ACGME & AOA Move Toward a Single Match

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Nothing in the agreement talked about a OMM requirement. Read it again.

OMM is still going to be a component, AOA directors furthermore still will likely show some favor to DO students as they value students who rotate with them.

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I'm wondering if people see this as a harbinger of DO schools seeking LCME accreditation in the not-too-distant future.


Personally I'd like to see that even more, as that would really end the separation, hopefully move OMM to being truly phased out as anything at all "necessary", and handle the suspicions that have been floating around about COCA's increasingly lax standards and oversight (bad rumors about some newer DO schools having poor clinical training, and then there's Rocky Vista...).
 
I'm wondering if people see this as a harbinger of DO schools seeking LCME accreditation in the not-too-distant future.


Personally I'd like to see that even more, as that would really end the separation, hopefully move OMM to being truly phased out as anything at all "necessary", and handle the suspicions that have been floating around about COCA's increasingly lax standards and oversight (bad rumors about some newer DO schools having poor clinical training, and then there's Rocky Vista...).

ugh, that damn RVU giving DOs such a bad bad name
 
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You will see more DO grads going into PC specialties. You can try to spin it any way you want. This is not necessarily a bad thing.

Think about the other way around: like half (or more than half) of the MD graduates also get into the primary care specialties. Starting to share ACGME PC spots with your fellow DOs will give some pain, I guess. I cannot see anything bad when looking from DOs' perpective, though.
 
Think about the other way around: like half (or more than half) of the MD graduates also get into the primary care specialties. Starting to share ACGME PC spots with your fellow DOs will give some pain, I guess. I cannot see anything bad when looking from DOs' perpective, though.
Many already share PC spots with DO's. Like half of all DO's go into ACGME positions now, lol.
 
I'm wondering if people see this as a harbinger of DO schools seeking LCME accreditation in the not-too-distant future.


Personally I'd like to see that even more, as that would really end the separation, hopefully move OMM to being truly phased out as anything at all "necessary", and handle the suspicions that have been floating around about COCA's increasingly lax standards and oversight (bad rumors about some newer DO schools having poor clinical training, and then there's Rocky Vista...).
No, they made it clear during the talk yesterday that COCA is going nowhere, and they haven't had any discussions outside of GME training.
 
No, they made it clear during the talk yesterday that COCA is going nowhere, and they haven't had any discussions outside of GME training.

Ok, is this talk available somewhere or is it something you had to see live?
 
I just grabbed these two quotes to show you guys the other side. Personally I still think it's a win for both parties. If you think otherwise, you may be missing some details.

DocEspana said:
Real talk time. And this is in no way extensive.... just a few points that I think need a big ol' dose of "admit-the-damn-truth"

- Anyone who says this is anything other than fantastic for those who wished to apply to both ACGME and AOA (As DO students) is completely wrong. You need to have witnessed the unique pain that is interview season and ranking to understand the very visceral way in which you are wrong. Being able to list off all of your preferences in numeric order regardless of what training affiliation they are is an immeasurable win for anyone who would be applying AOA+ACGME or even ACGME only. It lets the former rank the list exactly how they truly prefer and lets the former have a safety net that they previously had to make the hard choice to exclude. And there is no DO student in the history of "insert esoteric timeframe here" that wouldnt sleep better at night with a few AOA residencies tacked onto the end of their rank list.

- Biases exist. Period. On both sides. I know anecdotally from my friends trying for AOA ortho that some of the program directors are bitterly anti-MD. I can tell you first hand that *most* of the AOA urology programs are bitterly anti-MD. Not all, but numerically most. Any discussion of dual accreditation at those sites is met with venom and "why the hell would I want an MD when there are qualified DOs who want the spot." Integrating programs will not lead to the tsunami of MDs taking AOA spots in high demand fields because degree bias does go both ways.

- It goes both ways. A program that didn't take DOs on principle before, isnt gonna change either.

- Both of the above points will mellow (not erase) with time as this gives huge legitimacy to DO students (not PGY spots... but students) as these programs that always accepted DO students will be shown to have identical standards as the ones who only accepted MD students. Vis-A-Vis the applicants can be compared based on merits without a stigma (though it will never change that neither a DO school nor a low level MD school is ever gonna be a high level MD school)

- Some AOA programs will close. It will probably be 10 years from now. It will probably be very few. this number will be smaller than the number of new AOA and ACGME programs that will open in the same time period.

- This is in no way going to cripple the AOA nor bring about the end of its existence and prominence in our lives, and all of our glorious complaints about them will not change in the next 3-10 years barring an unexpected massive change. (this, for example, was an unexpected massive change)

- You will still have to pay the AOA all your fun licensing fees. Thats actually one of the other non-negotiables of the AOA's deal. They get to keep their membership fees from people trained under their residencies past and future.

- IM, FM, Peds. These are fields with many many unfilled spots nationwide if counting only american students. American student will still > american, foreign trained > foreign long term physician > foreign recent graduate. That won't change. IMGs will not be a serious threat to any AOA position except in cases of nepotism or insanely overqualified applicant, which is the only times they are threats to ACGME positions that are desired by american grads.

- This actively opens a world of education to DOs. Previously DO graduates could not be core faculty or program directors at an ACGME residency unless they both went to an ACGME residency AND jumped through a few arduous hoops (ACGME residency was not enough). This has entirely been abolished and any american residency graduate can now be core educational faculty. AOA has agreed to loosen their standards on this too to allow ACGME trained DOs to be core faculty and program directors and MDs to be core faculty without jumping through hoops, though I have not heard confirmed that MDs can be program directors.

- This is good news if ONLY because so many people had accepted the fellowship futures as limited/dead. Those who negatively rip on it here are not being pragmatic, are not being prophetic, are not being intuitive. They are being antagonistic and purposely ignoring the situations that surrounded this debate in months immediately prior to the announcement. AOA programs were having educational series on how to handle the loss of ACGME fellowship access as recently as August (I sat through one). The most nefarious thing here is (the fact) that some AOA residencies wont make it to 2022. But none of us will even BE in residency in 2022 (only exception, current 1st years who become neurosurgeons will be chief residents.... all 13, maximum, of you given current training numbers)

- At this moment there is zero acceptance of MDs into AOA programs. But the fact of the matter is they should be allowed in. Hell they should be allowed in without OMT training unless the program can prove they utilize OMT. But they will all claim they do and make up **** to prove it. So that last part is neither here nor there. But the fact is that the integration of MD students into AOA programs is entirely under debate and most of the details here have been accepted with this being one of the major "still under discussion" parts. The AOA is not opposed to it, but they are resistant. Real talk: they will lose that debate and the residencies will open. But under what time frame? Probably closer to the 10 year window set for all changes, than the 3 year window set for the single match.

- Haven't we all moaned on and on about how combining matches/degrees/diplomas/chromatin/lunchbox contents would lead to more respect for DO's? I know of only a very small number of you who have ever argued against that. They're excused from this comment. The rest of you, show some balls and embrace the fact that this is y/our chance to prove respect is deserved and parity exists by becoming one with the mother organization.

- The whole "ACGME will never be neutral because AAMC is a part of it". Well.... big deal. The AMA is a part of it too. As are about 4 other organizations. so 5 out of 6 (or 4 out of 5, i forget) controlling organizations represent both groups of physicians and of those groups its fair to argue that the AAMC has one of the lowest vested interest in residency. Unlike the AMA or the associated state medical societies.

- P.S. score one for DocE. First to break this on the internet (though i think someone else actually beat me, no one believed them)

HockeyDr09 said:
This is a HUGE win for D.O's, at this point I don't really care who says otherwise (just ignore them, they're always complaining about something)


We went from potentially not being able to even enter M.D fellowships after AOA and having to repeat our TRI's before entering the ACGME to:

  1. Being able to enter any fellowship or TRI, because they will all be accredited by one body.
  2. Be able to have 1 match list, no more worrying about matching AOA first and being pulled out of the match.
  3. Increasing the standards of some of our AOA residency programs by forcing them to to adhere to ACGME policies.
  4. As of right now MD/IMG students still cannot enter the AOA match which retains our AOA options (I fully expect this to change in the future, and MD's should be allowed to enter our programs, but as of right now, it's not happening).
  5. If you want to practice in one of the states that requires you to do an AOA TRI (Penn, Florida, Oklahoma, etc) you may not have to do that anymore (yes I know you could appeal but it's a pain) that very well might be disappearing.
  6. It will lead to more DO's matching into MD residencies and it will (in the future) lead to less discrimination. You kidding yourself if you think otherwise. It may take some time, but it will happen.
  7. The "influx" of MD student shooting for DO residencies (which they can't even do yet) will be moderated by DO program directors who know that we are actively discriminated against at the "top tier" MD residencies. Over time, just like with MD directors, we will start to see equality. For those of you who say this isn't going to happen, you haven't met some of the older DO's who are actively discriminated against most of their life. I'm not saying it's right. But it's going to happen.
  8. DO's now have a far easier time being PD's for MD residencies, which will obviously in time decrease discrimination.

For the last time, we are NOT in the "same" boat as we were before.

This is awful for IMG's.
They can't enter the AOA programs.
Now they need to do an ACGME residency to do a fellowship.
You're going to have more DO's applying to "MD" residencies which will kick out even more IMG's
 
Those quotes are nice, but the bit about IMGs is just not true. We all know that MD's are going to be allowed to for DO residencies somehow, and if they are, you can bet IMGs will be allowed to, as well. Me and you HockeyDr agree on this, they're going to be allowed in (by showing OMM competency or whatever), and it will likely be in 2015.
 
Those quotes are nice, but the bit about IMGs is just not true. We all know that MD's are going to be allowed to for DO residencies somehow, and if they are, you can bet IMGs will be allowed to, as well. Me and you HockeyDr agree on this, they're going to be allowed in (by showing OMM competency or whatever), and it will likely be in 2015.


Well, I guess that depends on if residency directors place higher priority for accepting American graduates (MD, DO) before accepting IMGs (American, foreign trained, or completely foreign recent graduates). After all, those residency positions are funded through Medicare money, and I think that perhaps the program directors would want to give those positions to people who have been American citizens, residents first.
 
We can only be certain about one thing...



:scared: WINTER IS COMING :scared:
 
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Well, I guess that depends on if residency directors place higher priority for accepting American graduates (MD, DO) before accepting IMGs (American, foreign trained, or completely foreign recent graduates). After all, those residency positions are funded through Medicare money, and I think that perhaps the program directors would want to give those positions to people who have been American citizens, residents first.
Many of these IMGs are citizens.
 
I swear if you read SDN long enough you'll assume that every DO is primary care and those DOs with offices that say they're derms, GIs, or surgeons is nothing but liesss! Plenty of DOs specialize now.

And plenty will continue to specialize after this goes through..
 
All you y'all are missing the freaking point of this whole thing. 2 years ago, it was proposed by ACGME that only ACGME graduates can apply to ACGME fellowships.. In their thoughts, they felt this would decrease the amount of IMG from getting in and taking our (DO and MD) spots.. again political (fact is that IMG were getting into ACGME more often then DO students, even though DOs paid US tax and IMG did not).. If this had passed, it would decrease the amount of physicians that the US would be putting out every year overall and crumble the DO match. Hence AOA proposed that a new initiative and this was the outcome.

first of all, all these MDs want to think their automatically better so they'd take over the match, BS. there will still be plenty of competition, the fact is that 50 % DOs still match in the MD match

This move is better for DOs b/c they won't have to try to do 2 matches.. being able to apply to both the MD and DO match with no risk of waiting out the DO match and not matching in the MD...

Regardless, has nothing to do with any of this, its just the fact that the original proposal was overturned, and this is what the AOA gained, not lost out of it.
 
I have two brother in laws that just finished IM residency, there still not citizens.. its not about what they are now, its the fact that during medical school and undergrad, they didn't pay US tax.. where do you think the money comes from to train medical students
 
Many of these IMGs are citizens.

I have two brother in laws that just finished IM residency, there still not citizens.. its not about what they are now, its the fact that during medical school and undergrad, they didn't pay US tax.. where do you think the money comes from to train medical students
 
All you y'all are missing the freaking point of this whole thing. 2 years ago, it was proposed by ACGME that only ACGME graduates can apply to ACGME fellowships.. In their thoughts, they felt this would decrease the amount of IMG from getting in and taking our (DO and MD) spots.. again political (fact is that IMG were getting into ACGME more often then DO students, even though DOs paid US tax and IMG did not).. If this had passed, it would decrease the amount of physicians that the US would be putting out every year overall and crumble the DO match. Hence AOA proposed that a new initiative and this was the outcome.

I don't interpret this as a win what so ever. Yes, the ability to enter MD fellowships was maintained, however you need to look at what the AOA gave up to keep this. They gave oversight and regulation of their residencies to the ACGME and reduced their sole power handle of them to one of 5-7 member organizations largely dominated by MDs.

first of all, all these MDs want to think their automatically better so they'd take over the match, BS. there will still be plenty of competition, the fact is that 50 % DOs still match in the MD match
50% of DOs still match in the MD match, but match in largely non competitive specialties. There is very little representation in the competitive specialties (3 Derm, 0 ENT, 1 NS, 2 Ortho, 0 Plastics, 0 Rad Onc for 2012). The MD and DO pools being combined only matters for competitive specialties.

This move is better for DOs b/c they won't have to try to do 2 matches.. being able to apply to both the MD and DO match with no risk of waiting out the DO match and not matching in the MD...

Regardless, has nothing to do with any of this, its just the fact that the original proposal was overturned, and this is what the AOA gained, not lost out of it.
The combined match is probably the only true positive gained for DO students. However, the loss of exclusivity for the competitive DO specialties if you are someone interested in those specialties outweighs any perceived benefits.

The students gained the combined match, but overall, the AOA lost power in this deal.
 
The students gained the combined match, but overall, the AOA lost power in this deal.

Lol.. No one cares about the AOA. I wanted to be an MD but I couldn't get in despite my borderline MD stats(32 MCAT and ~3.5 GPA) and my alternative was to do a special master's program that would have put me in a whole lot of debt.. It's a win for students if the DO degree gets recognized as being equal to an MD in every spectrum and internationally.. Even better would be to just have one degree so that current DO students are recognized as physicians first and foremost not only nationally but internationally, the same as MDs..

If the discrimination at certain residencies would just end.. I couldn't care less that MDs would vie for the competitive specialties on the DO side.. I don't care one iota as long as I get recognized for my own accomplishments(grades, research, step scores) and PDs aren't biased against me because of the two letters behind my name. I'm just so bitter that people would assume I had a low MCAT score or very low GPA just because I'm a DO. People keep telling me that my stats are an anomaly for DOs but I've met a number of students at my school who had the same or higher stats than me and had graduated from top undergraduate institutions.. They couldn't get into an MD school either! There's no way I could have afforded to have done a special master's program considering how much debt I'd have because of it..

People here are acting as if DO students should be crestfallen that the ACGME has taken over the management and accreditation of AOA residencies.. Are you people delusional? Attending a DO institution is almost always a second choice for students.. People attend DO institutions to become physicians not to learn OMM. If OMM were the only medicine that was taught at DO schools they would rapidly close down or at least not attract the same applicants. There's no real love for OMM or osteopathic organizations for the vast majority of DO students. I am, however happy that I was accepted to medical school.

I'm just going to come out and say it but I truly believe that most DO students(including me) would rejoice at the thought that the AOA is losing power and that the merger of residencies is a historical acceptance that DO training is equivalent to MD training.. Merging residencies might make DO credentials more reputable internationally(other than the 45-55 countries where DOs are already recognized as physicians with full practice rights).

Finally.. perhaps this merging of residencies might one day mean the merging of degrees or at least the disappearance in bias that's present against DOs at top residencies/specialties.. I mean OMM could be a great modality in certain situations but less than 5% of practicing DOs even USE it! What is the point of having a different name for the degree when we're learning the same material? It just makes it more difficult for the degree to be recognized internationally and gives PDs an excuse to discriminate against potentially awesome applicants!
 
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Lol.. No one cares about the AOA. I wanted to be an MD but I couldn't get in despite my borderline MD stats(32 MCAT and ~3.5 GPA) and my alternative was to do a special master's program that would have put me in a whole lot of debt... It's a win for students if the DO degree gets recognized as being equal to an MD in every spectrum and internationally.. Even better would be to just have one degree so that current DO students are recognized as physicians first and foremost not only nationally but internationally, the same as MDs..

If the discrimination at certain residencies would just end.. I couldn't care less that MDs would vie for the competitive specialties on the DO side.. I don't care one iota as long as I get recognized for my own accomplishments(grades, research, step scores) and PDs aren't biased against me because of the two letters behind my name. I'm just so bitter that people would assume I had a low MCAT score or very low GPA just because I'm a DO. People keep telling me that my stats are an anomaly for DOs but I've met a number of students at my school who had the same or higher stats than me and had graduated from top undergraduate institutions.. They couldn't get into an MD school either! There's no way I could have afforded to have done a special master's program considering how much debt I'd have because of it..

People here are acting as if DO students should be crestfallen that the ACGME has taken over the management and accreditation of AOA residencies.. Are you people delusional? Attending a DO institution is almost always a second choice for students.. People attend DO institutions to become physicians not to learn OMM. If OMM were the only medicine that was taught at DO schools they would rapidly close down or at least not attract the same applicants. There's no real love for OMM or osteopathic organizations for the vast majority of DO students.

I'm just going to come out and say it but I truly believe that most DO students(including me) would rejoice at the thought that the AOA is losing power and that the merger of residencies is a historical acceptance that DO training is equivalent to MD training.. Merging residencies might make DO credentials more reputable internationally(other than the 45-55 countries where DOs are already recognized as physicians with full practice rights).

Finally.. perhaps this merging of residencies might one day mean the merging of degrees or at least the disappearance in bias that's present against DOs at top residencies/specialties.. I mean OMM could be a great modality in certain situations but less than 5% of practicing DOs even USE it! What is the point of having a different name for the degree when we're learning the same material? It just makes it more difficult for the degree to be recognized internationally and gives PDs an excuse to discriminate against potentially awesome applicants!
Too many DO students are clamoring for the end of AOA and the DO degree. It's not going to happen. At least not for decades or ever. Last night's live AOA webcast made that very clear. AOA, COCA, COMLEX is all here to stay. The discrimination from MD's (and the general public, those most of the general public is either unaware or doesn't care) comes from the belief (fairly or not) that DO schools are inferior. In order to change that, current DO's and DO students should be pushing the AOA to improve standards, and most importantly, get COCA to actually start improving schools, getting some better rotation sites going, maybe some associations with teaching hospitals, research, etc. Having COCA open up more schools (and this GME move may encourage them, actually) will only make things worse, not better.
 
Too many DO students are clamoring for the end of AOA and the DO degree. It's not going to happen. At least not for decades or ever. Last night's live AOA webcast made that very clear. AOA, COCA, COMLEX is all here to stay. The discrimination from MD's (and the general public, those most of the general public is either unaware or doesn't care) comes from the belief (fairly or not) that DO schools are inferior. In order to change that, current DO's and DO students should be pushing the AOA to improve standards, and most importantly, get COCA to actually start improving schools, getting some better rotation sites going, maybe some associations with teaching hospitals, research, etc. Having COCA open up more schools (and this GME move may encourage them, actually) will only make things worse, not better.

They say one thing, but chances are the AOA will realize that with a combined match their students will need the USMLE. Furthermore while COCA might remain, I wouldn't be surprised if the AOA in the next few years works out a dual accreditation board.
 
They say one thing, but chances are the AOA will realize that with a combined match their students will need the USMLE. Furthermore while COCA might remain, I wouldn't be surprised if the AOA in the next few years works out a dual accreditation board.
Completely wishful thinking. AOA will push to keep things like they are now, you can take USMLE, but you'll have to take COMLEX, as well. And COCA isn't going anywhere. They're working on opening up more DO schools over the next decade, as we speak.
 
Completely wishful thinking. AOA will push to keep things like they are now, you can take USMLE, but you'll have to take COMLEX, as well. And COCA isn't going anywhere. They're working on opening up more DO schools over the next decade, as we speak.

Hmm, so this is how I sound when I'm being overly pragmatic. Either way, the point being is that the COMLEX in 2015 only serves as a means of becoming licensed, the USMLE will over time take the place of the standard for residency programs. I think that within time DO's will likely be able to take either the USMLE or the COMLEX as their accrediting exam, or better more the COMLEX will become an OMM exam.
 
Hmm, so this is how I sound when I'm being overly pragmatic. Either way, the point being is that the COMLEX in 2015 only serves as a means of becoming licensed, the USMLE will over time take the place of the standard for residency programs. I think that within time DO's will likely be able to take either the USMLE or the COMLEX as their accrediting exam, or better more the COMLEX will become an OMM exam.
The USMLE is already the standard for residency programs. The COMLEX makes the AOA money. Giving it up would be detrimental to their existence. The best case scenario that's likely is that the AOA steps up the quality of the COMLEX exam, and simply improves it. However, it will still be around. Now, could things change a decade or so from now? Yeah, sure, but who knows that far down the road?
 
The USMLE is already the standard for residency programs. The COMLEX makes the AOA money. Giving it up would be detrimental to their existence. The best case scenario that's likely is that the AOA steps up the quality of the COMLEX exam, and simply improves it. However, it will still be around. Now, could things change a decade or so from now? Yeah, sure, but who knows that far down the road?

Or they make the COMLEX a test that tests only OMM and OMT.
 
Or they make the COMLEX a test that tests only OMM and OMT.
They would only do that if they could still force every DO student to take it. This is how the AOA makes their money. They're not giving it up, and according to them, the ACGME hasn't even brought this up in discussions at all.

Either way, if there is any major change to COMLEX like you're describing, it won't be for another decade at the least. It doesn't really affect us, and who knows what will happen by then.

The best thing to hope for now is that AOA steps up the merits of COMLEX.
 
I wonder if they will make the MD applicants take the COMLEX in order to apply to AOA residencies? That seems absurd to me, especially considering they never took any OMT/osteopathic philosophy classes. If they are going to allow the MDs to apply, like they say they will, surely they would accept USMLE. Perhaps COMLEX will become optional, but they will still encourage the DOs to take it? The whole thing seems silly...
 
BTW, it looks like in March of 2015, there may just be one match. All under ACGME accreditation.

So, let me ask, how many of you will forgo Primary care residencies (if that's not what you want), and aim for previously AOA residencies in competitive fields?

I think it's a bit early for PRE-MEDs to be trying to answer that question. Honestly, I doubt I would be okay with answering this question until the end of 3rd yr simply because you lack the background to make any sort of judgement call concerning that until you've completed at least some of your core rotations. Even then, you're making a decision with very limited exposure. I suspect I will apply broadly to all programs for which I am eligible that are in my specialty of interest and fit with me otherwise (e.g., location, perceived fit, perceived strength of program, etc.).
 
Sorry I'm late to the party. Not sure if these have been addressed. I'm having a hard time seeing a major impact here.

As long as the ACGME (and LCME) have no control over the standards of DO schools, I don't think much of the stigma towards DO will disappear. Having a single match may be more convenient, and I think more established DO schools could benefit, but I don't really see this having a major impact on matching for many DO students, especially those at the newer schools. Sure, there still may be some MD stigma in AOA residencies too, but it's not really for fear that they are less qualified (unless you count OMM) but is more about protecting the DO brand. The explosion of new schools withe questionable clinical experiences seems like the biggest threat to DOs, and I don't think these changes do much about that.

How will this impact AOA residencies too? Is it possible that these will need to be improved or eliminated if they don't meet ACGME standards? I have only heard anecdotally that this may be a problem, so I'm not sure. Anyone know?
 
:thumbup: Agreed.

If you're a DO, you should be complaining because the AOA really **** the bed here. The desirable AOA residency slots will be filled by better qualified MDs, and DOs will be mostly relegated to less competitive primary care positions.

Think again, MD's would have to meet certain requirements before qualifing for a AOA residency. And what makes you think that DO's would choose to fill their competitive residency with MD's. There are alot of competent DO students that apply for these spots too. Not because someone has a MD degree does'nt mean they are above DO's. There are lots of MD's from overseas or even lower tier medical schools, so being a MD does'nt make you "superior". It is time for us to stop bashing each other and start concentrating and things which is more important= patient care.
 
Think again, MD's would have to meet certain requirements before qualifing for a AOA residency. And what makes you think that DO's would choose to fill their competitive residency with MD's. There are alot of competent DO students that apply for these spots too. Not because someone has a MD degree does'nt mean they are above DO's. There are lots of MD's from overseas or even lower tier medical schools, so being a MD does'nt make you "superior". It is time for us to stop bashing each other and start concentrating and things which is more important= patient care.

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