26 years old and a non traditional applicant. In light of Step 1 becoming P/F, should I reapply MD or take my DO acceptance?

[dielsalder34]

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Hello everyone,

I am fortunate to be accepted to a DO program. I am currently waitlisted at 4 MD programs and waiting to hear back from a 5th. I'm 26 years old and a career changer. If I reapplied, I know that DO would be off-limits, so I would most likely need to retake the MCAT. My ECs aren't particularly strong but they were good enough to get me a good amount of MD interviews with an MCAT in the 81st percentile.

Should I take the DO acceptance? I think I would be happy in primary care, but would much rather pursue an IM subspeciality or emergency medicine. Thank you for any feedback. I know this is a touchy subject for many.

 

[WaterFlow]

Congrats on the DO acceptance.
I think you should wait on your MD school waitlist outcomes before making any decisions. I think DO students will still be able to specialize despite the P/F change. Step 2 still exists.
Ultimately this is a personal choice for you. However, I do not think it is wise to turn down a med school acceptance because you are worried about the opportunity to specialize.

 

[RhesusPuffs]

Do not take the DO acceptance. Logically, it will only get worse for DOs and IMGs with this Step 1 change and the merger. Try again next year for MD.

 

[Type2Fiber]

You'll likely get in somewhere if you're on 5 waitlists. 81st percentile MCAT is pretty good, wouldn't consider a retake unless you slept through one of the blocks

IM and EM are both realistic options as a DO in the event you don't get in MD

 

[dielsalder34]

You'll likely get in somewhere if you're on 5 waitlists. 81st percentile MCAT is pretty good, wouldn't consider a retake unless you slept through one of the blocks

IM and EM are both realistic options as a DO in the event you don't get in MD

I hope I get off the waitlist. I am cautiously optimistic about that

 

[dielsalder34]

Do not take the DO acceptance. Logically, it will only get worse for DOs and IMGs with this Step 1 change and the merger. Try again next year for MD.

What is your opinion on the chances of pursuing IM subspecialties as a DO?

 

[ndafife]

Everything always seems easier on the other side, just reapply and get in somewhere better next time.

But realistically you need to what has changed in your application since last time. Assuming this is your first application cycle now, you are now a re-applicant at every school you applied to previously. So in and of itself, you are going to need to show something different in your application to say to those schools "you didn't accept me last year but look at how much better I am now." You say you "ECs aren't particularly strong," have you done anything this past year to make them better? Also if you go 0/5 for acceptances/interviews you should try doing some mock interviews with someone who can be critical about your answers or mannerisms because you should definitely be getting some acceptance if you are interviewing that many times.

 

[Ole_Toe]

I can't imagine going through the application process again especially if I had an acceptance. You are on several wait-lists so your chances are good! Also you'll be in the first class of P/F step 1, so no one can predict what that will look like. However you will certainly still be able to specialize as a US osteopathic physician. It's likely that you will need to take that Step 1 energy and devote some to leadership, publications, advocacy in your field of interest. And crush Step 2 🙂
Please update the thread once you hear back from your wait-lists

 

[Rachapkis]

As a threshold matter, there is a reasonable likelihood that you will be accepted by an MD program given your waitlist status. Of course, that Step 1 is now P/F may have a negative effect on DO applicants because this could potentially give them one less opportunity to demonstrate their chops. However, I am not sure the negative effect will be as dramatic as some expect because residency programs are likely to replace Step 1 performance with something else (e.g., Step 2 performance), thus replacing the lost opportunity. If I were in your shoes and were not accepted by an MD school this cycle, I would take my DO admission and never look back. Remember that 60 percent of applicants are not accepted anywhere, and DO schools will likely not take you again if you do not take the acceptance. A DO school will allow you to become a doctor and fulfill your dreams. If you do well at a DO program, the possibilities are endless. Good luck!

 

[Goro]

Hello everyone,

I am fortunate to be accepted to a DO program. I am currently waitlisted at 4 MD programs and waiting to hear back from a 5th. I'm 26 years old and a career changer. If I reapplied, I know that DO would be off-limits, so I would most likely need to retake the MCAT. My ECs aren't particularly strong but they were good enough to get me a good amount of MD interviews with an MCAT in the 81st percentile.

Should I take the DO acceptance? I think I would be happy in primary care, but would much rather pursue an IM subspeciality or emergency medicine. Thank you for any feedback. I know this is a touchy subject for many.

Go DO if the MD accepts don't come through.

Most of the sky is falling hype is exactly that: hype.

EM is a very DO friendly specialty. IM subspecialties are doable, I've got grads all over the country in them

 

[deleted966008]

You’re on 4 waitlists and it’s only February so your chances are still good. If the schools are responsive to updates / continued interest letters that may help. I’m not super knowledgeable on how the changes will impact DO but It’d be hard to imagine you couldn’t get an IM/EM residency if you did well at that school

 

[erdoc111]

If you don't get into an MD this year, why would Step 1 going P/F cause you to be more likely to get into MD in the future? If you don't get into MD, take the DO and move on with your life.

 

[7331poas]

of the 6582 DO grads who sought GME in 2019, there were 648 EM PGY-1 in NRMP and another 64 in remaining AOA programs, plus likely a few more via SOAP, Military Match, and Final Match. In short, more than 10% of DO grads went to EM

Which will definitely change in the future. Also EM isnt the question mark here, its university IM programs and more competitive specialties.

 

[7331poas]

There is no way to know what and what will change due to either merger, step 1 changes or whatever else. The growth in US based grads, which has increased over 40% in the past decade with MD/DO aggregate, and is the bigger driver of change than any other factor

They are both drivers. And I think now is an important time to ask if applying DO is worthwhile if you want general surgery or university IM.

 

[deleted966008]

They are both drivers. And I think now is an important time to ask if applying DO is worthwhile if you want general surgery or university IM.

While I agree with your sentiment, there is really no way to tell how the new policy will affect residency applications. The directors of general surgery / university IM residencies, who would be the best people to ask this sort of question, probably haven't even figured out what they're going to do yet

 

[Cornfed101]

Your chances of matching into a residency in any specialty are higher than your chances of getting into medical school in the first place. If you apply again and get 0 acceptances you will be in a much worse place. Don't turn down an acceptance to medical school for a chance at an acceptance next year.

 

[proudofmykids]

I can't imagine going through the application process again especially if I had an acceptance. You are on several wait-lists so your chances are good! Also you'll be in the first class of P/F step 1, so no one can predict what that will look like. However you will certainly still be able to specialize as a US osteopathic physician. It's likely that you will need to take that Step 1 energy and devote some to leadership, publications, advocacy in your field of interest. And crush Step 2 🙂
Please update the thread once you hear back from your wait-lists

By the time the Class of 2024 takes Step 2, it too will likely be Pass/Fail.

I agree, if no MD, do DO and don’t look back.

 

[meronebib]

If you don't get into an MD this year, why would Step 1 going P/F cause you to be more likely to get into MD in the future? If you don't get into MD, take the DO and move on with your life.

The OP mentions Step 1 going P/F because this may make it more difficult for DO students to “prove” themselves with a high Step 1 score in a sea of MD students. I believe this is a valid concern.

 

[Goro]

The OP mentions Step 1 going P/F because this may make it more difficult for DO students to “prove” themselves with a high Step 1 score in a sea of MD students. I believe this is a valid concern.

*sigh*

And as multiple PDs, attendings and residents have pointed out, people will want something to stratify candidates, and so Step 2 will fill that void. Throw in the importance of networking and audition rotations, and the sky is not falling for DO students.

 

[Lawpy]

well i can't be surprised the Step 1 change led to even more "should i drop my DO acceptance and risk never becoming a doctor again by reapplying MD?" threads...

 

[7331poas]

Your chances of matching into a residency in any specialty are higher than your chances of getting into medical school in the first place. If you apply again and get 0 acceptances you will be in a much worse place. Don't turn down an acceptance to medical school for a chance at an acceptance next year.

Sure, but the consequences of not matching are much higher than not getting accepted.

 

[ndafife]

Sure, but the consequences of not matching are much higher than not getting accepted.

In 2018 there were 18,818 US MD applicants and 4,617 US DO applicants for over 30k residency positions. Going to a DO school isn't going to be the reason you don't Match

 

[7331poas]

In 2018 there were 18,818 US MD applicants and 4,617 US DO applicants for over 30k residency positions. Going to a DO school isn't going to be the reason you don't Match

And how many IMG and FMG applicants? And how many of those 30k are undesirable FM and IM programs?

 

[ndafife]

And how many IMG and FMG applicants? And how many of those 30k are undesirable FM and IM programs?

And what of them? They aren't going to be the reason a DO student doesn't match

I doubt 12k programs are undesirable FM/IM programs

 

[readmypostsMD]

I literally don’t get this. Step 1 will just be replaced with step 2. Won’t you have the same opportunity to crush step 2 as you would have had step 1? This will afford you the same opportunity to differentiate yourself?

 

[Cornfed101]

I literally don’t get this. Step 1 will just be replaced with step 2. Won’t you have the same opportunity to crush step 2 as you would have had step 1? This will afford you the same opportunity to differentiate yourself?

Yeah... the main problem IMO is that you might be working for ortho (or something else competitive) doing aways, research, etc. and then you get a low step 2 that disqualifies you right before you have to apply. That sucks worse than doing poorly on step 1 where you have time to change gears.

 

[readmypostsMD]

Yeah... the main problem IMO is that you might be working for ortho (or something else competitive) doing aways, research, etc. and then you get a low step 2 that disqualifies you right before you have to apply. That sucks worse than doing poorly on step 1 where you have time to change gears.

Does your research have to be field specific? If you didn’t do so well on s2, wouldn’t the pubs still benefit you for other less competitive specialities?

What’s the deal with aways? Are those like specialty specific rotations?

 

[meronebib]

*sigh*

And as multiple PDs, attendings and residents have pointed out, people will want something to stratify candidates, and so Step 2 will fill that void. Throw in the importance of networking and audition rotations, and the sky is not falling for DO students.

I agree that the sky is not falling for DO students, but I can imagine that this general trend of making these exams pass/fail is a valid concern for future DO students. The purpose of Step 1 going pass/fail was to remove the reliance on a numerical score for what is supposed to be a competency exam; if PDs shift to using Step 2, the same discussion will be had about making that exam pass/fail. In my opinion, since these scores are basically used as a means for PDs to cut down application piles, I believe the solution should be to just limit the amount of residency programs students can apply to, but that’s another discussion.

 

[Goro]

...but I can imagine that this general trend of making these exams pass/fail is a valid concern for future DO students.

if PDs shift to using Step 2, the same discussion will be had about making that exam pass/fail. In my opinion, since these scores are basically used as a means for PDs to cut down application piles, I believe the solution should be to just limit the amount of residency programs students can apply to, but that’s another discussion.

Disagree with your first sentence.

1) That hasn't happened yet and wouldn't at least until the end of the 2020s.
2) Step 2 is NOT Step 1. There's a reason why it's called CK. The majority of the knowledge is clinical, and while scientific knowledge is still assessed, it's in a more clinically relevant manner, so that you don't have to be memorizing endless factoids.
3) Given historically that students invested a smaller amount of prep time (2 weeks vs 2 months) in Step 2 study and yet the national medians for both exams are pretty much the same, the exam should be less onerous for medical students.
4) CK comes more from what you learn and see in the clinic, so DO students should be on a more even playing field compared to their MD colleagues. The ones who will be at risk will be those who have inferior clinical training, and that means those students at the newest schools.

And please no chiming in about the timing of the exam relative to applying to residency...that's not the issue here.
Yes, it would be a lot simpler if PDs didn't have to wade through 1000s of apps. But that's also not the issue here.
And yes, we already know that Steps are used as a filter. We already know that's not what they were designed for.

 

[Moko]

Does your research have to be field specific? If you didn’t do so well on s2, wouldn’t the pubs still benefit you for other less competitive specialities?

What’s the deal with aways? Are those like specialty specific rotations?

Research in same field > research in other field >> no research at all (for academic programs).

Aways are when students do a clinical rotation at another institution (one that they would want to match to), often as an audition so the program can get to know them, and to hopefully get a letter from well known faculty. In general, those not applying to competitive specialties and those from higher ranked schools have less pressure to do an away.

 

[meronebib]

Disagree with your first sentence.

1) That hasn't happened yet and wouldn't at least until the end of the 2020s.
2) Step 2 is NOT Step 1. There's a reason why it's called CK. The majority of the knowledge is clinical, and while scientific knowledge is still assessed, it's in a more clinically relevant manner, so that you don't have to be memorizing endless factoids.
3) Given historically that students invested a smaller amount of prep time (2 weeks vs 2 months) in Step 2 study and yet the national medians for both exams are pretty much the same, the exam should be less onerous for medical students.
4) CK comes more from what you learn and see in the clinic, so DO students should be on a more even playing field compared to their MD colleagues. The ones who will be at risk will be those who have inferior clinical training, and that means those students at the newest schools.

And please no chiming in about the timing of the exam relative to applying to residency...that's not the issue here.
Yes, it would be a lot simpler if PDs didn't have to wade through 1000s of apps. But that's also not the issue here.
And yes, we already know that Steps are used as a filter. We already know that's not what they were designed for.

I mean, there’s a lot of good and true information here, but all I really said was that there was a purpose Step 1 was made pass/fail, and if Step 2 ends up fulfilling Step 1’s prior role, then Step 2 will be the next target (which you correctly identified will probably take a while). Ultimately, there is this underlying idea that “applicants are more than their scores” (which I agree with), and hence, there is a shift to remove/deemphasize scores so PDs don’t inadvertently rely on them.

Even with the increase in emphasis on a scored Step 2, I think we are moving towards this “holistic” direction because students generally do well on Step 2, and I cannot imagine it being as effective as Step 1 for differentiating between applicants. This is despite the minimal studying time, as you mentioned, and the fact that in previous years it wasn’t as important for the match.

In the end, I think this shift away from scores, either concretely or ideologically, will be more disadvantageous to students who aren’t in U.S. allopathic medical schools, as unfortunately, “holistic” assessment of applicants will likely include pedigree...

 

[Kardio]

Hello everyone,

I am fortunate to be accepted to a DO program. I am currently waitlisted at 4 MD programs and waiting to hear back from a 5th. I'm 26 years old and a career changer. If I reapplied, I know that DO would be off-limits, so I would most likely need to retake the MCAT. My ECs aren't particularly strong but they were good enough to get me a good amount of MD interviews with an MCAT in the 81st percentile.

Should I take the DO acceptance? I think I would be happy in primary care, but would much rather pursue an IM subspeciality or emergency medicine. Thank you for any feedback. I know this is a touchy subject for many.

OP, there are a few threads on this subject in the Medical Student - DO forum. I’d recommend giving them a read.

 

[AnatomyGrey12]

What is your opinion on the chances of pursuing IM subspecialties as a DO?

Very reasonable.

They are both drivers. And I think now is an important time to ask if applying DO is worthwhile if you want general surgery or university IM.

As long as Step 2 remains scored then it's still ok. If that goes P/F this could change.

2) Step 2 is NOT Step 1. There's a reason why it's called CK. The majority of the knowledge is clinical, and while scientific knowledge is still assessed, it's in a more clinically relevant manner, so that you don't have to be memorizing endless factoids.

I am currently prepping for Step 2 and will take it in the next few months. Step 2 is pretty similar to Step 1, at least UWorld is, with about 1/3rd of the questions being "next step" type questions. If you don't have the Step 1 foundation then you are hosed. There is a lot of clinical algorithm memorization. Trust me, plenty of flashcards to be had for memorizing endless factoids for Step 2 as well. The Dorian deck will become the foundation of a new Zanki type deck and it already has 15k cards in it.

3) Given historically that students invested a smaller amount of prep time (2 weeks vs 2 months) in Step 2 study and yet the national medians for both exams are pretty much the same, the exam should be less onerous for medical students.

The average for Step 1 last year was a 231. The average for Step 2 was a 242. The correlation between Step 1 score and Step 2 score is 0.55. The reason people spent less time on Step 2 is because their score didn't matter a lot of the time, as they were taking it AFTER having applied to residency. Now that the score matters a lot more expect most students to take a study month (or two) at the end of 3rd year as a dedicated period.

 

[Goro]

Very reasonable.


As long as Step 2 remains scored then it's still ok. If that goes P/F this could change.


I am currently prepping for Step 2 and will take it in the next few months. Step 2 is pretty similar to Step 1, at least UWorld is, with about 1/3rd of the questions being "next step" type questions. If you don't have the Step 1 foundation then you are hosed. There is a lot of clinical algorithm memorization. Trust me, plenty of flashcards to be had for memorizing endless factoids for Step 2 as well. The Dorian deck will become the foundation of a new Zanki type deck and it already has 15k cards in it.

The average for Step 2 last year was a 231. The average for Step 2 was a 242. The correlation between Step 1 score and Step 2 score is 0.55. The reason people spent less time on Step 2 is because their score didn't matter a lot of the time, as they were taking it AFTER having applied to residency. Now that the score matters a lot more expect most students to take a study month (or two) at the end of 3rd year as a dedicated period.

Grey, you mention Step 2 twice. Which is the Step I score?

 

[7331poas]

Grey, you mention Step 2 twice. Which is the Step I score?

Step 2 scores are higher. The test is much easier.

 

[Goro]

Step 2 scores are higher. The test is much easier.

Easier as in simply easier, or easier on that the material is more relevant and more recent in that your clinical training cements content better?

 

[AnatomyGrey12]

Grey, you mention Step 2 twice. Which is the Step I score?

Sorry, Step 1 was 231.

Easier as in simply easier, or easier on that the material is more relevant and more recent in that your clinical training cements content better?

Easier in that Step 1 took care of the heavy lifting. It’s application of the Step 1 foundation.

 

[deleted480308]

You got into a us med school. You won.

Don’t be dumb and give up your win.

 

[PreMedMissteps]

Go DO if the MD accepts don't come through.

Most of the sky is falling hype is exactly that: hype.

EM is a very DO friendly specialty. IM subspecialties are doable, I've got grads all over the country in them

Totally agree.

I don’t think DO students are going to be at a disadvantage. I think it’s the IMG students, particularly Caribb ones, that will be at a disadvantage.

That said, with that many WL to MD, you likely will come off one of them. If those schools accept updates, send a relative one.

 

[7331poas]

Easier as in simply easier, or easier on that the material is more relevant and more recent in that your clinical training cements content better?

easier as in the test is written much more poorly, step 1 already prepares students for the exam, and fewer people study for Step 2 in general.