical education programs are present, (2) the medical education program must be conducted in an environment that fosters intellectual challenge and a spirit of inquiry, and (3) the medical school should make available opportunities for medical students to participate in service-learning activities.
* The COCA standards make no mention of the academic environment or of such specific issues as intellectual challenge, spirit of inquiry, or student participation in service-learning activities."

El Dooderino said:

It's the biggest difference in accreditation standards between MD and DO and why so many crappy DO schools are popping up like weeds. For MD you need to have your med students doing clinicals in hospitals with GME programs with supervision from interns and residents with all the academic things that come along with that. Really helps you prepare for intern year and why so many osteo students come out unprepared

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To add to this topic, I've found teaching hospitals with residency programs to be head over heels a better environment as far as learning goes. This may seem intuitive to most, but I hear a lot of people on SDN vie for the smaller, outlying clinic because there is more of a "hands on" approach. At a teaching hospital there are more interesting and thought provoking cases (that you can acutally work up and not refer elsewhere), inpatient care with a team of students residents and attendings, mandatory teaching conferences and students have a lot more expected out of them. I have enjoyed having a few outpatient/private clinic rotations at places without programs, but I learn less and do not get very good prep for residency. I do a lot of sitting around in their office while they check their emails and chart on electronic systems that don't allow students to do anything.I have been fortunate (luck of the draw) to have about half of my rotations at teaching hospitals this year.

For 3rd year this is definitely an issue at many DO schools, even the established ones. In 4th year..it is really up to the student at our program and I suspect a lot of programs are similar. I am going to do most of my rotations next year at teaching hospitals, but some of my classmates will do theirs at private clinics or small hospitals....which in my opinion are more like shadowing experiences. In some ways I really like being able to set up my own rotations next year so I can get a great education, but I feel like a lot of students fall through the cracks and skate by. My 2 cents.

i feel like this thread has just turned into a doom and gloom thread. i read everywhere about the the MD/DO gap is closing and I come on here and read that i could spend all of this time to become a physician and then someone can come to me 15 years down the road and say, "sorry, you are out of a job and have to open an OMM/acupuncture clinic." some of this stuff is more than a little ridiculous. i am not going to let it phase or deter me as are no sources to justify this mentality (as of now) but it is frustrating.

FrkyBgStok said:

i feel like this thread has just turned into a doom and gloom thread. i read everywhere about the the MD/DO gap is closing and I come on here and read that i could spend all of this time to become a physician and then someone can come to me 15 years down the road and say, "sorry, you are out of a job and have to open an OMM/acupuncture clinic." some of this stuff is more than a little ridiculous. i am not going to let it phase or deter me as are no sources to justify this mentality (as of now) but it is frustrating.

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First off, most of us are not saying you're not going to have a job at the end of residency. What we are saying is that there are certain downsides to many DO schools (due to 3rd/4th year clinical year sites, post-graduate residency education choices, fellowship) that osteopathic students will have to work harder against these extra difficulties. Some specialties will not present as many roadblocks as others, especially if you're looking at those abundant in the AOA world.

FrkyBgStok said:

i feel like this thread has just turned into a doom and gloom thread. i read everywhere about the the MD/DO gap is closing and I come on here and read that i could spend all of this time to become a physician and then someone can come to me 15 years down the road and say, "sorry, you are out of a job and have to open an OMM/acupuncture clinic." some of this stuff is more than a little ridiculous. i am not going to let it phase or deter me as are no sources to justify this mentality (as of now) but it is frustrating.

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Welcome to SDN, lol.

Some of the points are valid, and people should know them going in. DO's do have a tougher time getting residencies vs. MD's. Of course, that's more pronounced in some specialties versus others, but the vast majority of DO's will get residencies (probably not in the same glamorous programs as MD's, but plenty do). However, DO's will make the same as their MD counterparts, and being a doctor in the community you want (where going to an MD school may be too difficult), as well as other personal reasons may push you one way or the other. No one knows what the future holds for DO or MD schools, but what happens to these schools 10-15 years from now shouldn't really impact where you go NOW, as it's too unpredictable. The last 5 years have been great for DO's as their match rate in the NRMP match has risen, and more specialties have opened up in ACGME and AOA residencies (there are more AOA residencies now in tougher specialties).

You just have to make sure that you have your priorities set, and be realistic about it.

Like I said, for me, I want to stay in this community more so than anything, I'm sure I don't want to do surgery at all, and I'm in a DO friendly state, and I don't really care about going to a top residency program, as long as it's the specialty I want (both my parents are FMG Internists, I know what to expect, lol). Of course, this may all change, but that's life. Sometimes you just have to take a risk, and be done with it. Everyone else should make up their own mind.

.

FrkyBgStok said:

i feel like this thread has just turned into a doom and gloom thread. i read everywhere about the the MD/DO gap is closing and I come on here and read that i could spend all of this time to become a physician and then someone can come to me 15 years down the road and say, "sorry, you are out of a job and have to open an OMM/acupuncture clinic." some of this stuff is more than a little ridiculous. i am not going to let it phase or deter me as are no sources to justify this mentality (as of now) but it is frustrating.

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Doom and Gloom is hot.

Just read the thread, thought I'd share the following points:

1)The state of U.S healthcare has changed immensely in the past decade or so and will continue to change in the future for better or for worst. All members of the healthcare team MD/DO, RN, NP, DNP, DDS/DMD,PT,DPT, OT, DOT, whatever the hell your end initials are, you are in for the ride.

2) Not all MD schools have their own university teaching hospitals.

3) Choose your medical school wisely. I have been on MD and DO school interviews. Their are some MD schools out there, albeit a very few that are worse off 3rd year/4th year than some DO schools which are themselves small in number, and vice-versa. Look at the the rotational sites and GME opportunities your school choice offers before making a decision either on frieda or osteopathic opportunities.

4) I will be attending a U.S osteopathic medical school, getting a world class education and am damn proud of being a soon to be OMS-1.I will be learning a medical skill set that is unparalleled to any other profession in the world. Depending on my future specialty, I will have so much to offer my future patients and will be uniquely equipped to manage their conditions.

donkeykong1 said:

2) Not all MD schools have their own university teaching hospitals.

3) Choose your medical school wisely. I have been on MD and DO school interviews. Their are some MD schools out there, albeit a very few that are worse off 3rd year/4th year than some DO schools which are themselves small in number, and vice-versa.

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I wouldn't use that as an excuse for so many DO schools not having their own university teaching hospitals. It's analogous to saying that the a few "top" DO schools have higher admissions GPA/MCAT than Morehouse and Ponce. I think we have to go by overall percentages to make an accurate comparison.

poopyhead said:

I wouldn't use that as an excuse for so many DO schools not having their own university teaching hospitals. It's analogous to saying that the a few "top" DO schools have higher admissions GPA/MCAT than Morehouse and Ponce. I think we have to go by overall percentages to make an accurate comparison.

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They don't call him poopyhead for nothing.

Dharma said:

They don't call him poopyhead for nothing.

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Does having a university teaching hospital with its own GME slots ever do more harm than good for students?

PCS50 said:

This seems a bit extreme to me. I could see the osteopathic residencies that are considered very bad, losing their funding like you say. But a conversion of ACGME trained DOs to MDs and changing of AOA trained DOs to manual medicine specialists does not seem rational with the physician shortage that we will be experiencing when many retire in the coming years.

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I think something like this would, in the long run, be for the best. It would be far better if there was a single accreditation service, and a single medical degree for doctors, instead of the political bull**** that comes out of having the two types competing. Is anyone not in agreement about this honestly? Screw pride, many hospital systems give their DOs coats labeled MD because patients don't know what a DO is, and to get rid of the need to explain to every patient that they're functionally the same thing. We are, for all intents and purposes the same, so why not just end the idiotic debate, if anything to shut up the arrogant MDs and the DOs who have inferiority complexes.

poopyhead said:

Does having a university teaching hospital with its own GME slots ever do more harm than good for students?

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poopy-If you're talking about your future schools' kennedy health system which is one of 8 of UMDNJ-SOMs clinical affiliates. Its really a consortium of "teaching hospitals" serving the allopathic branch of UMDNJ in addition to Robert Wood Johnson Medical School at Camden and also the SOM.

Yes, there are some AOA residency slots there and I would guess the clinical education there should be rather solid but I wouldn't consider it a full fledged osteopathic powerhouse like OU's Doctors Hospital or MSU Henry Ford Hospital that have loads of GME slots. Also as an side I would agree UMDNJ>NSU.

poopyhead said:

Does having a university teaching hospital with its own GME slots ever do more harm than good for students?

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I agree with you. Just playing.

mishaS said:

I think something like this would, in the long run, be for the best. It would be far better if there was a single accreditation service, and a single medical degree for doctors, instead of the political bull**** that comes out of having the two types competing. Is anyone not in agreement about this honestly? Screw pride, many hospital systems give their DOs coats labeled MD because patients don't know what a DO is, and to get rid of the need to explain to every patient that they're functionally the same thing. We are, for all intents and purposes the same, so why not just end the idiotic debate, if anything to shut up the arrogant MDs and the DOs who have inferiority complexes.

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IT WILL NEVER HAPPEN. Seriously... never (the conversion of degrees that is. Yeah, it happened in Cali back in the day, but that's a different time. The AOA will not let this happen again). I wouldn't even waste time thinking about it (or dreaming about it). And just for the record, the MD grads are hardly competing with DO grads.

We have a large teaching hospital in our area where there are a large number of DO's in residency slots. The lab coats all read "Dr." with no MD/DO designation.

Dharma said:

IT WILL NEVER HAPPEN. Seriously... never (the conversion of degrees that is. Yeah, it happened in Cali back in the day, but that's a different time. The AOA will not let this happen again). I wouldn't even waste time thinking about it (or dreaming about it). And just for the record, the MD grads are hardly competing with DO grads.

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Oh, I understand this; it's like the Marines being a military force that sensibly could be broken up, however this would never happen. Also, by competing, I meant from a political/funding standpoint.

SharonCorrea said:

We have a large teaching hospital in our area where there are a large number of DO's in residency slots. The lab coats all read "Dr." with no MD/DO designation.

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What do the Noctors' white coats say?

mishaS said:

Oh, I understand this; it's like the Marines being a military force that sensibly could be broken up, however this would never happen. Also, by competing, I meant from a political/funding standpoint.

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ahhhhh. my bad. what are the differences in terms of politics/funding?

I chose DO as my #1 and would have done so regardless of stats.

My stats wouldn't have given me a shot at MD, luckily for me I never wanted MD in the first place. I like being a bit different, not in a nerdy off the wall way, but in a counter-culture type way. The whole story related in Gevitz' book "The DO's" is pretty damn cool if you ask me!

I really identified with that, so that's where I was going from the first moment I heard of it.

I also really enjoyed my undergraduate degree (hated the pre-med hoops, but enjoyed my non-science degree). It taught me how to relate to people who are ill, and how to get a heath-improvement message across effectively. The DO's I met seemed most interested in this type of approach to healthcare, medicine followed up by solid patient education is the way to go.

Do you know how many people I've met that hate their doctor because he just throws them a bottle of pills and sends them on their way (their words not mine). Well DO's are known much more for involving their patients in their own health care. I saw it first hand, and that's all it took for me. I couldn't be happier.

donkeykong1 said:

I will be learning a medical skill set that is unparalleled to any other profession in the world.

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Wow. I's good you're not getting too carried away.

Dharma said:

(The AOA will not let this happen again).

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You don't seriously believe the AOA could stop this were it come to pass, do you? In the big picture, the AOA defines impotence. Were they able to prevent the ACGME from requiring an ACGME preliminary year for several specialties (and more coming every day)? Do you think they will be able to stop the whole fellowship initiative? Despite all the AOA's bravado, >65% of new DO grads enter ACGME residencies and that is also increasing every year. So far all the AOA has been able to do is sit idly by while DO schools expand at an irresponsible rate with no regard to clinical education.

SLC said:

I chose DO as my #1 and would have done so regardless of stats.

My stats wouldn't have given me a shot at MD, luckily for me I never wanted MD in the first place.

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Ok...

DO Anes said:

Ok...

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?

DO Anes said:

Ok...

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I get it I get it, misery loves company and all that hogwash. Why does it burn you up that somebody might want to take this path? I know exactly what it is, what challenges it could place in front of me, and I embrace it. I always have.

I can't see why that's so hard for some people to comprehend?

SLC said:

?

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It's more the rationalization and ego defense than the actually act of choosing the DO pathway.

SLC said:

I get it I get it, misery loves company and all that hogwash. Why does it burn you up that somebody might want to take this path? I know exactly what it is, what challenges it could place in front of me, and I embrace it. I always have.

I can't see why that's so hard for some people to comprehend?

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Well, you really didn't choose DO over US MD, did you?

DO Anes said:

Well, you really didn't choose DO over US MD, did you?

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Long before I ever applied, yes. Was that not clear from my post?

serenade said:

It's more the rationalization and ego defense than the actually act of choosing the DO pathway.

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Ok, I don't need you (or anyone for that matter) to believe me. That doesn't change anything. But the question was asked so I thought I'd answer it.

Some people are so cynical.

DO Anes said:

You don't seriously believe the AOA could stop this were it come to pass, do you? In the big picture, the AOA defines impotence. Were they able to prevent the ACGME from requiring an ACGME preliminary year for several specialties (and more coming every day)? Do you think they will be able to stop the whole fellowship initiative? Despite all the AOA's bravado, >65% of new DO grads enter ACGME residencies and that is also increasing every year. So far all the AOA has been able to do is sit idly by while DO schools expand at an irresponsible rate with no regard to clinical education.

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In terms of a degree change? Yeah, I could be wrong about the AOA stopping it from happening, but I'm sure they won't be the only ones up in arms.

Let's see how they do with the fellowship/transitional year thing. I'm betting against the odds and going with AOA on this one... just for $hits and giggles BTW has there been any word on a final resolution yet?

DO Anes said:

Wow. I's good you're not getting too carried away.

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Hmm..its funny how this is coming from an attending who posited just a few posts earlier that some US DOs will be converted to licensed professionals to the likes of British osteopaths. anyways, i agree that times are tough and i respect your argument, but then at the end of the day its just plain speculation with loads of uncertainty.

DO Anes said:

Finally, grads of LCME-accredited DO schools who completed ACGME residencies are converted to MD, while the others are limited to manipulation only, like British DO's.

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donkeykong1 said:

Hmm..its funny how this is coming from an attending who posited just a few posts earlier that some US DOs will be converted to licensed professionals to the likes of British osteopaths.

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I'm not the most well versed on the history of health care in our country, but has there ever been an instance where practice rights were revoked from a certain type of provider? I was always under the impression that when you achieve a certain level of practice, its extremely unlikely to get rolled back, ie. noctors?

AlbertVOligh said:

I'm not the most well versed on the history of health care in our country, but has there ever been an instance where practice rights were revoked from a certain type of provider? I was always under the impression that when you achieve a certain level of practice, its extremely unlikely to get rolled back, ie. noctors?

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The Flexner Report


Not that the providers were disenfranchised of their practice rights, but rather that the schools conferring the degrees had those rights taken away if they were not up to standard (the number of medical schools was halved in the years following). I think this is more the sort of scenario DO Anes is envisioning - and a believable one, I think.

AlbertVOligh said:

I'm not the most well versed on the history of health care in our country, but has there ever been an instance where practice rights were revoked from a certain type of provider? I was always under the impression that when you achieve a certain level of practice, its extremely unlikely to get rolled back, ie. noctors?

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I'm not sure, but I'm starting to think that DO Anes is sampling a bit when no one is looking at work...

Wow. You are so smart and funny for a pre-med.

DO Anes said:

Wow. You are so smart and funny for a pre-med.

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As someone wanting to be a DO gas man in the future...

Did you do an MD residency? Was it overly challenging to obtain that residency?

mishaS said:

I think something like this would, in the long run, be for the best. It would be far better if there was a single accreditation service, and a single medical degree for doctors, instead of the political bull**** that comes out of having the two types competing. Is anyone not in agreement about this honestly? Screw pride, many hospital systems give their DOs coats labeled MD because patients don't know what a DO is, and to get rid of the need to explain to every patient that they're functionally the same thing. We are, for all intents and purposes the same, so why not just end the idiotic debate, if anything to shut up the arrogant MDs and the DOs who have inferiority complexes.

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I agree with you on this...

Tebow said:

As someone wanting to be a DO gas man in the future...

Did you do an MD residency? Was it overly challenging to obtain that residency?

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Yes. The MD residencies are far and away the only choice. It is moderately competitive. Scoring high on the boards is a must, first attempt. USMLE preferred over COMLEX.

DO Anes said:

Yes. The MD residencies are far and away the only choice. It is moderately competitive. Scoring high on the boards is a must, first attempt. USMLE preferred over COMLEX.

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Yeah, that's what I expected. I'm in Florida and the only AOA residency is in Largo, which I've heard is meh. Thanks.

DO Anes said:

Yes. The MD residencies are far and away the only choice. It is moderately competitive. Scoring high on the boards is a must, first attempt. USMLE preferred over COMLEX.

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Did you take USMLE firrst and then COMLEX? Even though you go to DO school, you are well prepared for both exams, right? If you were to go for the primary care specialties like FM, IM and PED, you don't probably need to take USMLE?

WaterDragon said:

Did you take USMLE firrst and then COMLEX? Even though you go to DO school, you are well prepared for both exams, right? If you were to go for the primary care specialties like FM, IM and PED, you don't really need to take USMLE?

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Also curious about this...

Is it acceptable to score very well on the USMLE and only fairly on the COMLEX? Do residency directors see both scores? Did you spend more time studying for either one?

Oh, and I know research options are generally limited for osteopathic medical students. Where is research on the pecking order of importance for gas?

Tebow said:

Also curious about this...

Is it acceptable to score very well on the USMLE and only fairly on the COMLEX? Do residency directors see both scores? Did you spend more time studying for either one?

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I'm not a medstudent yet, but I've read from multiple students around SDN that the best thing to do is to study for the USMLE first, take it... then take the COMLEX about 2 weeks after, during which time you will just be reviewing OMM material.

Iliketoytles said:

I'm not a medstudent yet, but I've read from multiple students around SDN that the best thing to do is to study for the USMLE first, take it... then take the COMLEX about 2 weeks after, during which time you will just be reviewing OMM material.

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Fair enough...thanks!