AOA/ACGME merger and DO surgical residency

[budda10000]

Hello all, I wanted to pose a question to all you DO's eyeballing surgery/surgical sub-specialty. Given that my USMLE isn't an ungodly 260+(got 244), I cannot apply ACGME ortho with any realistic hope of a match so I am left with applying AOA. What do you think the prospect of these residency programs achieving ACGME approval is? Should I even bother applying since I would be SOL if the residency program closed mid-training?

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[OnlyOneZlatan]

As a DO, you can shoot for ACGME surgical programs, but know that you're unlikely to match unless you rotate at those programs even WITH a 250+. Your best bet is to kill the rotations you do and hope they are willing to match a DO and make their program seem less competitive. A 244 isn't even that good for an MD applicant that isn't from a school in the top 40. You're going to have a hard time, but if you're willing to forgo something else to do surgery, then by all means give it a shot.

 

[hallowmann]

I would apply to both AOA and ACGME, and I'd probably have a backup lined up. Focus on AOA programs with the greatest likelihood of getting ACGME accreditation. Ideally by next Jan, you'll have an idea of the programs on the AOA side that will or may have just received ACGME accreditation, then you can choose to only rank those sites on the AOA side.

Like I said, I'd also be sure to have an ACGME backup plan. Something else you could see yourself doing, like PM&R or something you're interested in.

Also, the mean Step 1 score for allopathic seniors that matched Ortho in 2016 was 247, but you're a DO. It was 245 for US IMGs, so you're probably in the range, but you're not above it. I'd see how you do in terms of ACGME interviews. Apply very broadly. Like to as many reasonable programs you can afford.

Also, even if your program closes, while it would suck and probably lose you a lot of time, I imagine you'll have some options. That said, they'll probably be less than you have applying now. It's really up to you and how much you want ortho to decide whether it's worth the risk going to an AOA program. I certainly know people that want Ortho enough that they're taking the risk, and I hope it works out for them.

 

[Skynnyrd]

Hello all, I wanted to pose a question to all you DO's eyeballing surgery/surgical sub-specialty. Given that my USMLE isn't an ungodly 260+(got 244), I cannot apply ACGME ortho with any realistic hope of a match so I am left with applying AOA. What do you think the prospect of these residency programs achieving ACGME approval is? Should I even bother applying since I would be SOL if the residency program closed mid-training?

If you match into a pre-accredited or continued accreditation program that does not meet the 2020 deadline you WILL be allowed to complete your training at said program and become AOA board certified.

New Agreement Addresses Residents' Needs in the Transition to the Single GME Accreditation System

 

[Major]

What do you guys think the outlook will be for DOs matching into General Surgery after 2020? Are current ACGME GS programs more open to taking DOs?

 

[OnlyOneZlatan]

What do you guys think the outlook will be for DOs matching into General Surgery after 2020? Are current ACGME GS programs less likely to deny DOs?

Changed it for you

 

[Major]

Changed it for you

What do you think the outlook will be for DOs wanting to match into GS after 2020?

 

[AnatomyGrey12]

It's competitive but it is a realistic goal. Just be above average and you will have a shot. The competitiveness probably lies somewhere a little harder than EM but easier than the surgical subs.

 

[Major]

It's competitive but it is a realistic goal. Just be above average and you will have a shot. The competitiveness probably lies somewhere a little harder than EM but easier than the surgical subs.

So still Challenging, but perhaps not such as much as say Ortho?

Fellowship wise, should the merger post 2020 help?

 

[OnlyOneZlatan]

I will always refer to this when it comes to fields AND programs that are usually DO unfriendly - Radiology Faculty--Answering Questions/"AMA"

DOs that match anything surgical in the ACGME pre-merger realm is very impressive and likely requires multiple auditions and Step scores well into the 250s +/- extensive research and connections. I did not go into surgery, but this is based off of friends, classmates, and previous graduates that went that route. Like I said elsewhere, there are still programs that will remain "loyal" to DOs, but that will soon go away as GS programs close or programs become more "MD friendly".

 

[AnatomyGrey12]

So still Challenging, but perhaps not such as much as say Ortho?

Fellowship wise, should the merger post 2020 help?

Fellowships depend on the residency you go to and connections. Yes GS is not as competitive as ortho and never will be.

I will always refer to this when it comes to fields AND programs that are usually DO unfriendly - Radiology Faculty--Answering Questions/"AMA"

DOs that match anything surgical in the ACGME pre-merger realm is very impressive and likely requires multiple auditions and Step scores well into the 250s +/- extensive research and connections. I did not go into surgery, but this is based off of friends, classmates, and previous graduates that went that route. Like I said elsewhere, there are still programs that will remain "loyal" to DOs, but that will soon go away as GS programs close or programs become more "MD friendly".

Sorry but no you don't need a 250+ to match ACGME gen surg. People are successful with a step score at the average for the specialty and with a broad app. Research is not a make or break in GS either.

 

[hallowmann]

View attachment 216785

If you match into a pre-accredited or continued accreditation program that does not meet the 2020 deadline you WILL be allowed to complete your training at said program and become AOA board certified.

New Agreement Addresses Residents' Needs in the Transition to the Single GME Accreditation System

Wow, this just happened, and is awesome. Basically makes everything easy for residents in the transition.

...Sorry but no you don't need a 250+ to match ACGME gen surg. People are successful with a step score at the average for the specialty and with a broad app. Research is not a make or break in GS either.

This has been the experience of most I know that went into ACGME GenSurg. Certainly not easy, but being strategic, having competitive enough scores, and maybe an audition seemed enough. Obviously use all tools at your disposal including networking. That actually has a huge effect. If you get in good with faculty from a program, that means a lot more than 5 research experiences.

 

[OnlyOneZlatan]

Sorry but no you don't need a 250+ to match ACGME gen surg. People are successful with a step score at the average for the specialty and with a broad app. Research is not a make or break in GS either.

I am in no position to call you naive, but without you having gone through the process, you're making an excessively bold statement thinking DOs can easily match ACGME GS programs that weren't previously AOA to begin with. If you look at all the match lists each year, you'd be lucky to find 1 person per class of 200+ that has matched ACGME GS.

 

[budda10000]

View attachment 216785

If you match into a pre-accredited or continued accreditation program that does not meet the 2020 deadline you WILL be allowed to complete your training at said program and become AOA board certified.

New Agreement Addresses Residents' Needs in the Transition to the Single GME Accreditation System

What is the view on fellowship opportunities for these graduates? I was under the impression that AOA would be effectively barred from ACGME fellowship programs.

 

[budda10000]

As a DO, you can shoot for ACGME surgical programs, but know that you're unlikely to match unless you rotate at those programs even WITH a 250+. Your best bet is to kill the rotations you do and hope they are willing to match a DO and make their program seem less competitive. A 244 isn't even that good for an MD applicant that isn't from a school in the top 40. You're going to have a hard time, but if you're willing to forgo something else to do surgery, then by all means give it a shot.

And your point is.... what exactly? I wasn't even asking about my chances with ACGME, in fact I even made it a point to say that isn't an option for me. I know you were trying to make me feel inferior and elevate yourself. Best of luck to you on the interview cycle with that charming personality! Please refrain from "educating" me further.

 

[Skynnyrd]

What is the view on fellowship opportunities for these graduates? I was under the impression that AOA would be effectively barred from ACGME fellowship programs.

Here is one poster's opinion about ortho fellowships. From his perspective it seems that ACGME fellowships are relatively receptive to AOA grads.
Bias against DOs in the orthopedic world?

 

[AnatomyGrey12]

thinking DOs can easily match ACGME GS

Who ever said that? You said you needed a 250+, which is just not true.

If you look at all the match lists each year, you'd be lucky to find 1 person per class of 200+ that has matched ACGME GS.

Wut? what have you looked at like 1 match list? ACGME general surgery is not an easy match but it happens often enough that it is a reasonable goal. ACGME ortho has like 5ish DOs match every year, ACGME GS generally has around 50+.

 

[budda10000]

Here is one poster's opinion about ortho fellowships. From his perspective it seems that ACGME fellowships are relatively receptive to AOA grads.
Bias against DOs in the orthopedic world?

Doesn't look so bad, thanks for the info!

 

[CCmetal94]

Essentially every single DO school matches a few ACGME gen surg every year. Even the brand new ones. Gen surg is your best bet as a DO when it comes to being a surgeon.

 

[OnlyOneZlatan]

Who ever said that? You said you needed a 250+, which is just not true.

Wut? what have you looked at like 1 match list? ACGME general surgery is not an easy match but it happens often enough that it is a reasonable goal. ACGME ortho has like 5ish DOs match every year, ACGME GS generally has around 50+.

Just wait until you try yourself or get more anecdotes to compare because unfortunately the data isn't there. Hope we hear of stories of those who matched with only 240+ lol

 

[AnatomyGrey12]

Just wait until you try yourself or get more anecdotes to compare because unfortunately the data isn't there. Hope we hear of stories of those who matched with only 240+ lol

Seriously? There is a poster in the surgical forums with an 23o's who only applied to 20 programs and got a lot of interviews. The data is there, I have talked to more than one resident. You are simply wrong. The residents I talked to said that every person they know who had a 235+ and applied broadly matched. Gen surg is not even close to the same competitiveness as the surgical subs.

 

[Drrrrrr. Celty]

Just wait until you try yourself or get more anecdotes to compare because unfortunately the data isn't there. Hope we hear of stories of those who matched with only 240+ lol

I've read of a few DOs on this forum who matched GS with high 230s when I was a pre-med . But I personally know nothing about the field or what a DO needs to have to really match well. But being fair I also don't think someone needs a 250 to match into ACGME GS. A 250 is a marginal score for matching into in a subspecialty like Optho.

 

[IslandStyle808]

I've read of a few DOs on this forum who matched GS with high 230s when I was a pre-med . But I personally know nothing about the field or what a DO needs to have to really match well. But being fair I also don't think someone needs a 250 to match into ACGME GS. A 250 is a marginal score for matching into in a subspecialty like Optho.

A 250 is not a marginal score for optho though. There are several DOs on the forums through the years who have matched in the 230s. However, a 230 is not really a good score to be applying with true.

 

[OnlyOneZlatan]

ACGME Ophtho/Ortho/ENT/Plastics - it's not enough to have a 250 step, you also would need research and multiple auditions. Most of my classmates, friends, and previous graduates that went after one of these ended up using GS as a backup and unfortunately a lot of them end up in general surgery. It's rough out there for a DO trying to do surgery. My problem is that this discussion is excessively optimistic and people forget that being a DO is already a problem. I stand by this post that I constantly refer to when it comes to the "Can I do XYZ as a DO?" - Radiology Faculty--Answering Questions/"AMA"

 

[OnlyOneZlatan]

lol talking about @AnatomyGrey12 anecdotal evidence and yet you keep referring to one anecdotal post

I mention anecdotes in a positive light? I think if you can find those few DOs that match at ACGME GS programs and get information from them as to what they did and what aspects of their application were involved (geography, score, letters, aways, connections), then that would help calm the fears of going this route. Mentioning that ~50 DOs match ACGME GS each year is like what I said earlier as well -- slightly more than 1 per graduating class. Does that really look like being a DO and doing ACGME GS is promising?

 

[Lexdiamondz]

lol At talking about @AnatomyGrey12 anecdotal evidence and yet you keep referring to one anecdotal post

But there is data on this. Look at the NRMP data - the number of DOs who have matched ACGME surgical subs is generally in the single digits, and the ones that do are very much outliers, not the norm. Even for Gen Surg only half match into PGY-1 spots.

 

[Drrrrrr. Celty]

ACGME Ophtho/Ortho/ENT/Plastics - it's not enough to have a 250 step, you also would need research and multiple auditions. Most of my classmates, friends, and previous graduates that went after one of these ended up using GS as a backup and unfortunately a lot of them end up in general surgery. It's rough out there for a DO trying to do surgery. My problem is that this discussion is excessively optimistic and people forget that being a DO is already a problem. I stand by this post that I constantly refer to when it comes to the "Can I do XYZ as a DO?" - Radiology Faculty--Answering Questions/"AMA"

Which is fine. I think surgical sub specialties are a different discussion than GS.

 

[Lexdiamondz]

Really? Mentioning that radiology post where he says says they don't consider DOs is in a positive light? I know you will never get enough fully proven and validated data to ever admit you were wrong and that's fine. But the fact is it was mentioned that ACGME GS is relatively doable for DOs. The also clearly abundant fact is you are not saying anything that isn't fully and completely articulated on SDN and liked by alteredscale

A match rate of 50% isn't "relatively doable" it's a coin toss.

 

[OnlyOneZlatan]

Really? Mentioning that radiology post where he says says they don't consider DOs is in a positive light? I know you will never get enough fully proven and validated data to ever admit you were wrong and that's fine. But the fact is it was mentioned that ACGME GS is relatively doable for DOs. The also clearly abundant fact is you are not saying anything that isn't fully and completely articulated on SDN and liked by alteredscale

GS is doable for DOs because there are AOA GS residencies, but many of them are closing and therefore we as DOs lose more spots. Those programs that make it through the accreditation process are then open for MDs and believe me, spots will be lost to MDs. In regards to the ACGME GS spots, you're saying "relatively doable" is 1 student per match class/50 per year/1%?

 

[Drrrrrr. Celty]

GS is doable for DOs because there are AOA GS residencies, but many of them are closing and therefore we as DOs lose more spots. Those programs that make it through the accreditation process are then open for MDs and believe me, spots will be lost to MDs. In regards to the ACGME GS spots, you're saying "relatively doable" is 1 student per match class/50 per year/1%?

I think you're oversimplifying things here. Many people who apply AOA GS do so because they don't wish to risk not matching.

 

[Drrrrrr. Celty]

Regardless, this thread is getting horribly off topic. ACGME ortho with a 240 probably is going to be a hard match. AOA Ortho is safer.

Unless there is a DO who is currently an Orthopedic resident in an ACGME program or someone with similar experience who wishes to comment, all others can pipe down with their useless noise.

 

[68PGunner]

I am in no position to call you naive, but without you having gone through the process, you're making an excessively bold statement thinking DOs can easily match ACGME GS programs that weren't previously AOA to begin with. If you look at all the match lists each year, you'd be lucky to find 1 person per class of 200+ that has matched ACGME GS.

False. Complete bs.

My DO school blows that mark by a wide margin for GS. For last year class, 6% went into General Surgery.

 

[AlteredScale]

Given that my USMLE isn't an ungodly 260+(got 244), I cannot apply ACGME ortho with any realistic hope of a match so I am left with applying AOA. What do you think the prospect of these residency programs achieving ACGME approval is?

If you're applying to newly ACGME-accredited AOA ortho programs (or applying strictly to AOA ortho if using the NMS system still) you should be fine if your cards are played right (good letters, good research, good auditions). The ortho PD here in blue springs (part of KCU's GME) has stated that even though they are open to MD applications now because they are a part of the NRMP system, they will still favor DO applications simply because that is what they are used to and because they understand how difficult it is for DO's to get into ACGME ortho programs that were never AOA in the first place. The research thing is becoming more and more important as ACGME requirements are much more stringent on that end and that's the kicker. There are MD applicants with very very strong ortho research behind them and many DO's with very minimal ortho research (specifically this has also been addressed with concern by the same PD). Will they then keep their word about keeping DO's on the forefront then? We will have to wait and find out.

Good luck with the process.

 

[W19]

Really? Mentioning that radiology post where he says says they don't consider DOs is in a positive light? I know you will never get enough fully proven and validated data to ever admit you were wrong and that's fine. But the fact is it was mentioned that ACGME GS is relatively doable for DOs. The also clearly abundant fact is you are not saying anything that isn't fully and completely articulated on SDN and liked by alteredscale

It's not...

ACGME GS is easier for MD students with 220s step1 from middle of the road schools than a DO with 240s

 

[Major]

So for DOs graduating after 2020, we should focus more of our energy on applying/interviewing/rotating at surgical programs with the "Osteopathic Recognition?"

 

[IslandStyle808]

ACGME Ophtho/Ortho/ENT/Plastics - it's not enough to have a 250 step, you also would need research and multiple auditions. Most of my classmates, friends, and previous graduates that went after one of these ended up using GS as a backup and unfortunately a lot of them end up in general surgery. It's rough out there for a DO trying to do surgery. My problem is that this discussion is excessively optimistic and people forget that being a DO is already a problem. I stand by this post that I constantly refer to when it comes to the "Can I do XYZ as a DO?" - Radiology Faculty--Answering Questions/"AMA"

The situation would not change whether the score was a 270 for a DO. This is an inbreeding issue with top programs. For instance, low tier MD student are only chosen to inflate their numbers so that they can have more ivy medical school grads to make their programs look better. However, not all programs function this way and some will take the best of the best whether MD or DO (ex. Mayo-Rochester).

In the end, you will have to know what programs are willing to look at DOs. The situation doesn't really change even if you are a 10+ above average USMLE DO.

 

[hallowmann]

It's not a big deal. Some people think it's hard, some think it's easy. Truth is, it's difficult, but certainly not as impossible as it seems. If it was, it wouldn't be the case that >25% of DOs who do GS are at ACGME programs.

There is also something to the statement that people are risk averse, and most would go AOA even if they could be strongly competitive for ACGME programs because they know they'll match AOA.

So for DOs graduating after 2020, we should focus more of our energy on applying/interviewing/rotating at surgical programs with the "Osteopathic Recognition?"

Its too early to tell. Just sit tight for a bit. It should become more obvious as things progress. The 2020 match will probably be crazy, but no one can really predict what will happen afterwards as of now.

 

[AlteredScale]

So for DOs graduating after 2020, we should focus more of our energy on applying/interviewing/rotating at surgical programs with the "Osteopathic Recognition?"

The majority of surgical programs that were once AOA and converted to ACGME have not/are not intending apply for osteopathic recognition since that would then require OMM competencies to be built into the program at every PGY level.

Focus on programs that were AOA now ACGME and continue to look at their roster yearly, if there's a sudden switch to all or majority MDs as residents you can assume that they are no longer putting DO applications as a priority. As @hallowmann said however, it's too early to tell what will happen.

 

[Major]

The majority of surgical programs that were once AOA and converted to ACGME have not/are not intending apply for osteopathic recognition since that would then require OMM competencies to be built into the program at every PGY level.

Focus on programs that were AOA now ACGME and continue to look at their roster yearly, if there's a sudden switch to all or majority MDs as residents you can assume that they are no longer putting DO applications as a priority. As @hallowmann said however, it's too early to tell what will happen.

Its too early to tell. Just sit tight for a bit. It should become more obvious as things progress. The 2020 match will probably be crazy, but no one can really predict what will happen afterwards as of now.

Cool deal. That makes sense. Thanks fellas!!

 

[0ncogene]

GS is doable for DOs because there are AOA GS residencies, but many of them are closing and therefore we as DOs lose more spots. Those programs that make it through the accreditation process are then open for MDs and believe me, spots will be lost to MDs. In regards to the ACGME GS spots, you're saying "relatively doable" is 1 student per match class/50 per year/1%?

Sorry but ACGME GS is not competitive like you describe. ACGME surgical specialties like ortho are.

 

[2021Doctor]

Here is a DO surgery program that transitioned from AOA to ACGME:
https://www.mercydesmoines.org/Portals/0/media/documents/residencydocuments/2015-2016 GS Program.pdf
http://www.mercydesmoines.org/Portals/0/media/documents/residencydocuments/RSPR-SRG-13621-2016-2017 Surgery Residents flyer11x17.pdf

Notice that 6 out of 8 residents in last 2 years (the last two PGY-1 classes) are MD.

 

[kenjixshadow]

Here is a DO surgery program that transitioned from AOA to ACGME:
https://www.mercydesmoines.org/Portals/0/media/documents/residencydocuments/2015-2016 GS Program.pdf
http://www.mercydesmoines.org/Portals/0/media/documents/residencydocuments/RSPR-SRG-13621-2016-2017 Surgery Residents flyer11x17.pdf

Notice that 6 out of 8 residents in last 2 years (the last two PGY-1 classes) are MD.

Also notice that they just lost accreditation recently so they went back to AOA for this cycle.
http://www.desmoinesregister.com/st...training-program-lose-certification/95958954/

 

[68PGunner]

Also notice that they just lost accreditation recently so they went back to AOA for this cycle.
http://www.desmoinesregister.com/st...training-program-lose-certification/95958954/

All MDs will now avoid former AOA surgical programs now...

 

[Bobcat18]

.

 

[AlteredScale]

I'll be applying only for ACGME General Surgery- I'll let everyone know my experience after the interview season.

Good luck.

 

[doing_all_the_things]

I just wanted some perspective on this ACGME accreditation thing since it was brought up that a program got full accreditation and then lost it. Do traditional ACGME programs have their accreditation revoked often? Does it vary by specialty? The fact that it was an AOA program prior to ACGME and then lost ACGME accreditation raises some questions about future "former-AOA" programs, but does the same thing happen to brand new ACGME programs just starting out?

 

[hallowmann]

I just wanted some perspective on this ACGME accreditation thing since it was brought up that a program got full accreditation and then lost it. Do traditional ACGME programs have their accreditation revoked often? Does it vary by specialty? The fact that it was an AOA program prior to ACGME and then lost ACGME accreditation raises some questions about future "former-AOA" programs, but does the same thing happen to brand new ACGME programs just starting out?

Yes. Programs usually get sanctioned. They tend not to completely lose accreditation, but I don't know the details of Mercy. If you look at the ACGME reports, they describe programs that are put on probation or lose accreditation. It's interesting, I think a FM program in Chicago that was dual-accredited lost its ACGME accreditation last year. I realized it right after I applied, obviously didn't schedule an interview there.

Usually a withdrawal of accreditation is a big deal, but it does happen.

Edit: Here's the list with programs on probation - ACGME - Accreditation Data System (ADS)

 

[NurWollen]

All MDs will now avoid former AOA surgical programs now...

And thus was born the SDN doctrine that even initial accreditation of a former AOA program is suspect.

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[AnatomyGrey12]

And thus was born the SDN doctrine that even initial accreditation of a former AOA program is suspect.

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What's funny is that the program was accredited years ago. Something had to have happened between accreditation and now to cause this, yet of course the SDN neuroticism will now spout this ad nauseum just as you say.

 

[Scrubs101]

And thus was born the SDN doctrine that even initial accreditation of a former AOA program is suspect.

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Spread it like wildfire, tell them all that previously AOA programs wont be safe for at least another 10 years.....




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