Academic IM as a DO

[DrWhozits]

I know this topic has been broached before; however, is hoping for an updated/more specific answer.

I'm a DO student considering IM, but I would like to keep fellowships open as a possibility later, so an academic program would be the goal.

If I were aiming to end up somewhere in the southeast (VA, NC, SC, KY, TN, GA, FL) or Texas, and applying reasonably to state school-affiliated and communiversity type programs, what sort of scores are expected?

There are plenty of DOs in programs like these, but are the people that end up doing IM at somewhere like University of Kentucky (just a random example) as DOs scoring way above average or is it more attainable than that?

Most of the threads discussing academic IM on here always seem to discuss Emory, Duke, Vandy, etc when talking about the SE.

Thanks

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[acapnial]

I know this topic has been broached before; however, is hoping for an updated/more specific answer.

I'm a DO student considering IM, but I would like to keep fellowships open as a possibility later, so an academic program would be the goal.

If I were aiming to end up somewhere in the southeast (VA, NC, SC, KY, TN, GA, FL) or Texas, and applying reasonably to state school-affiliated and communiversity type programs, what sort of scores are expected?

There are plenty of DOs in programs like these, but are the people that end up doing IM at somewhere like University of Kentucky (just a random example) as DOs scoring way above average or is it more attainable than that?

Most of the threads discussing academic IM on here always seem to discuss Emory, Duke, Vandy, etc when talking about the SE.

Thanks

About 240+ would be a safe score. I think you could probably get some love from academic programs in those places with less but it'd be less of a sure thing.

 

[Robotfishbrain]

I had face-to-face meetings with three PDs in the midwest before I decided to attend a DO school. This might be different from the southwest, but the consensus was with a good away rotation and hitting the mark on the step (scoring average to above average for the specific program) you will not be hindered in anyway as a DO. If you're looking for academic IM, you're going to have to do some kind of research -- but that is true for both MD and DO.

 

[acapnial]

I had face-to-face meetings with three PDs in the midwest before I decided to attend a DO school. This might be different from the southwest, but the consensus was with a good away rotation and hitting the mark on the step (scoring average to above average for the specific program) you will not be hindered in anyway as a DO. If you're looking for academic IM, you're going to have to do some kind of research -- but that is true for both MD and DO.

I did it with no aways (at most of the programs I interviewed at and where I matched, I mean), and with no research. Just sayin.

 

[GaryColeman]

What kind of comlex score gets you interviews at lower tier academic/university programs ?

 

[Lexdiamondz]

What kind of comlex score gets you interviews at lower tier academic/university programs ?

Just take the USMLE. Seriously

 

[sunnyk123]

If you're looking for academic IM, you're going to have to do some kind of research -- but that is true for both MD and DO.

I did it with no aways (at most of the programs I interviewed at and where I matched, I mean), and with no research. Just sayin.

Wait is there a difference between "academic IM" versus matching at a University program or are the the same thing? @Robotfishbrain did the PDs you spoke to say you need research and a ~240 step? I didn't realize mid-tier University programs were that competitive.

So what should a DO with a ~225 step and no research be aiming for?

 

[Mad Jack]

What kind of comlex score gets you interviews at lower tier academic/university programs ?

The kind that's measured in 200s and comes from the NBME

 

[Robotfishbrain]

Wait is there a difference between "academic IM" versus matching at a University program or are the the same thing? @Robotfishbrain did the PDs you spoke to say you need research and a ~240 step? I didn't realize mid-tier University programs were that competitive.

So what should a DO with a ~225 step and no research be aiming for?

The programs I talked to had average steps around 220-230, so no you do not need a 240 step. The PDs told me very clearly that they look at step scores first, and then they look for interest in the field/program via away rotations and research to separate applicants from the rest of the pack. Take that how you will. The programs I spoke to were in Ohio and Indiana.

 

[acapnial]

Wait is there a difference between "academic IM" versus matching at a University program or are the the same thing? @Robotfishbrain did the PDs you spoke to say you need research and a ~240 step? I didn't realize mid-tier University programs were that competitive.

So what should a DO with a ~225 step and no research be aiming for?

Academic and university are one and the same. Your app should stand out in one way or another. It's not that you need a 240+ step 1, but it makes it easy for your app to stand out. If you have a more average kind of step score, there are other ways to stand out- others in this thread are discussing good ways to do that.

 

[DrWhozits]

Thanks for everybody's responses so far.

What did you all do for IM LoRs?

 

[acapnial]

Thanks for everybody's responses so far.

What did you all do for IM LoRs?

1 core IM 2 subspecialty 1 fp. I think I could have done the same without the fp letter though.

 

[DrWhozits]

1 core IM 2 subspecialty 1 fp. I think I could have done the same without the fp letter though.

Were the letters from the aways you did? This is to say: were your letters from community docs or from academic centers?

 

[acapnial]

Were the letters from the aways you did? This is to say: were your letters from community docs or from academic centers?

Community docs from home. By the time I did my first away it was really too late to be tinkering with my application.

 

[DrWhozits]

Community docs from home. By the time I did my first away it was really too late to be tinkering with my application.

Ok, that's good to know. Thanks

 

[Herbspalsy]

Is it a big deal if you don't have research?

 

[Robotfishbrain]

Is it a big deal if you don't have research?

It certainly helps. Academic IM programs tend to attract those interested in research.

 

[Rekt]

I was under the impression that away rotations for IM were a big no-no?

 

[DrfluffyMD]

Honestly never heard of USMD audition for IM.

 

[DrWhozits]

Honestly never heard of USMD audition for IM.

I've gathered the same. However coming from a DO school without an associated academic hospital, aways are more useful (for all specialities).

 

[W19]

I was under the impression that away rotations for IM were a big no-no?

Why? I think it can be a good thing if you are gung-ho about a particular program... But the average MD student (220+ step1 with no red flags) can easily get into low/mid tier university IM, so there is no need for them to audition anywhere.

 

[IslandStyle808]

I was under the impression that away rotations for IM were a big no-no?

I remember a question like this posed a long time ago. It is because doing an away rotations has hurt the applicant more often than help them. For instance, if you are an MD student, already have a 240+ on the USMLE, multiple publications, and have done well in your rotations; you already are a rock star. If you did an audition in this situation, there is more to lose than gain.

For DOs, this is a grey area. Unfortunately we don't have the same amount of residency and the PDs of those residencies may not be known to ACGME PDs of other programs. So it is more incentive to do auditions and get letters from people in these academic centers. Its not going to break you if you don't, but it does go a long way.

 

[AlmadeDr]

I did several away rotations during 4th year as a DO student applying solely to ACGME programs. I think they have utility depending on what you are trying to get out of them and also what the situation is at your core site.

For me, doing a Sub-I early on in 4th year was essential in order to get letters. My core site did not have an internal medicine residency program, so my only other pure IM letter I had was from the relatively disinterested in academic medicine hospitalists we spent our IM time with. I got 2 letters from the rotation from people that actually had leadership positions within the residency program, which was an essential part of my application.

I did 2 other aways, but they were in IM subspecialties, not as Sub-I's. I got valuable things out of those rotations that helped me be behaviorly and expectations-wise prepares to enter an academic-focused internal medicine residency, but not specifically helpful to my application.

I did interview at all the places I did away rotations at. I don't think I got any big boost in consideration from any of it, with the exception of my Sub-I. I felt very comfortable using that as a safety program, but I can't prove that they liked me as much as I think they did because I didn't go down that far on my match list.

If there is something that your school is lacking in its ability to give you a good application or in your ability to experience a typical residency program style of practice, I would encourage people to use the flexibility of the 4th year schedule to fill these holes. If you are able to get what you need where you are, it is certainly not mandatory and as others have said can harm you if you are not ready to be 110% excellent all the time.

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[ortnakas]

Thanks for everybody's responses so far.

What did you all do for IM LoRs?

Other question on IM LORs-- do they all have to be IM? I have two solid IM letters. Not sure what to do for a third letter. I can think of a few people I could ask in IM, but it would be from attendings I had more limited interactions with, so I don't know how strong of a letter it would get me. I could get pretty strong recommendations from a couple other attendings I had throughout third year, but I'm not sure if letters from a general surgeon, neurologist or family medicine doc would be valued.

 

[acapnial]

Other question on IM LORs-- do they all have to be IM? I have two solid IM letters. Not sure what to do for a third letter. I can think of a few people I could ask in IM, but it would be from attendings I had more limited interactions with, so I don't know how strong of a letter it would get me. I could get pretty strong recommendations from a couple other attendings I had throughout third year, but I'm not sure if letters from a general surgeon, neurologist or family medicine doc would be valued.

They don't all have to be IM. The only potential pitfall is the letter writer may not know what you want to do and say "ortnakas will make a great surgeon!". This happened to someone I know who got a letter from an orthopod (and was applying gen surg), and they had to spend the interview trail explaining that they were NOT just applying to gen surg as a backup to orthopedic surgery. So you can just throw out a reiteration that you're going to IM if you think they might have forgotten.

 

[firstaidforever]

I'd feel comfortable applying to those with a 230 and 3 pubs.

If I had less, I'd ask myself if I'd be happy with community IM and no fellowships. Then maybe I'd start looking at family med, peds, neurology, psych instead of general IM.

 

[DrWhozits]

I'd feel comfortable applying to those with a 230 and 3 pubs.

If I had less, I'd ask myself if I'd be happy with community IM and no fellowships. Then maybe I'd start looking at family med, peds, neurology, psych instead of general IM.

3 pubs??? I feel like everyone I have talked to has had fewer (or none).

 

[AlteredScale]

3 pubs??? I feel like everyone I have talked to has had fewer (or none).

The part that really makes you stand out is wen you're first/second author on all of those and they are in high impact journals. That's what makes getting into academic IM harder as a DO.

MD students have many more resources regarding research than most DO schools. Their faculty are professors who are consistory publishing and so hopping on the train is much easier on that end.


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[IslandStyle808]

The part that really makes you stand out is wen you're first/second author on all of those and they are in high impact journals. That's what makes getting into academic IM harder as a DO.

MD students have many more resources regarding research than most DO schools. Their faculty are professors who are consistory publishing and so hopping on the train is much easier on that end.


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I can seriously confirm this. Just look at their publications on pubmed or even google scholar and you can see the difference. The researcher I am working with is in the next city over at one of the MD schools. Good god the difference is enormous. She publishes at least once a year (At one point she did 6 articles in one year!).

 

[Drrrrrr. Celty]

The part that really makes you stand out is wen you're first/second author on all of those and they are in high impact journals. That's what makes getting into academic IM harder as a DO.

MD students have many more resources regarding research than most DO schools. Their faculty are professors who are consistory publishing and so hopping on the train is much easier on that end.


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That's very rare honestly. No major PD in a major lab is going to give you you're own thing to do for a month and expect you to get there. Third author is honestly far more common.

But yah, there's almost no opportunities for DOs to do research. And when you throw in OMM, there's also no time either.

 

[Drrrrrr. Celty]

I'd feel comfortable applying to those with a 230 and 3 pubs.

If I had less, I'd ask myself if I'd be happy with community IM and no fellowships. Then maybe I'd start looking at family med, peds, neurology, psych instead of general IM.

I mean, if you're happy with ID, Endo, Rheum, and a few others then community IM will still be enough of a spring board.

 

[Robotfishbrain]

The part that really makes you stand out is wen you're first/second author on all of those and they are in high impact journals. That's what makes getting into academic IM harder as a DO.

MD students have many more resources regarding research than most DO schools. Their faculty are professors who are consistory publishing and so hopping on the train is much easier on that end.


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This is why I feel uncomfortable when people say there aren't any "tiers" for DO schools. DO schools such as MSU-COM, OUHCOM, PCOM, CCOM, etc. are part of R1 universities that contain an expansive amount of research you have access to right on campus. I guess this doesn't have to do with the med schools themselves, but certainly this is an important consideration for those that may be considering academic medicine.

 

[AlteredScale]

That's very rare honestly. No major PD in a major lab is going to give you you're own thing to do for a month and expect you to get there. Third author is honestly far more common.

But yah, there's almost no opportunities for DOs to do research. And when you throw in OMM, there's also no time either.

I think however when you are in a lab as an MD student (or simply with a group conducting clinical research) there is a sensitivity in knowing that you should have some opportunity to place yourself as a first author. Now for basic science research sure, it's very unlikely you'll get a first authorship unless you pursue a fellowship or are in a dual MD PhD or DO PhD track. That's why all of my research has strictly been case report and retro.

This is why I feel uncomfortable when people say there aren't any "tiers" for DO schools. DO schools such as MSU-COM, OUHCOM, PCOM, CCOM, etc. are part of R1 universities that contain an expansive amount of research you have access to right on campus. I guess this doesn't have to do with the med schools themselves, but certainly this is an important consideration for those that may be considering academic medicine.

I agree. The schools affiliated with larger universities tend to have stronger research opportunities. Rowan and TCOM have def stood out in this realm due to their expansive GME and tight teaching hospital partnerships.

 

[Drrrrrr. Celty]

This is why I feel uncomfortable when people say there aren't any "tiers" for DO schools. DO schools such as MSU-COM, OUHCOM, PCOM, CCOM, etc. are part of R1 universities that contain an expansive amount of research you have access to right on campus. I guess this doesn't have to do with the med schools themselves, but certainly this is an important consideration for those that may be considering academic medicine.

I think there are strong and established DO schools, but I don't think traditional tiers exist. You could go to an enormous research institute with a DO schools, but that doesn't change the fact that you're probably not going to be able to access it and in many cases the doctors training you aren't going to be part of the research institute.

 

[DrfluffyMD]

To a MD PD all DO students are equal.

 

[acapnial]

The part that really makes you stand out is wen you're first/second author on all of those and they are in high impact journals. That's what makes getting into academic IM harder as a DO.

MD students have many more resources regarding research than most DO schools. Their faculty are professors who are consistory publishing and so hopping on the train is much easier on that end.


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That is not what makes getting into academic IM harder as a DO. The PD's have doubts about osteopathic applicants/education that don't get erased by one or two publications, even if they're real publications.

I know you probably didn't mean what you said the way I took it, but I'm taking it and running with it. Consider the medicine section of the 2016 PD report- http://www.nrmp.org/wp-content/uploads/2016/09/NRMP-2016-Program-Director-Survey.pdf

For handing out interviews, only 32% of program directors said they cared about research at all. And the ones that do care ranked it at 3.3- valued less than step 3, leadership qualities, "other" life experience, audition rotation, class rank, letters of recommendation, personal statement, clinical grades, perceived commitement to specialty, step 2, step 1, and a few more. Less than extracurricular activities, for god's sake. Only 26% use it for ranking, and it jumps up to a 3.4 in importance. Still lower than extracurriculars and personal statement.

There are super acacemic powerhouses out there, like hopkins, and harvard, that care quite a bit about research and it's an unwritten requirement to not only have research but some decent research to be considered at places like those. But those programs have never taken DO's and will not do so any time soon. High quality osteopathic applicants to internal medicine nearly universally end up at mid-tier university programs, which just value other things more. Board scores, letters of recommendation, a sense that you are capable of getting along with your future coresidents, and so on. Research is the cherry on top of the application sundae, and if your ice cream is bland and watery, the cherry is not going to be enough to get anyone to endorse your dessert.

On an anecdotal level, I have done no research in medical school. None. You could take that section of my ERAS application and make a few sketches to fill in the blank space. But I had enough interviews from academic programs (some low tier, most mid tier) that I had to cancel several to free up some time and money. Only one program brought up my lack of research at all, and it was a community program, ironically. And if there's one truth about residency interviews you can rest your head on, it's that if there's a part of your application that concerns someone at the program who has seen your app, you will be asked about it.

This is why I feel uncomfortable when people say there aren't any "tiers" for DO schools. DO schools such as MSU-COM, OUHCOM, PCOM, CCOM, etc. are part of R1 universities that contain an expansive amount of research you have access to right on campus. I guess this doesn't have to do with the med schools themselves, but certainly this is an important consideration for those that may be considering academic medicine.

Have we reached a level of desperation for tiers that we are now using theoretical access to research as our method of stratifying? Dark times we live in.

 

[Drrrrrr. Celty]

To a MD PD all DO students are equal.

I doubt that's true either tbh. Half of the programs in Kansas City are full of KCU graduates. And many of the program directors are familiar and know our school. Do I think someone will know my school in CA? Maybe not.

 

[AlteredScale]

That is not what makes getting into academic IM harder as a DO. The PD's have doubts about osteopathic applicants/education that don't get erased by one or two publications, even if they're real publications.

I know you probably didn't mean what you said the way I took it, but I'm taking it and running with it. Consider the medicine section of the 2016 PD report- http://www.nrmp.org/wp-content/uploads/2016/09/NRMP-2016-Program-Director-Survey.pdf

For handing out interviews, only 32% of program directors said they cared about research at all. And the ones that do care ranked it at 3.3- valued less than step 3, leadership qualities, "other" life experience, audition rotation, class rank, letters of recommendation, personal statement, clinical grades, perceived commitement to specialty, step 2, step 1, and a few more. Less than extracurricular activities, for god's sake. Only 26% use it for ranking, and it jumps up to a 3.4 in importance. Still lower than extracurriculars and personal statement.

There are super acacemic powerhouses out there, like hopkins, and harvard, that care quite a bit about research and it's an unwritten requirement to not only have research but some decent research to be considered at places like those. But those programs have never taken DO's and will not do so any time soon. High quality osteopathic applicants to internal medicine nearly universally end up at mid-tier university programs, which just value other things more. Board scores, letters of recommendation, a sense that you are capable of getting along with your future coresidents, and so on. Research is the cherry on top of the application sundae, and if your ice cream is bland and watery, the cherry is not going to be enough to get anyone to endorse your dessert.

On an anecdotal level, I have done no research in medical school. None. You could take that section of my ERAS application and make a few sketches to fill in the blank space. But I had enough interviews from academic programs (some low tier, most mid tier) that I had to cancel several to free up some time and money. Only one program brought up my lack of research at all, and it was a community program, ironically. And if there's one truth about residency interviews you can rest your head on, it's that if there's a part of your application that concerns someone at the program who has seen your app, you will be asked about it.

Thanks for the explanation.

My statement was meant to focus in on IM programs that do not or rarely accept DO's. The rift that does exist is apparent in that a DO could have stellar board scores, strong letters, and honors in their rotations but still not get interviews against MD students with similar or even lower academics. A big part of why this is first the questionable clinical training, the effect on the prestige of the program, the lack of letters from formidable clinicians from reputable hospitals, and a lack of research that shows a potential to grow into academic medicine. And this spans quite widely to about 30-40 programs. And to reiterate, these are the programs that all the MDs are vying for. That is my expansion on "this is what makes getting into [top and high mid tier] academic IM programs harder to get into for DOs".

 

[Robotfishbrain]

I think there are strong and established DO schools, but I don't think traditional tiers exist. You could go to an enormous research institute with a DO schools, but that doesn't change the fact that you're probably not going to be able to access it and in many cases the doctors training you aren't going to be part of the research institute.

I don't agree that "you're probably not going to be able to access it" at all. Why do you say this? MD or DO you can't significantly conduct research until the summer.

 

[Lexdiamondz]

I don't agree that "you're probably not going to be able to access it" at all. Why do you say this? MD or DO you can't significantly conduct research until the summer.

You'd be surprised. I have multiple classmates who started research the second they matriculated and had pubs by the end of the summer. Given the resources, proactive people can be very productive if they put their minds to it.

 

[ortnakas]

I doubt that's true either tbh. Half of the programs in Kansas City are full of KCU graduates. And many of the program directors are familiar and know our school. Do I think someone will know my school in CA? Maybe not.

No offense at all to KCU but I think this is more a geographic thing than a quality thing. CA programs are familiar with Touro/Western grads, upstate NY/PA/OH programs are familiar with OUHCOM and LECOM grads, midwest programs are familiar with KCU and DMU grads, etc.

 

[Drrrrrr. Celty]

No offense at all to KCU but I think this is more a geographic thing than a quality thing. CA programs are familiar with Touro/Western grads, upstate NY/PA/OH programs are familiar with OUHCOM and LECOM grads, midwest programs are familiar with KCU and DMU grads, etc.

That's pretty much what I was getting at. I was simply saying that some program directors will know about the school and hold it probably higher than Xcom.

 

[DrfluffyMD]

That's pretty much what I was getting at. I was simply saying that some program directors will know about the school and hold it probably higher than Xcom.

That's a geographic thing right there.

 

[Drrrrrr. Celty]

That's a geographic thing right there.

I'm not the one talking in absolutes.

 

[IslandStyle808]

That's a geographic thing right there.

That's the point he's trying to get across. There may not be tiers amongst DO schools from the perspective ACGME PDs, but there is geographic preference. Not saying this from the stand point of them being in 'close proximity' but the fact that they may have matched students in the past and are more willing to take them versus a school just a good but on the other side of the country.

 

[DrWhozits]

That's the point he's trying to get across. There may not be tiers amongst DO schools from the perspective ACGME PDs, but there is geographic preference. Not saying this from the stand point of them being in 'close proximity' but the fact that they may have matched students in the past and are more willing to take them versus a school just a good but on the other side of the country.

I feel like I can second (or third?) this notion. The state university and affiliates in my state are loaded with grads from my school.

 

[Robotfishbrain]

You'd be surprised. I have multiple classmates who started research the second they matriculated and had pubs by the end of the summer. Given the resources, proactive people can be very productive if they put their minds to it.

Definitely, but that holds true for a DO as well as an MD. Just because there's no OMM doesn't mean MDs dont have classes taking up their time they don't want to take (biostats, tropical diseases, etc -- just take a look at the allo forums there are loads of complaints about classes).

 

[DrWhozits]

Came across this, which may help a little. This is from the PD from Indiana University.

Q: What are residency program directors looking for? Do I need to do service projects or research electives? What about additional degrees (M.S., M.B.A., Ph.D.)?
Dr. Goldman: Residency directors are looking for people who have obviously worked hard and done well in the coursework and clinical rotations. Performance in the medicine clerkship, and especially the subinternship, bear obvious parallels to how you might perform as an intern. Your scores on USMLE are evidence of your mastery of the first years of medical school, and we like to see the USMLE 2 CK scores. Programs often set minimum levels of USMLE 1 and/or USMLE 2 scores needed for an interview because they receive thousands of applications and are unable to interview everyone. Letters of recommendation should reflect your hard work, contribution to the evaluation and management of the patients, and eagerness to learn (including evidence that you have developed good habits in reading about your patient’s illnesses during your time away from the hospital). Individual service activities or research electives carry very little weight in comparison to the above. Obviously if you have a passion for service, we appreciate knowing about that, but frankly it doesn’t prepare you for many of the demands of residency, and doesn’t increase your competitiveness if your overall performance is average. We think that induction into the Gold Humanism Society is a real honor, but this is less important than your academic performance. Evidence of serious research involvement (publications, especially as first author) are great and reflect on your intellectual curiosity and abilities. But again, your performance as a medical student, working with patients who have complex illnesses, is more important than your research ability as you enter residency.

If you really are interested in the business side of medicine and can foresee yourself in a business/administrative role, then an MBA may be a good preparation for that career. But if you think that simply adding another degree to your CV will make your application look better, then this is ill-advised. Plus, many physicians later on go back and pursue an MBA degree and their clinical experience can add so much more perspective and meaning to their MBA pursuits than someone who has only the clinical experience of a third year medical student.

 

[IslandStyle808]

Definitely, but that holds true for a DO as well as an MD. Just because there's no OMM doesn't mean MDs dont have classes taking up their time they don't want to take (biostats, tropical diseases, etc -- just take a look at the allo forums there are loads of complaints about classes).

If they are complaining about biostats, then they are ******ed. Not only is it on the boards, but also useful in research and interpretation of articles. The amount of statistics and understanding of journal articles that goes on in a lot of medical schools is a joke (nowhere near enough in this age of information).

OMM has so much voodoo in it that you can study till your eyes turn red, but it won't matter if your OMM proctor "feels" you don't know it at all. Your grade will take a nose dive. I would take biostats and even tropical diseases (yes I have taken both in the past) over OMM any day of the week, especially in multiple choice test format.

 

[W19]

Definitely, but that holds true for a DO as well as an MD. Just because there's no OMM doesn't mean MDs dont have classes taking up their time they don't want to take (biostats, tropical diseases, etc -- just take a look at the allo forums there are loads of complaints about classes).

You are not comparing biostats to OMM! Are you?