,

[AnatomyGrey12]

The fields that would have actually been hurt the most by being barred from ACGME fellowships was ironically the fields like the surgical subs where AOA fellowships are essentially no existent. Even from AOA general surgery programs residents matched fellowships like CT, vascular, with the occasional plastic fellowship. Residents in ENT and ortho could pretty much land almost all fellowships in those fields. It would have been a big blow to those residents. So while I actually agree with the sentiment that the merger, as constituted, is a raw deal for DOs, barring AOA grads from ACGME fellowships would have been an even worse situation.

When people talk about fellowships most jump to IM but forget that grads from AOA programs in most fields were matching ACGME fellowships on a consistent and comfortable basis.

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[ThreeCheers]

The fields that would have actually been hurt the most by being barred from ACGME fellowships was ironically the fields like the surgical subs where AOA fellowships are essentially no existent. Even from AOA general surgery programs residents matched fellowships like CT, vascular, with the occasional plastic fellowship. Residents in ENT and ortho could pretty much land almost all fellowships in those fields. It would have been a big blow to those residents. So while I actually agree with the sentiment that the merger, as constituted, is a raw deal for DOs, barring AOA grads from ACGME fellowships would have been an even worse situation.

When people talk about fellowships most jump to IM but forget that grads from AOA programs in most fields were matching ACGME fellowships on a consistent and comfortable basis.

I don't agree that it would be an even worse situation, honestly. Again, going unmatched for residency is MUCH worse than the horrific fate of holding a cushy 6-figure job as a general ENT or ortho surgeon.

I also fail to see how the merger makes it easier to become a fellowship-trained surgeon. With or without the merger, you can't get to an ACGME fellowship without earning acceptance into an ACGME residency. In a hypothetical universe where AOA-trained physicians are barred from ACGME fellowships, trainees have the option of working hard to land an ACGME residency if they ultimately wish to subspecialize. As it stands now with the merger, these same trainees would have to work hard to land an ACGME residency to become a generalist OR a specialist.

 

[neuromom]

This is a really good point. And one I totally agree with. and luckily it's a known issue that I truly hope will get solved. The current political climate doesn't seem to want to focus on investing in health of our citizens, so clearly investing into the residency spots are just not there. Will AOA residencies still be favorable to DO applicants even after the merge?

Perhaps opening up new or expanding current DO hospital-affiliated residency programs can be something that's done with 3rd and 4th year tuition money. Instead of schools putting money into new schools.

I also want to know why some people are not getting matched. Are they being realistic with their goals? Don't some FM residency spots go unfilled each year? Are they getting proper counseling with creating ranking orders and interview skills and what not? Looking at programs that are not competitive and having back ups?

Most of our tuition goes to paying hospitals to take us on as students. My school is not using its tuition money to open any new schools, and we have the highest tuition of all of them.

 

[AnatomyGrey12]

I don't agree that it would be an even worse situation, honestly. Again, going unmatched for residency is MUCH worse than the horrific fate of holding a cushy 6-figure job as a general ENT or ortho surgeon.

You are capping the best students for the sake of the worst.

I also fail to see how the merger makes it easier to become a fellowship-trained surgeon.

Because without the merger the fellowships would have become off limits....

In a hypothetical universe where AOA-trained physicians are barred from ACGME fellowships, trainees have the option of working hard to land an ACGME residency if they ultimately wish to subspecialize.

This sounds nice on paper until you realize that in real life that these students matching into these specialties don’t really have the option of going to (former) ACGME programs.

The merger sucks, but it is still better than the alternative.

 

[hallowmann]

There are also some benefits of the merger that seemed to have been overlooked. For one thing it wasn't just fellowships. DOs who went AOA for say a TRI would not be able to continue into their advanced positions in an ACGME residency, something that a non-insignificant amount of people did, given mainly that TY's are competitive.

At the time, >50% of DOs were going ACGME with literally no control or say in the ACGME itself. AOA programs could barely support 50% of graduates, and with schools expanding that problem would have only gotten worse. If the ACGME at any time wanted to change what DOs had to do to apply let alone enter into their residencies or make other policies, they would have been able to do it with zero input from DOs (which is basically what happened with the whole "common requirements" thing). Now DO organizations carry 28% of the voting seats in the ACGME, even though we represent <20% of residents). We actually now have input into the programs that more than half of our grads were going to.

Add on the fact that a lot of what makes the DO degree recognized in other countries is the eligibility of DOs to go ACGME, but by the ACGME basically saying AOA programs are subpar, it ultimately means that DOs would be viewed as subpar, let alone would have prevented any DOs going AOA from practicing in those countries.

The merger streamlines the GME process as well, so you have all the pluses associated with not having to divide your resources across two apps/matches.

Yeah, transitions suck. There's a lot of uncertainty with it and some DOs, especially at the bottom are going to struggle a bit more than before, but its still an overall net positive for the profession. It would be even more so if DO schools were actually required to have certain placement outcomes, but COCA felt that DO graduates actually getting a job when they graduate wasn't important enough to leave that requirement in apparently.

Yeah it sucks that Northshore is doing this (although to be completely honest they were screwing over DOs and their DO programs pretty much from the time they opened Hofstra-LIJ - closing their AOA programs, suddenly dropping DOs from rosters, etc. - this was going on long before the merger).

 

[ThreeCheers]

You are capping the best students for the sake of the worst.

It's not capping because nobody is entitled to be a pediatric neurocardiac surgical dermatologists. The truly "best" students would have every opportunity to make it a priority to match into ACGME residencies, and therefore would be unaffected. It's been done before. In fact, I'm pretty sure I've seen you argue several times that matching ACGME surgery is not an unrealistic goal as a DO.

In general I don't think DO students that reach graduation deserve to be unemployed and 300K in debt, regardless of whether or not they are "the worst". Is that not the entire basis of the anti-Caribbean circle-jerk?

Because without the merger the fellowships would have become off limits....

Not if they complete an ACGME residency.

This sounds nice on paper until you realize that in real life that these students matching into these specialties don’t really have the option of going to (former) ACGME programs.

This doesn't make sense. If these students couldn't match into ACGME programs before the merger, what makes you think they will after the merger? Especially since many AOA surgical programs are struggling for the 3rd consecutive year to achieve accreditation.

 

[ThreeCheers]

The merger streamlines the GME process as well, so you have all the pluses associated with not having to divide your resources across two apps/matches.

Yeah, transitions suck. There's a lot of uncertainty with it and some DOs, especially at the bottom are going to struggle a bit more than before, but its still an overall net positive for the profession. It would be even more so if DO schools were actually required to have certain placement outcomes, but COCA felt that DO graduates actually getting a job when they graduate wasn't important enough to leave that requirement in apparently.

Yeah it sucks that Northshore is doing this (although to be completely honest they were screwing over DOs and their DO programs pretty much from the time they opened Hofstra-LIJ - closing their AOA programs, suddenly dropping DOs from rosters, etc. - this was going on long before the merger).

I agree that there are benefits to the merger, namely the unified match. Also agree about Northshore.

I suppose my main problem is that it feels like it was so horrifically planned by osteopathic leadership. I realize that COCA, NBOME, and AOA are all separate organizations, but like... do they communicate with one another at all? Why is the NBOME promoting COMLEX only in light of the merger? Why is COCA carrying on with DO school expansion in light of the merger? Why did the AOA drop the ball with establishing GME programs to accommodate the increased number of graduates, which put them in a position where they could be threatened with an ultimatum? It's a mess all around, and the admin making these decisions aren't going to be the ones that suffer.

 

[W19]

FMG/IMG are the biggest winners of that merger... As for now, I think the merger is a net loss for DO.

 

[TeddyBoomBoom]

NBOME - makes $$$ from COMLEX. Has vested interest in never ever ever ever ending COMLEX.

COCA- Makes $$$ from schools. Does not have students’ best interests at heart. Specifically took away requirement for placement into residencies.

AOA- makes $$$ from physicans. There is no MD equivalent for a board that requires yearly fees personally paid to the AOA for the rest of your professional career to maintain state licensure.

 

[AnatomyGrey12]

It's not capping because nobody is entitled to be a pediatric neurocardiac surgical dermatologists. The truly "best" students would have every opportunity to make it a priority to match into ACGME residencies, and therefore would be unaffected. It's been done before. In fact, I'm pretty sure I've seen you argue several times that matching ACGME surgery is not an unrealistic goal as a DO.

You are telling the best students, who have matched into competitive specialties, that they can’t pursue additional training for the pure reason that it’s unfair that the worst DO students now have to take USMLE if they want to match family med? The best DO students aren’t in ACGME programs, they are largely in the AOA specialty programs.

Yes general surgery is realistic, it doesn’t change the fact that any of the subs are now barred from the multitude of fellowships they had easy access to. You also are punishing the hundred or so AOA GS residents.

In general I don't think DO students that reach graduation deserve to be unemployed and 300K in debt, regardless of whether or not they are "the worst". Is that not the entire basis of the anti-Caribbean circle-jerk?

There are most definitely students who shouldn’t ever be let near a patient, but that’s not the issue. It is t similar to the Carib because those schools let people in who they know full well won’t make it. We are talking about people who are heading for largely uncompetitive fields and most of the AOA programs in these fields have made the merger. We shouldn’t be upset and bar our best students from fellowships simply because they can’t simply walk into AOA FM residencies anymore.

Not if they complete an ACGME residency

You are barring about half of DO residents from access to fellowships.

This doesn't make sense. If these students couldn't match into ACGME programs before the merger, what makes you think they will after the merger? Especially since many AOA surgical programs are struggling for the 3rd consecutive year to achieve accreditation

Again, in a perfect world this would be the case but the best DO students actually used to go AOA because the ACGME programs wouldn’t even give them a look. With the merger yeah some of these programs won’t make it and some MDs will take some spots, but at least these former AOA programs will still give the DO applicants a fair shake and no throw the DO apps in the toilet.

The big picture item you are missing is that if the AOA didn’t agree to the merger it would have essentially been the AOA conceding that their programs are inferior to the ACGME programs. This would not have been a good thing. All it would have done is give life to the opinion that DOs are lesser trained, and inferior physicians.

The transition is going to suck, and it is sucking, but the alternative is still worse.

 

[ThreeCheers]

You are telling the best students, who have matched into competitive specialties, that they can’t pursue additional training for the pure reason that it’s unfair that the worst DO students now have to take USMLE if they want to match family med? The best DO students aren’t in ACGME programs, they are largely in the AOA specialty programs.

Yes general surgery is realistic, it doesn’t change the fact that any of the subs are now barred from the multitude of fellowships they had easy access to. You also are punishing the hundred or so AOA GS residents.

Historically, AOA surgical residencies are not that competitive and people matching into those fields are not necessarily the top of their class. Many DO students regularly match AOA surgery with average (if that) COMLEX scores and no USMLE, especially if they make friends with the right people on audition rotations. Such an applicant wouldn't make it into an ACGME surgical residency after the merger anyway, and thus should not feel entitled to a coveted ACGME fellowship position.

As an aside, I'm pretty sure that DO students do not have to take the USMLE to match FM as it stands now. But if they do, then that would screw over 1/3+ of DO students (including many of the AOA surgery-caliber applicants that you keep insisting are *the best* students).

There are most definitely students who shouldn’t ever be let near a patient, but that’s not the issue. It is t similar to the Carib because those schools let people in who they know full well won’t make it. We are talking about people who are heading for largely uncompetitive fields and most of the AOA programs in these fields have made the merger. We shouldn’t be upset and bar our best students from fellowships simply because they can’t simply walk into AOA FM residencies anymore.

Agreed, but those students should be weeded out well before the school collects 4 years of tuition. If this year's placement rates are any indication, that isn't happening.

You are barring about half of DO residents from access to fellowships.

Nobody would be barred in this scenario. Trainees would just have to take the proper pathway if they want the extra specialization. If people want to do an ACGME fellowship, then they should do an ACGME residency. Simple as that. I don't understand why you think it's so unfair that students should have to do better on USMLE/research/etc (or a strong gap year to get into MD school) if they want to do a prestigious subspecialty, rather than sneaking their way in via a significantly less competitive AOA residency.

Again if you're suggesting that the USMLE should be required, then you are barring 1/3+ of DOs (including most of those DO residents that you just referred to) from ANY sort of practice.

Again, in a perfect world this would be the case but the best DO students actually used to go AOA because the ACGME programs wouldn’t even give them a look. With the merger yeah some of these programs won’t make it and some MDs will take some spots, but at least these former AOA programs will still give the DO applicants a fair shake and no throw the DO apps in the toilet.

ACGME programs have given the truly best students in my class not only a look but also a residency position.

The big picture item you are missing is that if the AOA didn’t agree to the merger it would have essentially been the AOA conceding that their programs are inferior to the ACGME programs. This would not have been a good thing. All it would have done is give life to the opinion that DOs are lesser trained, and inferior physicians.

I agree that perception is an advantage to the merger, along with the unified match.

Having gone through the match recently, and all the (ultimately unfounded) anxiety that was associated with the fear of not having any sort of job... I personally think the disadvantages have the potential to be far stronger than the advantages. Like I said, it's still too early to say definitively either way.

EDIT: The last thing I'd like to point out is that DO students across the board will be hurt by the merger in terms of residency prospects, not just the weak ones. Good students will be shut out of competitive specialties, and average students will have limited options outside of primary care.

 

[AnatomyGrey12]

Historically, AOA surgical residencies are not that competitive and people matching into those fields are not necessarily the top of their class. Many DO students regularly match AOA surgery with average (if that) COMLEX scores and no USMLE, especially if they make friends with the right people on audition rotations. Such an applicant wouldn't make it into an ACGME surgical residency after the merger anyway, and thus should not feel entitled to a coveted ACGME fellowship position.

What are you talking about? I’m not just talking about general surgery, I’m talking all forms of it. If you think a lot of the ortho or ENT residents aren’t some of the best DO students then I don’t know what to tell you. Those people aren’t given the time of day in the ACGME match and therefore the AOA (or former AOA) programs are their only chance.

As an aside, I'm pretty sure that DO students do not have to take the USMLE to match FM as it stands now. But if they do, then that would screw over 1/3+ of DO students (including many of the AOA surgery-caliber applicants that you keep insisting are *the best* students).

Again, what are you talking about? Your whole rant is based off of one single health system now requiring the USMLE.

Agreed, but those students should be weeded out well before the school collects 4 years of tuition. If this year's placement rates are any indication, that isn't happening.

That’s not my fault. You don’t get to control my fellowship options simply because the school fails to weed out the worst students.

Nobody would be barred in this scenario. Trainees would just have to take the proper pathway if they want the extra specialization. If people want to do an ACGME fellowship, then they should do an ACGME residency. Simple as that. I don't understand why you think it's so unfair that students should have to do better on USMLE/research/etc (or a strong gap year to get into MD school) if they want to do a prestigious subspecialty, rather than sneaking their way in via a significantly less competitive AOA residency.

If you think AOA ortho programs are “significantly less competitive” then our discussion ends there. This whole statement would be completely valid if the DO bias didn’t exist, but it does. We live in a world where a DO with a 270 and 15 publications only gets 3 plastic surgery interviews. You are telling that person “too bad, you don’t get to do a fellowship now because there is ACGME bias and you have to do an AOA program where you can’t do a fellowship.”

Again if you're suggesting that the USMLE should be required, then you are barring 1/3+ of DOs (including most of those DO residents that you just referred to) from ANY sort of practice.

Never said that. I do actually think USMLE should be required but that isn’t part of our discussion.

ACGME programs have given the truly best students in my class not only a look but also a residency position

Again, in what fields? You are screwing over the most competitive students because the bottom of the class should have uninhibited access to AOA residencies.

Competition is a good thing. If we can’t outcompete the IMGs or low tier MD students (because let’s be honest, that’s who will be aiming for the majority of these former AOA programs outside the super competitive specialties) then we need to take a hard look at the caliber of our student body.

I also disagree with the notion that the merger hurts people applying to uncompetitive fields, if anything it helps them because now all their programs are in one match.

 

[ThreeCheers]

What are you talking about? I’m not just talking about general surgery, I’m talking all forms of it. If you think a lot of the ortho or ENT residents aren’t some of the best DO students then I don’t know what to tell you. Those people aren’t given the time of day in the ACGME match and therefore the AOA (or former AOA) programs are their only chance.



Again, what are you talking about? Your whole rant is based off of one single health system now requiring the USMLE.

Before the merger, many students made it into AOA ortho with above-average-but-not-great COMLEX scores and no USMLE (as it was not required). If I remember correctly, there was an interview last year with the Broward ortho PD where he stated that he was only now raising the minimum COMLEX required to a 600. Maybe AOA ortho applicants are stronger compared to their class, but collectively (obviously there are exceptions), they don't measure up to the US MD students applying ACGME ortho.

My "rant" (it was literally just me stating my perspective in less than 2 paragraphs before you started picking apart everything I say sentence-by-sentence) is based off of he fact that we keep getting more information that supports DOs being hurt in terms of residency matches. I've already stated that Northwell is likely an isolated incident, but it's not great news when you combine it with things like the residency placement rate decreasing at various schools, COCA expansion, COCA pulling the placement rate requirement, etc

That’s not my fault. You don’t get to control my fellowship options simply because the school fails to weed out the worst students.

It's not the unplaced students' fault either. They made an informed decision to pay $200K based on the 99%+ residency placement rates that are already dropping before the merger has even had any substantial effect on most fields.

If you think AOA ortho programs are “significantly less competitive” then our discussion ends there. This whole statement would be completely valid if the DO bias didn’t exist, but it does. We live in a world where a DO with a 270 and 15 publications only gets 3 plastic surgery interviews. You are telling that person “too bad, you don’t get to do a fellowship now because there is ACGME bias and you have to do an AOA program where you can’t do a fellowship.”

Again, in what fields? You are screwing over the most competitive students because the bottom of the class should have uninhibited access to AOA residencies.

AOA ortho is significantly less competitive than ACGME ortho, with or without the perceived bias.

I won't talk specifically about my class for anonymity purposes, but the past few classes at my school have seen ACGME matches in ENT, ortho, well-regarded university IM, surgery, derm, radonc.

I don't understand what nerve I hit with you here. I'm pretty sure I've seen you arguing (repeatedly) in the past that the ACGME superstar matches do not require unreasonable stats, and that DO students are for the most part are given a chance as long as they make their applications look like their MD colleagues'. I remember this pretty distinctly because it was a breath of fresh air compared to all the whining about how mean ACGME PDs are to DO students. I'm genuinely curious what caused this 180?

Competition is a good thing. If we can’t outcompete the IMGs or low tier MD students (because let’s be honest, that’s who will be aiming for the majority of these former AOA programs outside the super competitive specialties) then we need to take a hard look at the caliber of our student body.

I also disagree with the notion that the merger hurts people applying to uncompetitive fields, if anything it helps them because now all their programs are in one match.

We can't compete with IMG's because they have little academic responsibility outside of passing NBMEs for 2 years, and then they get 6 months off to study for step. I think we need to take a hard look at both the caliber of the student body (and by that I mean the dilution that occurs as a result of COCA expansion) and the curriculum.

The match is definitely helpful for people that are punching down in terms of their residency choice (e.g. strong applicants that are interested in primary care or superstar surgery applicants that ended up in AOA programs due to the crappy timing of the match). I would have likes to see the inconveniently timed matches solved years ago, with or without the merger.

To be clear, I don't think that shutting DOs out of ACGME residencies is ideal. I was merely speculating that it may be preferable to a significant number of DO students potentially graduating with no residency. I personally feel that the merger has the potential to make DO schools look more comparable to Caribbean schools. The new McDO schools are accepting applicants with a 22 MCAT, knowing (and not caring) that they are setting those students up to fail. It may not be on as large of a scale as the Caribbean schools yet, but we're headed in the wrong direction. I feel that DO leadership should have collaborated to make sure that their students are protected when making big decisions like entering the merger. That's just my perspective. Sorry that it's different from yours.

 

[AnatomyGrey12]

I don't understand what nerve I hit with you here. I'm pretty sure I've seen you arguing (repeatedly) in the past that the ACGME superstar matches do not require unreasonable stats, and that DO students are for the most part are given a chance as long as they make their applications look like their MD colleagues'. I remember this pretty distinctly because it was a breath of fresh air compared to all the whining about how mean ACGME PDs are to DO students. I'm genuinely curious what caused this 180?

You didn’t hit a nerve and there isn’t a 180. My comments you mention are still 100% my opinion but I disagree with the idea that DO residents being barred from ACGME fellowships is a better alternative to the merger. While I hold the above opinion it still doesn’t change the fact that in these specialties ACGME PDs hold a significant bias and the AOA programs are the best chance for these fields as DO applicants. The 270/15 pub numbers I threw out wasn’t just me making something up, that is a true story from this last cycle and no they didn’t match.

To be clear, I don't think that shutting DOs out of ACGME residencies is ideal. I was merely speculating that it may be preferable to a significant number of DO students potentially graduating with no residency.

And I disagree based on the fact that the numbers of people who actually aren’t finding a residency of any kind is still small. The merger is still preferable to no fellowships.

The new McDO schools are accepting applicants with a 22 MCAT, knowing (and not caring) that they are setting those students up to fail. It may not be on as large of a scale as the Caribbean schools yet, but we're headed in the wrong direction.

No argument here. Agree completely.

I feel that DO leadership should have collaborated to make sure that their students are protected when making big decisions like entering the merger. That's just my perspective. Sorry that it's different from yours.

And I don’t disagree with this. The merger is going to hurt, that is an unarguable fact, but I disagree with the idea that barring AOA residents from fellowships is better than the merger.

DO leadership doesn’t give two craps about the students, the sooner people realize that the better.

 

[TheaterOfTheme]

NBOME - makes $$$ from COMLEX. Has vested interest in never ever ever ever ending COMLEX.

COCA- Makes $$$ from schools. Does not have students’ best interests at heart. Specifically took away requirement for placement into residencies.

AOA- makes $$$ from physicans. There is no MD equivalent for a board that requires yearly fees personally paid to the AOA for the rest of your professional career to maintain state licensure.

For AOA, is this the case coming out of an ACGME residency??

 

[Neopolymath]

For AOA, is this the case coming out of an ACGME residency??

Nope. No AOA residency = No Osteopathic board license = no mandatory AOA membership money

 

[hallowmann]

I agree that there are benefits to the merger, namely the unified match. Also agree about Northshore.

I suppose my main problem is that it feels like it was so horrifically planned by osteopathic leadership. I realize that COCA, NBOME, and AOA are all separate organizations, but like... do they communicate with one another at all? Why is the NBOME promoting COMLEX only in light of the merger? Why is COCA carrying on with DO school expansion in light of the merger? Why did the AOA drop the ball with establishing GME programs to accommodate the increased number of graduates, which put them in a position where they could be threatened with an ultimatum? It's a mess all around, and the admin making these decisions aren't going to be the ones that suffer.

Yeah that's fair. NBOME makes money off of the COMLEX, and without it they're obsolete. COCA has a similar benefit, but it also has close ties with current schools, and making more stringent requirements ultimately means those schools have to spend more of their money, which schools don't want to do.

NBOME - makes $$$ from COMLEX. Has vested interest in never ever ever ever ending COMLEX.

COCA- Makes $$$ from schools. Does not have students’ best interests at heart. Specifically took away requirement for placement into residencies.

AOA- makes $$$ from physicans. There is no MD equivalent for a board that requires yearly fees personally paid to the AOA for the rest of your professional career to maintain state licensure.

Actually MD specialty boards do have fee requirements, but its not the AMA or anything. The AOA also discontinued that requirement, I believe they announced it a couple years ago. Don't know if it's completely implemented, but remember being surprised when they announced it.

 

[NurWollen]

Yeah that's fair. NBOME makes money off of the COMLEX, and without it they're obsolete. COCA has a similar benefit, but it also has close ties with current schools, and making more stringent requirements ultimately means those schools have to spend more of their money, which schools don't want to do.



Actually MD specialty boards do have fee requirements, but its not the AMA or anything. The AOA also discontinued that requirement, I believe they announced it a couple years ago. Don't know if it's completely implemented, but remember being surprised when they announced it.

I got a letter in the mail when I graduated a year ago urging me to rejoin the AOA. It said that requirement would be fazed out. Again, this was a year ago.

Sent from my SM-G930V using SDN mobile

 

[Solodyn]

The AOA Membership requirement is voted to be dropped. However, the resolution is to take effect on an undetermined date. No one know when that will be. So for all intended purpose, AOA membership is still required to maintain board certification.

 

[sab3156]

I don't understand what nerve I hit with you here. I'm pretty sure I've seen you arguing (repeatedly) in the past that the ACGME superstar matches do not require unreasonable stats, and that DO students are for the most part are given a chance as long as they make their applications look like their MD colleagues'. I remember this pretty distinctly because it was a breath of fresh air compared to all the whining about how mean ACGME PDs are to DO students. I'm genuinely curious what caused this 180?

What you and others don't seem to realize is that stats don't really much to do with this. Yeah, you obviously need good stats and good quality research, but even then - it will never be a reliable thing for a DO to match into specialties like ophtho, ENT, ortho, etc. in ACGME, even with an application that is on par with the best MD applicants of the cycle. I don't think people understand what pedigree bias is until they work in academic medicine and see it first-hand. Or when they don't match.

 

[Dwan]

I don't understand what nerve I hit with you here. I'm pretty sure I've seen you arguing (repeatedly) in the past that the ACGME superstar matches do not require unreasonable stats, and that DO students are for the most part are given a chance as long as they make their applications look like their MD colleagues'. I remember this pretty distinctly because it was a breath of fresh air compared to all the whining about how mean ACGME PDs are to DO students. I'm genuinely curious what caused this 180?

There's a big difference between stats required/ stats among people who made it in, and actual odds. Per the stats from MD applicants, we only need a 220s-230s to have a shot at top 10 programs in the most competitive specialties, and a good amount make it with scores in that range. However, I wouldn't bet on it, as many with those #s also fail to get in, especially if from a low-tier institution.

 

[2021Doctor]

1982 case of Weiss vs York Hospital

IV. Conclusions of Law.
1. The York Hospital Medical and Dental Staff conspired to deny or impede reasonable, fair, equal, or full access to staff privileges at York Hospital by osteopathic physicians, in violation of Section 1 of the Sherman Act.

2. The York Hospital committed the offense of monopolization in violation of Section 2 of the Sherman Act unreasonably to *1061 exclude both Plaintiff Weiss and the Plaintiff Class from York Hospital Staff privileges.

3. The York Hospital committed the offense of attempt to monopolize in violation of Section 2 of the Sherman Act by attempting to acquire the power to control prices in or exclude competitors from the relevant market resulting in injury to Plaintiff Weiss and the Plaintiff Class.

4. The York Hospital committed the offense of conspiracy to monopolize in violation of Section 2 of the Sherman Act by conspiring with others to obtain the power to control prices in or exclude competitors from the relevant market, resulting in injury to Plaintiff Weiss and the Plaintiff Class.

.............
1. Pursuant to the Court's authority under 15 U.S.C. § 26, this Court hereby declares that the following equitable relief shall be entered against Defendants York Hospital and York Hospital Medical and Dental Staff:

1.1 The York Hospital and the York Hospital Medical and Dental Staff are restrained and enjoined from undertaking any overt act against either Plaintiff Weiss or members of the Plaintiff Class which would in any way impede or deny the Plaintiffs full, reasonable, fair, or equal access to the facilities of York Hospital and full, reasonable, fair or equal access to staff privileges at the York Hospital.

Weiss v. York Hosp., 548 F. Supp. 1048 (M.D. Pa. 1982)

The law has established that trying to bar fully licensed osteopathic physicians from hospital staffs is an illegal antitrust violation.
So wouldn't an attempt to bar fully licensed osteopathic physicians from ACGME fellowship programs be an illegal antitrust violation?

 

[ThreeCheers]

I understand the disadvantages of being a DO just fine. Superstar matches by DOs can be done with reasonable stats, but I never meant to imply that that it is not more challenging to accomplish as a DO. On the other hand, I have a hard time believing that these clearly intelligent students didn’t know that prestige and name recognition would be important for residency apps when they chose to matriculate into a DO school. Personally, I think that pre-orthos should do everything in their power (including a potential gap year) to get into MD school. No need to add an extra obstacle to an already lofty goal.

I do question how many residents in competitive AOA specialties have apps that actually look like their MD counterparts’. Step scores are one thing, but it is difficult to get strong research and important letters as a DO. MD students, on the other hand, have key connections through their school, and therefore are more likely to build a stronger app.

Anyway, I think I’ve exhausted this discussion. Everybody knows the potential advantages and disadvantages of the merger. It is a matter of opinion whether the good outweighs the bad.

 

[ChicagoBear]

1982 case of Weiss vs York Hospital

IV. Conclusions of Law.
1. The York Hospital Medical and Dental Staff conspired to deny or impede reasonable, fair, equal, or full access to staff privileges at York Hospital by osteopathic physicians, in violation of Section 1 of the Sherman Act.

2. The York Hospital committed the offense of monopolization in violation of Section 2 of the Sherman Act unreasonably to *1061 exclude both Plaintiff Weiss and the Plaintiff Class from York Hospital Staff privileges.

3. The York Hospital committed the offense of attempt to monopolize in violation of Section 2 of the Sherman Act by attempting to acquire the power to control prices in or exclude competitors from the relevant market resulting in injury to Plaintiff Weiss and the Plaintiff Class.

4. The York Hospital committed the offense of conspiracy to monopolize in violation of Section 2 of the Sherman Act by conspiring with others to obtain the power to control prices in or exclude competitors from the relevant market, resulting in injury to Plaintiff Weiss and the Plaintiff Class.

.............
1. Pursuant to the Court's authority under 15 U.S.C. § 26, this Court hereby declares that the following equitable relief shall be entered against Defendants York Hospital and York Hospital Medical and Dental Staff:

1.1 The York Hospital and the York Hospital Medical and Dental Staff are restrained and enjoined from undertaking any overt act against either Plaintiff Weiss or members of the Plaintiff Class which would in any way impede or deny the Plaintiffs full, reasonable, fair, or equal access to the facilities of York Hospital and full, reasonable, fair or equal access to staff privileges at the York Hospital.

Weiss v. York Hosp., 548 F. Supp. 1048 (M.D. Pa. 1982)

The law has established that trying to bar fully licensed osteopathic physicians from hospital staffs is an illegal antitrust violation.
So wouldn't an attempt to bar fully licensed osteopathic physicians from ACGME fellowship programs be an illegal antitrust violation?

The ability to practice your licensed profession and earn a living is NOT the same as the ability to obtain additional fellowship training. If the state has given you a medical license, a hospital can't use the letters of your degree to deny privileges and keep you from earning an income. That is logical and is good public policy. However, no one has a right to fellowship training - even MD's. If you desire a sub-specialty that requires an ACGME fellowship - don't do an AOA residency.

To me this is no different than a HS graduate saying he has the right to go to Ivy League for undergrad or any college graduate saying they have the right to go to an Ivy for medical/law/MBA school. I would be more concerned that if some DO resident did file suit, and the case actually got to the discovery phase, expert testimony/depositions would provide evidence and justification for a finding that DO residencies are not equivalent to ACGME programs, and there are in fact legitimate reasons for the fellowship rule.

 

[2021Doctor]

The ability to practice your licensed profession and earn a living is NOT the same as the ability to obtain additional fellowship training. If the state has given you a medical license, a hospital can't use the letters of your degree to deny privileges and keep you from earning an income. That is logical and is good public policy. However, no one has a right to fellowship training - even MD's. If you desire a sub-specialty that requires an ACGME fellowship - don't do an AOA residency.

To me this is no different than a HS graduate saying he has the right to go to Ivy League for undergrad or any college graduate saying they have the right to go to an Ivy for medical/law/MBA school. I would be more concerned that if some DO resident did file suit, and the case actually got to the discovery phase, expert testimony/depositions would provide evidence and justification for a finding that DO residencies are not equivalent to ACGME programs, and there are in fact legitimate reasons for the fellowship rule.

Your analysis is incorrect
"No one has a right to fellowship training - even MD's" - true
No one has a right to bar people of Croatian origin from fellowship training - true
Suddenly and arbitrarily barring DOs from fellowship training would be an antitrust violation - true

Here is a nice post from 2014:
I hope every HOD representative receives this and goes in on Friday demanding answers and not giving up until they are given answers that are direct and clear. Stop the ACGME merger as it is now proposed and treat it like the contract negotiation that it actually is, with in-depth professional investigative assessments using outside evaluators of the contracts issues and pitfalls and with full disclosure to the membership of every detail before asking for a full membership ratification of the finalized version. IF ACGME refuses to negotiate, walk away. If they attempt to shut down access to certification, licensing or our own credentialing processes they will be in direct violation of antitrust law.
Journal of Contemporary Health Law & Policy
Volume 10 | Issue 1
1994
The Specialty Boards and Antitrust: A Legal Perspective
John J. Smith

ALL DOs must read this now prior to AOA delegates mtg July 18, 2014

 

[BorntobeDO?]

Your analysis is incorrect
"No one has a right to fellowship training - even MD's" - true
No one has a right to bar people of Croatian origin from fellowship training - true
Suddenly and arbitrarily barring DOs from fellowship training would be an antitrust violation - true

Here is a nice post from 2014:
I hope every HOD representative receives this and goes in on Friday demanding answers and not giving up until they are given answers that are direct and clear. Stop the ACGME merger as it is now proposed and treat it like the contract negotiation that it actually is, with in-depth professional investigative assessments using outside evaluators of the contracts issues and pitfalls and with full disclosure to the membership of every detail before asking for a full membership ratification of the finalized version. IF ACGME refuses to negotiate, walk away. If they attempt to shut down access to certification, licensing or our own credentialing processes they will be in direct violation of antitrust law.
Journal of Contemporary Health Law & Policy
Volume 10 | Issue 1
1994
The Specialty Boards and Antitrust: A Legal Perspective
John J. Smith

ALL DOs must read this now prior to AOA delegates mtg July 18, 2014

Wow, I just, can't. Nope not doing it. AOA is gonna AOA.

 

[ChicagoBear]

Your analysis is incorrect
"No one has a right to fellowship training - even MD's" - true
No one has a right to bar people of Croatian origin from fellowship training - true
Suddenly and arbitrarily barring DOs from fellowship training would be an antitrust violation - true

Here is a nice post from 2014:
I hope every HOD representative receives this and goes in on Friday demanding answers and not giving up until they are given answers that are direct and clear. Stop the ACGME merger as it is now proposed and treat it like the contract negotiation that it actually is, with in-depth professional investigative assessments using outside evaluators of the contracts issues and pitfalls and with full disclosure to the membership of every detail before asking for a full membership ratification of the finalized version. IF ACGME refuses to negotiate, walk away. If they attempt to shut down access to certification, licensing or our own credentialing processes they will be in direct violation of antitrust law.
Journal of Contemporary Health Law & Policy
Volume 10 | Issue 1
1994
The Specialty Boards and Antitrust: A Legal Perspective
John J. Smith

ALL DOs must read this now prior to AOA delegates mtg July 18, 2014

Well, you forced me to do some research. It appears Congress has already made the decision.

In 2004, an antitrust suit started by some residents and fellows was in district court. The suit included dozens of charges and allegations concerning the fairness of the Match, restraint of trade, limitations of positions, etc. The thought of disrupting the Match system (including fellowships) caused Congress to pass 15 USC 37b. This amendment to the antitrust laws caused the judge, who had made some preliminary rulings in favor of the residents/fellows, to dismiss the entire case. Congress specifically:

1. Exempted the Match (including fellowships) from antitrust laws;
2. Chose to override any conflicting state antitrust laws;
3. Forbade any court from considering any evidence about conducting, sponsoring or participating in the Match thereby virtually eliminating any conspiracy, price fixing or other claims through back channels, since to prove those claims you would have to touch upon conducting, sponsoring or participating in the Match;
4. The only part of antitrust law still applicable is a prohibition of collusion around residents/fellows salary and benefits.

15 U.S. Code § 37b - Confirmation of antitrust status of graduate medical resident matching programs

Below is article summarizing the case and decision in non-legalese.

Challenging the Medical Residency Matching System through Antitrust Litigation, Feb 15 - American Medical Association Journal of Ethics (formerly Virtual Mentor)

Given all of this, the chance of any new lawsuit being successful is extremely remote. It would mostly likely be dismissed after the initial reply motions given Congress' broad exemption and limitation on evidence - it would likely never even get to discovery.

EDIT: While the current AOA/ACGME situation was likely not envisioned by Congress, the amendment they passed was written so broadly as to foreclose almost any attack on the Match system. If the results are too bad for DO's, the appeal would need to be to Congress.

 

[ChicagoBear]

Apples and oranges.
The ability to conduct the NRMP match has an antitrust exemption.
However, suddenly barring DOs from the match after allowing DOs in the match for decades would be a massive antitrust lawsuit.

And how exactly are you going to prove in court your massive antitrust violation without the ability to admit into evidence any documents or testimony about the conducting, sponsoring or participating in the Match? Also remember that both ACGME and AOA meet the definition of Match in the statute - so no evidence from either Match program. This is an explicit absolute prohibition so the judge has no choice.

The judge in the case above had preliminarily ruled for the plaintiffs. As much as he hated to, he had no choice given the revised law but to reverse his preliminary findings and dismiss the case in total. He said in his opinion that there was no way to sever the antitrust and conspiracy allegations from evidence concerning the Match. He also denied a plethora of constitutional, due process, unjust taking arguments and every other kitchen sink motion that the plaintiffs tried to keep their preliminary victory.

 

[Geraltofrivia]

Hey I just wanted to put my 2c into the picture. I didn't match this year. This topic has really stressed me out, especially seeing what seems like people that don't know what it's like to go through the match hoping (honestly expecting to match), and then not matching. Before people start saying "Oh you know what you signed up for" etc etc put yourself in an applicants shoes. I took all exams (steps and comlex) and had no failures. I passed all boards on first try. No red flags. 10 ranks, didn't match. It can happen to anybody. I was lucky enough to get a TRI and now I'm hoping to match next year, but just know it can happen to anybody. There is no need to be so negative in here. Thanks

 

[Cath Up]

Hey I just wanted to put my 2c into the picture. I didn't match this year. This topic has really stressed me out, especially seeing what seems like people that don't know what it's like to go through the match hoping (honestly expecting to match), and then not matching. Before people start saying "Oh you know what you signed up for" etc etc put yourself in an applicants shoes. I took all exams (steps and comlex) and had no failures. I passed all boards on first try. No red flags. 10 ranks, didn't match. It can happen to anybody. I was lucky enough to get a TRI and now I'm hoping to match next year, but just know it can happen to anybody. There is no need to be so negative in here. Thanks

Thank you for this.

What specialty did you try to match?

 

[Dr.Bruh]

Hey I just wanted to put my 2c into the picture. I didn't match this year. This topic has really stressed me out, especially seeing what seems like people that don't know what it's like to go through the match hoping (honestly expecting to match), and then not matching. Before people start saying "Oh you know what you signed up for" etc etc put yourself in an applicants shoes. I took all exams (steps and comlex) and had no failures. I passed all boards on first try. No red flags. 10 ranks, didn't match. It can happen to anybody. I was lucky enough to get a TRI and now I'm hoping to match next year, but just know it can happen to anybody. There is no need to be so negative in here. Thanks

It’s crazy how much of a crapshoot the match can be. I know a 4th year at my school that had 3 pre clinical failures, 30-40 %ile on both step and comlex, and was generally described and as unpleasant person to be around.....matched university IM.

 

[TheaterOfTheme]

It’s crazy how much of a crapshoot the match can be. I know a 4th year at my school that had 3 pre clinical failures, 30-40 %ile on both step and comlex, and was generally described and as unpleasant person to be around.....matched university IM.

Amazing--you always hope these are the types that get weeded out.

 

[ciestar]

As a MD student who almost attended a DO school, I thought the merger was ill-conceived even if many in SDN were for it.. Everyone thinks they will be a hot shot in med school since they were way above average in undergrad, but the reality is that you will be competing against the smartest students in the US. It's no secret that most (emphasis on most here) people go to DO school because they did not do too well in the MCAT, and med school is all about standardized exams like the MCAT. Therefore, you will be at a disadvantage albeit one can overcome that... You will be competing with MD students who are overall better at these exams and FMG who have an unfair advantage since they can spend months or even years studying for the USMLE.

I don't know whether DO school curriculum gear toward USMLE or not. But if the COMLEX is anything like the COMQUEST which was provided to us sans OMT section, I would say the COMLEX is a lot easier than the USMLE. Mediocre DO students who had Path/IM/FM/Neurology/Psych/PM&R wide open to them pre-merger are going to feel the brunt of the merger.

My friend is at a DO school. She blew her COMSAE (>650..) out of the water and barely cracked a 200 on her first NBME. They really don’t gear towards USMLE at all. I’d assume most DO’s don’t since I am not aware of any that you must take/pass step 1 to even graduate.

But by reading that about Northwell..if that becomes the norm and something less isolated, I’d guess a lot of DO’s are in trouble. Especially since a lot of schools won’t let you/dont recommend sit for it if you’re at a certain rank in the class or scoring high enough on your COMSAE’s.

Eye opening.

 

[Scrubb]

Thank you for this.

What specialty did you try to match?

Looking at their post history, they were going for psych.

And according to their own post: “Many attendings (I did not have any residents my third year) felt I was intense and came across as arrogant sometimes”.

 

[Dr.Jekyll75]

My friend is at a DO school. She blew her COMSAE (>650..) out of the water and barely cracked a 200 on her first NBME. They really don’t gear towards USMLE at all. I’d assume most DO’s don’t since I am not aware of any that you must take/pass step 1 to even graduate.

But by reading that about Northwell..if that becomes the norm and something less isolated, I’d guess a lot of DO’s are in trouble. Especially since a lot of schools won’t let you/dont recommend sit for it if you’re at a certain rank in the class or scoring high enough on your COMSAE’s.

Eye opening.

This was the story for half of my friend group . Great on Comlex, couldnt pass NBMEs. We are not taught to take step, we are taught to think magically for the comlex. I did very well on comlex and avg on step. I had to work harder to get used to step style questions as opposed to comlex jargon

 

[Neopolymath]

Hey I just wanted to put my 2c into the picture. I didn't match this year. This topic has really stressed me out, especially seeing what seems like people that don't know what it's like to go through the match hoping (honestly expecting to match), and then not matching. Before people start saying "Oh you know what you signed up for" etc etc put yourself in an applicants shoes. I took all exams (steps and comlex) and had no failures. I passed all boards on first try. No red flags. 10 ranks, didn't match. It can happen to anybody. I was lucky enough to get a TRI and now I'm hoping to match next year, but just know it can happen to anybody. There is no need to be so negative in here. Thanks

Best of luck to you!

 

[sab3156]

My friend is at a DO school. She blew her COMSAE (>650..) out of the water and barely cracked a 200 on her first NBME. They really don’t gear towards USMLE at all. I’d assume most DO’s don’t since I am not aware of any that you must take/pass step 1 to even graduate.

In my DO school, I've heard of several top students just doing very mediocre, or even poorly, on Step 1. And COMLEX is apparently a joke of an exam compared to Step 1, so honestly a school probably doesn't even really need to put forth any effort to have its students pass the COMLEX.

 

[DNC127]

In my DO school, I've heard of several top students just doing very mediocre, or even poorly, on Step 1. And COMLEX is apparently a joke of an exam compared to Step 1, so honestly a school probably doesn't even really need to put forth any effort to have its students pass the COMLEX.

for what its worth I took 3 comsaes before dedicated started and they were all 95th percentile+. At that time was only at a 230ish on my NBMEs after studying for almost 8 months haha. People don't understand how hard it is to do 250+ on USMLE. I know scores like that get thrown around a ton on SDN so it seems easy enough but you really have to be gifted or willing to bust your back throughout MS2 because DO schools (mine at least) do not prepare you for USMLE at all.

 

[Dr.Bruh]

In my DO school, I've heard of several top students just doing very mediocre, or even poorly, on Step 1. And COMLEX is apparently a joke of an exam compared to Step 1, so honestly a school probably doesn't even really need to put forth any effort to have its students pass the COMLEX.

Idk who you talk to or if you just make this stuff up, but I go to the same school and have talked to multiple upperclassman about this. Vast majority of them say that comlex/step score are similar percentile for most people, but there are a few outlier (kills comlex, bombs step, and vice versa). Most people are studying for step anyways.

 

[DNC127]

Idk who you talk to or if you just make this stuff up, but I go to the same school and have talked to multiple upperclassman about this. Vast majority of them say that comlex/step score are similar percentile for most people, but there are a few outlier (kills comlex, bombs step, and vice versa). Most people are studying for step anyways.

We had 7 people in 3rd year class well above 700 last year (99th percentile), highest USMLE was mid 250's (88th-92nd percentile). Only 2 of these people broke 250 (84th percentile). I doubt everybody that gets a 700+ also gets 265+.

 

[Dr.Jekyll75]

Idk who you talk to or if you just make this stuff up, but I go to the same school and have talked to multiple upperclassman about this. Vast majority of them say that comlex/step score are similar percentile for most people, but there are a few outlier (kills comlex, bombs step, and vice versa). Most people are studying for step anyways.

228 (48- 50th percentile i think?) and 659 (94th) theres a VAST difference in these exams...

 

[sab3156]

Idk who you talk to or if you just make this stuff up, but I go to the same school and have talked to multiple upperclassman about this. Vast majority of them say that comlex/step score are similar percentile for most people, but there are a few outlier (kills comlex, bombs step, and vice versa). Most people are studying for step anyways.

I don't know if you're really that gullible or are just trolling, but you really have no clue what percentiles are if you think that basically all people who score, say, 99%ile on COMLEX are also getting 99%ile on Step 1. Sounds like you spoke to people who have no clue what Step 1 even is. COMLEX is an easier exam and the percentiles absolutely are not going to be the same, because Step 1 has a far better pool of students taking it (MD students). Just read the comments above mine for further information.

 

[W19]

I don't know if you're really that gullible or are just trolling, but you really have no clue what percentiles are if you think that people who score, say, 99%ile on COMLEX are also getting 99%ile on Step 1. Sounds like you spoke to people who have no clue what Step 1 even is. COMLEX is an easier exam and the percentiles absolutely are not going to be the same, because Step 1 has a far better pool of students taking it (MD students). Just read the comments above mine for further information.

I think it's the former... The SDN community is not a representative sample, so it makes other people over confident about their ability. Most people in here think once they get into med school, they are going to be some hot shot like undergrad. They totally ignore their competition.

 

[ZatAnteater]

Idk who you talk to or if you just make this stuff up, but I go to the same school and have talked to multiple upperclassman about this. Vast majority of them say that comlex/step score are similar percentile for most people, but there are a few outlier (kills comlex, bombs step, and vice versa). Most people are studying for step anyways.

Lol I just wanted to let you know, before my dedicated I took a full length practice Level 1 COMLEX where all I did was look for buzzwords and took about 30 seconds to answer each question. Got a passing score. I took my time and tried really hard on a practice Step 1 NBME and failed it. Don't tell me that they're the same when I don't even have to think for half of the COMLEX questions lol. If Caribbean students have to take it to be competitive and practice, the self-proclaimed "better DO students" should have to take it to be competitive too.

 

[DrMcLovin]

Lol I just wanted to let you know, before my dedicated I took a full length practice Level 1 COMLEX where all I did was look for buzzwords and took about 30 seconds to answer each question. Got a passing score. I took my time and tried really hard on a practice Step 1 NBME and failed it. Don't tell me that they're the same when I don't even have to think for half of the COMLEX questions lol. If Caribbean students have to take it to be competitive and practice, the self-proclaimed "better DO students" should have to take it to be competitive too.

What did you end up getting on the actual COMLEX and USMLE? You must have killed the COMLEX

 

[ZatAnteater]

What did you end up getting on the actual COMLEX and USMLE? You must have killed the COMLEX

Lol I'll let you know next week when I get my score.

 

[TeddyBoomBoom]

The COMLEX is wayyyy easier than the USMLE. First order questions, buzzwords, and more narrow breadth mark the COMLEX.

It’s not like COMLEX = DO material and USMLE = MD material. It’s more like COMLEX = easy and USMLE = hard.

Other than OMT (and let’s face it- Savarese is written at a 5th grade level and is more than enough for the COMLEX,) the COMLEX is a watered down test and an embarrassing exam. The fact that DO students want to be equally compared to MD students WITHOUT TAKING COMPARABLE EXAMS is amazing.

Btw DO student here.

 

[ThreeCheers]

The COMLEX is wayyyy easier than the USMLE. First order questions, buzzwords, and more narrow breadth mark the COMLEX.

It’s not like COMLEX = DO material and USMLE = MD material. It’s more like COMLEX = easy and USMLE = hard.

Other than OMT (and let’s face it- Savarese is written at a 5th grade level and is more than enough for the COMLEX,) the COMLEX is a watered down test and an embarrassing exam. The fact that DO students want to be equally compared to MD students WITHOUT TAKING COMPARABLE EXAMS is amazing.

Btw DO student here.

For some fields, DO students are equally compared to MD students without taking comparable exams. It's been that way since long before the merger. I don't think any student that's done their research would expect to match into non-primary care specialties without the USMLE, and I don't think anyone disputes that it should be that way. The discussion here is about a bottom-of-the-barrel FM program screening out COMLEX only applicants, which likely implies that they'd favor IMGs over DOs. This is shocking to me because it contradicts what was being said back in the Spring of 2014, when I researched the potential effects of the merger after being blindsided by the announcement. It's still too early to tell whether this is an isolated decision made by one corporation, or if the merger's completion will make this closer to the new norm.

I also don't think anyone disagrees that the COMLEX is the easier (albeit, in my opinion, also more exhausting and miserable) exam, or that the OMM content on COMLEX is overbearing. Most people (myself included) simply take a few days after the USMLE to cram Savarese and do well. The bigger problem is the pre-clinical curriculum at DO schools. In addition to the lack of NBME-style questions on pre-clinical exams, OMM can be a massive time suck that takes away from precious board prep time in M1-M2. At least at my school, there were weekly mandatory OMM labs/lectures, and the pre-clinical exams required much more than just Savarese. I realize that this varies from school to school, though, and may not account for every student that chooses to sit out the USMLE.

 

[W19]

@ThreeCheers

This should not be shocking. PDs need applicants who are likely to pass the board. Would you rather take a DO with 420 COMLEX 1/2 or an IMG from the middle east with 230+ in step 1/2?

I know DO will benefit from the merger by getting standardized training and the ability to pursue ACGME fellowships, but boys! COCA has given away a lot to get these things..

 

[Dr.Jekyll75]

@ThreeCheers

This should not be shocking. PDs need applicants who are likely to pass the board. Would you rather take a DO with 420 COMLEX 1/2 or an IMG from the middle east with 230+ in step 1/2?

I know DO will benefit from the merger by getting standardized training and the ability to pursue ACGME fellowships, but boys! COCA has given away a lot to get these things..

Many DO students Drink the Koolaid given to them by admin and the AOA of Certifying DO , "no need for that pesk step exam. Comlex will be accepted by all "