DO vs MD - A practicing DO's response

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Amy B

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After the debate about DO verses MD and whether or not we would be looked upon as less of a doctor, and a previous poster's talk about the DOs they work with telling them not to apply DO, I felt compelled to email the DO at the site listed in the thread.
http://forums.studentdoctor.net/showthread.php?s=&threadid=99205&perpage=20&pagenumber=3
Here is my email and his response.

"""Greetings Dr. Orons,
I am a member of SDN, a student doctor forum on the Internet. I have been accepted to Virginia College of Osteopathic Medicine and will start there this fall. We are all having a debate about whether or not DOs are thought to be inferior to MDs out in the working world of health care. A poster stumbled onto the UPMC web site and saw that you are the director of the Radiology Residency program at a MD medical school location. This is an ongoing debate at SDN and was wondering if you would be willing to give us some imput about how you feel?


My questions to you if you wouldn't mind answering is do you feel you have a stigma attached to yourself for being an DO verses an MD? And if you had it to do over, would you still have chosen to become a DO?Thank you for your help,



Subject: RE: A question from a student
Date: Sun, 18 Jan 2004 21:13:08 -0500
Dear Amy,

This is an interesting debate, and one which has been ongoing since A.T. Still was making his rounds in Missouri in the late 1800s. I graduated from PCOM in 1986 and remember hearing something during my first year about a supposed study that was performed by the ACGME or some other allopathic body looking at the average credentials of osteopathic first year medical students vs. those of first year allopathic students. Apparently, the purpose of the study was to determine if there was a difference between M.D. and D.O. students academically.

Supposedly, the study found that there was no statistically significant difference between the two groups with respect to MCAT scores, grades, etc, but to my knowledge, the study was never published. My father is a D.O. and I became an osteopathic physician because I admired the way my father practiced medicine. I was really not aware of the differences between the way M.D.s and D.O.s were regarded, or the issues D.O.s faced once they reached the level of postgraduate training and clinical practice.

I didn't apply to any allopathic schools. I believed then, and I believe now, there is no meaningful difference between the quality of education received by D.O.s and M.D.s at the medical school level. The curricula, resources, and faculty are very similar - sometimes even identical and shared between schools. However, I believe that in postgraduate training, and especially when it comes to subspecialty fields, there may be enormous differences in the opportunities available to D.O.s.

To say that D.O.s are believed inferior to M.D.s in the working world of health care is to paint with a very broad brush to say the least. However, when individuals are being considered for competitive postgraduate training opportunities at academic allopathic institutions, D.O.s are definitely at a disadvantage. There are some individuals in the academic allopathic world (and probably more than a few in osteopathic medicine as well) who believe that many (even most?) individuals who end up in an osteopathic medical school do so for the same reason some people end up attending medical school in the Caribbean - because they were rejected from M.D. schools. And let's face it - for some individuals this is indeed the case.

Hopefully, most people who pursue an osteopathic education do so because they find the osteopathic philosophy appealing. Because some people (even in my own institution) do feel this way, I believe osteopathic students and residents have to work that much harder to put their best efforts forward at all times. When we have the occasional resident who comes through our department who is not where he or she should be in terms of knowledge base, or worse, in terms of effort put forth, they may be looked at differently by some depending on the initials after their name. If their degree is M.D., a comment might be "dumb", or "geeze, he's lazy!". If the person is a D.O., the comment might be "Oh, he's a D.O." as if such behavior or performance is less surprising because less is expected of that person.

The most important thing for any D.O. (let's face it - for any physician) to do is to always put their full effort into their work. There is no substitute for work ethic and dedication. Would I do it again? I would. I have had some measure of success in the allopathic world and I am proud of my training and background. Maybe some of my success was just being in the right place at the right time, but I hope it was because when I was given the chance to compete with M.D.s on their turf, I gave enough effort to be seen not as a D.O. trying to compete in an M.D.'s world, but just as another physician in training, and then as faculty, who was doing a good job.

Some others, however, may have difficulty getting the chance to show what they're made of; some subspecialty fields are so competitive, D.O.s may find it harder to get the opportunity to train in them at large academic institutions. Unfortunately, there are very few large academic osteopathic institutions, and I believe that these types of institutions, in general, are at an advantage in terms of the ability to provide the best subspecialty education and training in some fields.

However, most physicians end up in private practice or on staff at smaller institutions with completely mixed staffs and whether one is an M.D. or a D.O. is completely irrelevant. Also, there is little difference in training between allopathic and osteopathic institutions in primary care and general medical fields. There are other issues as well with regard to primary care vs. specialty fields, and the choices of M.D.s vs. D.O.s, but this is a separate discussion. I would be happy to discuss these things with you in more detail if you would like.

Best of luck in your future training. If the right effort is put into your career, you can achieve any goals you set for yourself. I am proud of my osteopathic background and I know that D.O.s are equal to M.D.s in every way. Don't ever be ashamed or embarrassed by your choices.

Sincerely,
Philip D. Orons, D.O.
Associate Professor of Radiology
Director, Radiology Residency Program
UPMC Health System

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Wow, that's a really nice e-mail. Those radiologist, they really do do nothing but write e-mails and drink coffee in their dark rooms all day. ;) He sounds like a nice professor.
 
what a nice guy to take time out to write that. Thank you!
 
Members don't see this ad :)
I was really surprised about his response. This is a great type of DO to have out there. One who is willing to discuss things with us pre-DO and DO students. Yippee for him!!!!!!!!:clap: :clap:
 
The two above comments qualify why I am choosing DO over MD. Every DO I have had contact with was personable, curteous, and genuine. Whether this is a product of the osteopathic education or simply the sort of personalities that DO schools attract (non anal retentive neurotic grade ******) I dont' know.
 
Good work Amy, I never would have thought of doing something like that. Dr. Orons sounds like a great guy.
 
this post should be a sticky. it's very well written. it's optomistic as well as realistic. great work Amy B!

JKD Med, not everyone that goes to MD schools are grade ******. Most of my friends that are going to MD schools aren't...nor am I. Some people work really hard because that's the only way they can learn something well - in turn they get good grades. Other people want to do their best because they feel like they shouldn't let the opportunity be taken for granted. Yes, there are some lame grade dependent people, but DO and MD schools both have those. Also, not every DO is super nice and personable, I've met a few stuck up ones as well...it has more to do with how you're brought up as a person, not what medical school you go to. You can't say...because that person is an MD, he must have been taught to be cocky. I know a lot of really cool MD's that are really personable and school didn't teach them that, it was their personality. If you went to an MD school, you wouldn't be any more or less friendly, you'd be who you are.

We're all going to be working together one day, so no stereotyping.
 
That was really nice of him to reply with such an in-depth answer. Thats exactly why I would prefer to be a DO over an MD. I know every group has its few, but I've had nothing but good experiences with DO's. I hope one day when we are all doctors we try our best to help others out...just like Dr.Orons has helped us. :clap: :clap:
 
fyi - the head of urology at Memorial SLoan Kettering Cancer Cetner is a DO. (kevin kelly)

they are out there!!

thanks amy, its nice to hear a perspective on osteopathy from someone not on SDN :)
 


However, most physicians end up in private practice or on staff at smaller institutions with completely mixed staffs and whether one is an M.D. or a D.O. is completely irrelevant.

Philip D. Orons, D.O.
Associate Professor of Radiology
Director, Radiology Residency Program
UPMC Health System




One of the earliest litmus test for medical school applicants probably is how she/he handles the irrelevant issue of DO vs MD dilemma. What if all medical schools make it mandatory for every applicant to discuss it? I bet that any confrontational tone or "my dog is bigger than your dog" theme would immediately trigger a premature forfeiture. I don't know what would adcoms do to those who retaliate though. My crystal ball always tells me that all lying-in-wait warriors from either camp will eventually be subjected to an intentional foul penalty or two, and thus, are incarcerated within the prison of irrelevant dilemma itself for life.
 
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Great post by Dr. Orons. I hope that this will squash any other attempts by naive, but curious pre-meds to start this question/debate. If in doubt, ask a D.O. instead of people who might want to start a useless debate....
 
I must say that being a DO in an MD program has not been an issue at all thus far.

Good luck in school!
 
Another example of the DO/MD melting pot: The Emergency Medicine Residency PD at the Akron General Medical Center, Ohio (a level-1 trauma center) is a DO. EM PD Also the two cheif residents are DO's. Chief Residents
 
Hey thanks for the link here. It is AWESOME!!!!!!!!!!!!!! I didn't know how to find residency program possiblities and this site gives you everthing you need; pay, hours, extras, locations, specialty, etc.

Thanks for sharing:clap:
 
Does anyone really believe that MD's and DO's have no statistical difference between grades and MCAT's?

Can you really believe that DO's are not considered inferior in the medical world if it is significantly more difficult for them to get the same residency as an MD?

Can you really rely on the opinion of a person who's major premise for their argument is false?:confused: :confused:
 
What exactly is it that I believe??:confused:
 
What are you talking about and why did you have to ruin a perfectly benign sticky?
 
I think generally if you are accepted into a residency then others assume you belong and deserve to be there. :D
 
That is a very wise statement because it is true.

"A devotion to science, a saturation with its spirit, will give you that most precious of all faculties--a sane, cool reason which enables you to sift the true from the false in life and, at the same time, keeps you well in the van of progress." -Osler-:)
 
Personally, I have no preference in becoming a D.O. or an M.D., (although I love Yoga and I think that manipulation is awesome). I view this ongoing disagreement, where one person thinks he/she is better than another, the same way I view racism, religious disputes, and sex/age discrimination. People will always have an opinion about these things; and, unfortunately these opinions may not always be in another person's best interest.

I'm sure we have all fallen victim to discrimination of some sort, b/c people come from all different backgrounds. I think that this "dispute" is just another struggle that comes with the territory. What territory you ask? LIFE!

-kmwmorris
U. New England College of Osteopathic Medicine
 
I am a chiropractor. Could you please explain to me why you feel a career in chiropractic is more rewarding than that of a MD or DO?
 
I agree very much with what kmwmorris said.

There are always people who feel the need to put down other people in order to feel better about themselves. Looking back in history, I see personal insecurity which resulted in one's oppression of others as the main cause for most of the historical events.

That's exactly what Hitler did, and so did the KKK, killers of Matthew Shepard, European imperalists, hip-hop artists dissing others, Islamic terrorists, Americans waging war on Iraq, Chinese threatening to attack the Taiwanese....etc.

The world would be a much better place if we could all learn to be comfortable with ourselves and know our own worth without worrying about how it relates to the worth of other people.
 
A little learning is a dangerous thing;
Drink deep, or taste not the Pierian Spring:
There shallow draughts intoxicate the brain,
And drinking largely sobers us again.
-Alexander Pope: 1711


It is true that a hatred of others through irrational or rational prejudices has and will continue spur atrocities against humanity. We must not be niave enough to put the blame of such historical events on the men who committed such atrocities. For there will be men of ill will tomorrow as their was yesterday. History has demonstrated time and again that it is the indifference and ignorance of society that allows such men to flourish. Hitler became ?Hitler? only after European and American indifference and denial of his anti-Semitic message. The same could be said other problems such as racism and terrorism. Long before two planes flew into the World Trade Center many people including ourselves where either indifferent too or denied the existence of people like Osama Bin Laden.
It is intellectually insulting to yourself to think that the denial of prejudice will eradicate the problem. For it is only through intolerant acceptance that prejudice can be eradicated as a societal doctrine. To deny the prejudice in Healthcare against Osteopaths is neither helpful nor consistent with the search for the truth that all persons of medicine should strive. One day when you?re a doctor, I hope you can understand that it is this search for truth that liberates your naive but prejudice behavior. Yes, denial is not only the most prevalent form of prejudice, it is the most destructive. For it allows small men and women of ill will to flourish. Be wary of those who offer false justice through idealistic hypocrisy, for the road to hell is paved with good intentions. As a physician you must learn to discern the true from the false even when it is not packaged with pretty red ribbon or the answer is not which you desire. For it is from this undesirable answer that you must often begin to find the solution. I wish I could say that Osteopathic physicians were held in the same esteem as Allopathic physicians. But the injustice of this idealism is similar to denying racism against minorities in our society. All it does is make you feel better about yourself at the time you make the proclamation. Thus doing nothing to promote a solution to the problem minorities see on a daily basis.

?A devotion to science, saturation with its spirit, will give you that most precious of all faculties?a sane, cool reason which enables you to sift the true from the false in life and, at the same time, keeps you well in the van of progress.
-Osler-
:)
 
Originally posted by Amy B
To say that D.O.s are believed inferior to M.D.s in the working world of health care is to paint with a very broad brush to say the least. However, when individuals are being considered for competitive postgraduate training opportunities at academic allopathic institutions, D.O.s are definitely at a disadvantage. There are some individuals in the academic allopathic world (and probably more than a few in osteopathic medicine as well) who believe that many (even most?) individuals who end up in an osteopathic medical school do so for the same reason some people end up attending medical school in the Caribbean - because they were rejected from M.D. schools. And let's face it - for some individuals this is indeed the case.

Sincerely,
Philip D. Orons, D.O.
Associate Professor of Radiology
Director, Radiology Residency Program
UPMC Health System [/B]

I don't mean to open up a can of worms, but this is an important point for many pre-meds who don't think ahead. There are people who apply to both MD and DO schools and get accepted to both. Many will pick the MD school, but some will pick the DO school. I don't want to sound like an alarmist, but those that choose the DO school with the idea that they are going into primary care so it doesn't matter, are putting themselves in an awkward position. Many of you 4th year students and residents know how quickly we can change our minds about our specialty of choice. How many incoming students were gung-ho for surgery and ended up in primary care, and how many wanted to go into primary care but were attracted to the specialties. If you decide on allopathic schools, then you still have your options open with regards to what specialty you choose. All you need to do is do well in school. If you go through the osteopathic route, even if you do well in school, some specialties will still be difficult to get into. Primary care, EM, Anesthesiology at this point are fairly open to DOs, but ortho, ophtho, ENT, derm, rads will be more difficult. Of course everyone knows anecdotal people who are DOs who are in competitive allopathic residencies, but as a whole things are more difficult, just as Dr. Orons mentioned. Also, I realize that DOs have their own residencies when it comes to those specialties, but they are not as good as even mid-tiered allopathic programs. I'll probably get flamed for this, but please believe me that I'm not trying to start a flame war. I just want people to make informed decisions by thinking ahead. I know when I was a first year med student, I didn't think any further than my first test, but I know from experience that you should always keep the big picture in mind. That includes thinking about residencies, and the possibility of changing your mind about what you are going into many, many times before you finally decide.
 
I don't believe Chiropractic is much more rewarding nor would ever go to one because I have heard sooo many stories about how people have to keep going there because they don't get better and in fact if anything get worse a lot of the time.

Chiropractic can be very rewarding. It all depends on the individual. I?ve heard many stories about chiropractic and many similar stories regarding other healthcare professionals. It doesn?t mean all the stories are true. I wouldn?t base why opinion on what I?ve ?heard?. Go find out for yourself and make your own decisions.

If you have a bad experience with a dentist are you going to boycott all dentists and let your teeth fall out? Most people will have enough sense to realize that they?re not all bad and will certainly go and find a new one. The same should be said towards chiropractic. Too often people stereotype the whole profession. This is a shame because there are patients that I could help that don?t seek chiropractic care because of what they ?heard?. It is my job as a chiropractor, to educate other doctors and the public so they know that we are not all bad.

Listen, there are some chiropractors out there that keep patients coming forever. That is a shame and they are the ones who make us ALL look bad. The same could be said for psychiatrists. Most patients have enough sense to realize that if they are not getting better they should quit going. If I was seeing a doctor and wasn?t getting better I would be finding a new doctor for a second opinion.

You say, ?in fact if anything they get worse a lot of the time?. If it were a ?fact? that most of our patients get worse a lot of the time, I wouldn?t think we, as a profession, would'nt still be here.

Anyhow, the other thing is......... I would rather do DO because see DO's do palpitation and chiropractic stuff, but they know when there is a need for medication to also use it in their treatments and they can do all the fields of medicine that MD's do.

Going to a DO is fine by me. My kid?s pediatrician is DO. At least you see the value in manual medicine. I am a chiropractor and I know when there is a need for medication. In fact, I work with DO?s and MD?s when there is such a need. We are not all against medication. Most chiropractors in my opinion have no problem with patients taking medication when it is needed.

They actually fix the problem, whereas most chiropractors make the problem worse from all the stories I have heard.

As a chiropractor our goal is to fix the problem, it?s every doctor?s goal. If a patient comes in with back pain we want to find the source of the problem and correct it. Although giving a patient pain medication is of great value it does nothing to correct the problem that causes the pain.

Again, if most chiropractors made problems worse, then they wouldn?t have any patients. This is not the case as chiropractic has been around for more than a hundred years.
 
Also, I realize that DOs have their own residencies when it comes to those specialties, but they are not as good as even mid-tiered allopathic programs.

WoW. I love it when people on this forum just make up $hit. Get a clue before you start shouting off at the mouth.
 
I always find it interesting when first year medical students advise physicians on the reality of medicine. Behold, a little knowledge is dangerous. I am reminded of a story, it goes something like this.

When I was a first year medical student I realized how little I knew when I was an undergrad. When I was a first year intern I realized how little I knew as a medical student. When I was a fellow I realized how little I knew as a resident. While in practice I realized how little I knew as a fellow. Now as Chief of Medicine at a little hospital with over 600 beds I realize how much I still have to learn from everyone I encounter.

I hope this will help lend perspective to how much both you and I still have to learn. This perspective has made my life much more complete.
 
well i went and contacted a DO here at Memorial Sloan Kettering (affiliated with Cornell Presbyterian) to ask his persepctive... here is his response:



It is great that you got accepted to Osteopathic school.

For your questions: There is always biases when you are different and not the norm but that?s also what makes you unique. My father was an MD and my mother ( a nurse) really gave it to me for several years but came around when they realized how well trained and accomplished I became. I enjoyed my DO training and was much better prepared to handle the real world of medicine than a lot of my counterparts. I do not regret my decision even though the path might have been easier. I have been the first DO on staff at Cornell and that turned a lot of heads initially but now no one really turns there head anymore but keeps referring patients to me.

Hope this is helpful and I wish you luck in your career- you chose a good one.
 
here is his bio, if interested:

William Kevin Kelly

Education
D.O., Philadelphia College of Osteopathic Medicine

Residencies
Albert Einstein Medical Center (Philadelphia)

Fellowships
Memorial Sloan-Kettering Cancer Center; The New York Hospital-Cornell Medical Center

Board Certifications
Internal Medicine; Medical Oncology

Clinical Expertise
Prostate, Bladder, Testicular, and Kidney Cancers and Other Genitourinary Malignancies; New Investigational Agents
 
That is the type of realistic clarity one must utilize when practicing medicine. It provides a realistic look at the challenges you may face while providing hope that you can overcome these prejudices. It accomplishes all of this without providing false or misleading information which would erode its credibility. :thumbup:
 
Great post Chrisobean.

As I have said before......... You are what you make of your career. There can be great DOs and great MDs or there can be horrible DOs and horrible MDs. The education path you follow does not determine your success, nor does it determine how good of a doctor you will be............Only you can make it true.
 
That is true, but choosing the DO route will require more effort. I know, for example, that lecture and lab time at osteopathic schools average around 30-35hours! Whereas, MD's are closer to 20-25 hours. Most DOs end up having to study for both the COMLEX and the USMLE, which is no small task. I think the DO approach is very useful, but if you do decide to go that route, be sure you know that it's the right choice for you.
 
msufb16, what's your deal? are you a DO?
 
When two people meet, there are really six people present. There is each man as he sees himself, each man as the other person sees him, and each man as he really is. Is the man I see the same as you? Probably not! But the teacher defends his pupils against his own influence.

The beauty of Morrow Bay sets with me still today. An old friend who now designs golf courses once pitched for your wonderful school. I was always jealous of him playing baseball in Hawaii for a week each year. Johnny Madden is a wonderful example of a person being successful despite limited knowledge of the game he once coached and still announces today, football. You will find medicine, like much of life, to be exactly the same.

I believe everything that can be said about these topics has been said. So, good luck with your education.
:)
 
hmm I wonder how Dr. Oron views osteopathic philosophy affecting his radiology practice? Does he practice different from the MD radiologist? Is his approach to any part of radiology different because of his osteopathic training?

Just wondering :confused:
 
It is hard to tell if you are trying to be profound or condescending in this thread, but since the person whom I really am doesn't really care...I guess it doesn't really matter. I do appreciate the fact that you acknowledge the beauty of where I live; it will be difficult to leave. Also, it is Morro Bay not Morrow Bay. "Morro" is Spanish for "bluff".
 
There are always people who feel the need to put down other people in order to feel better about themselves. Looking back in history, I see personal insecurity which resulted in one's oppression of others as the main cause for most of the historical events. That's exactly what Hitler did, and so did the KKK, killers of Matthew Shepard, European imperalists, hip-hop artists dissing others, Islamic terrorists, Americans waging war on Iraq, Chinese threatening to attack the Taiwanese....etc.

I believe in karma, which is why I don't want my first post to be too presumptuous or brash. But I have to point out that this is the most flawed and oversimplified argument I have read in many years. Reducing a millenium of religious conflict to simple insecurity is unfathomable, while the Taiwanese strait is an issue of property rights. Imperialism - insecurity?

I'm just glad you're going into medicine and not foreign policy! ;)
 
I think it should be noted that when people consider DOs to be equal to MDs, they are in fact referring to allopathically-trained DO graduates. Most osteopathic residency programs are, in fact, inferior to their allopathic counterparts. I would be hesitant to visit an osteopathically-trained DO.
 
JKDMed,

Just wondering on what basis is the inferior stigma warranted? From your perspectuve. I have always been curious why some people feel that way and others do not.

mb
 
JKmed,

You have been posting for quite some time, and once upon a time I used to respect what you had to say. Now it seems you cant stop the river of crap from coming out of your mouth. You have been chastised for doing this before and apparently you didnt catch on. You have absolutely no first hand experience (or second hand experience, for that matter) in the quality of osteopathic residencies.

What about osteopathic residency trained physicians now teaching at allopathic residencies? where do they fall on your list?

And with that said, I don?t really have 1st hand exp. either but at least I do have second hand experience. So while trying not to beat a dead horse I'll say the only truth there seems to be in the quality of programs; there are both good and bad osteopathic and allopathic residencies. Good and bad doctors (of both degrees).

Great Med schools and Great residencies sometimes make bad doctors. Why? Because the individual determines how good of a physician they will be. So on the other side of the coin this is how "sub-par" residencies (again both ACGME and AOA ones) and med schools can produce great doctors.

The best way to choose a physician is through word of mouth, and from their track record of patient satisfaction. Making assumptions and blanket statements is the wrong way to go through life and will ultimately lead to poor decision-making.
 
Originally posted by JKDMed
I would be hesitant to visit an osteopathically-trained DO.
I'm sorry, dude, but that deserves the big :rolleyes:.

Osteopathic programs, on average, may provide less pathology, have fewer beds, and have less than state-of-the-art equipment, but there's a lot to the equation you're choosing to ignore...

*A large number of osteopathic residencies are integrated with allopathic ones.

*Osteopathic programs are marked with the American standard of healthcare. It's as if you're equating "osteopathically-trained physicians" with physicians trained in the third-world... and as if it mattered, we all know there's some great physicians that've been trained in third-world countries.

*Lastly, your average osteopathically-trained DO who's been in practice 5 years is more competent a physician than your average allopathically-trained MD who's coming straight out of residency.
 
well said cowboy, jkd seems to be just another dumba#$....ahh, to be 22 and ignorant...this person doesn't need to go into medicine....try computers or something that needs no human interaction....
 
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