AOA and ACGME merge!!

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Makati2008 said:
That's a very good question. Do you have any insider information law2doc to prove your theory?
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It's a material term of the agreement, and actually the term on which the deal fell apart previously. This is the big ticket item osteo had to sell to make this deal happen. (allo wanted this to be part of the deal, osteo said no -- wanted this to vaguely be a "to be discussed" kind of issue. Then osteo left the negotiation table for a few months, and finally cane back and Essentially said "you win, all spots are open". Do you really think it's not going to be policed?
 
Law2Doc said:
There will be pressure on both sides to look at numbers and CVs rather than the MD/DO distinction. I'm not sure that works in DOs favor for anything competitive, since few osteo programs have the same kind of research opportunities, etc. As an allo derm program you would still take the people with top board scores and solid derm research/pubs, and so at least initially That would be mostly allo grads. But now the borderline derm applicant from allo will be allowed to take a crash course in OMM and let his board scores and research snare him an osteo spot. It won't really work in reverse.

remember which side needs this merger more. Osteo was going to get squeezed out of all allo residencies in the next few years. They basically caved on the separate residency issue and came back to the table to avoid this. They got swallowed up by a much larger and more powerful organization -- it wasn't a Merger of equals. And this hugely helps the DO grad to get into a noncompetitive field. Now an allo program can consider DO grads freely without worrying how their peer programs or perspective med school applicants will view them for not being allo oriented. If I was an osteo grad going into a primary care field this merger would be awesome news. If I was a DO going into derm, I'd feel screwed.
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I am unclear as to where you get your facts. DOs have been entering allopathic residencies for decades and would continue to do so had the merger failed to go through. 55% of osteopathic graduates enter allopathic residencies. Where did you hear that DOs would be squeezed out of allo residencies? After the merger failed last year there was some talk about the ACGME no longer allowing physicians having completed AOA residencies/internships to crossover into ACGME fellowships/residencies, but that clause was promptly changed. Nothing was said about not allowing DOs to enter ACGME residencies. You are poorly informed.
 
rjgennarelli said:
I am unclear as to where you get your facts. DOs have been entering allopathic residencies for decades and would continue to do so had the merger failed to go through. 55% of osteopathic graduates enter allopathic residencies. Where did you hear that DOs would be squeezed out of allo residencies? After the merger failed last year there was some talk about the ACGME no longer allowing physicians having completed AOA residencies/internships to crossover into ACGME fellowships/residencies, but that clause was promptly changed. Nothing was said about not allowing DOs to enter ACGME residencies. You are poorly informed.
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You misunderstand. 93%-94% of allo grads match each year. Another 5% successfully scramble/soap. The numbers of allo grads has been going up each year, but those rates have stayed constant. So you don't have to be a Mathematician to see that as the number if allo grads reaches the number of allo residency slots, as is projected to happen in just a few years, everyone else gets squeezed out. This deal was a self preservation move by DO to ensure that they wouldn't be one of the groups squeezed out.
 
Law2Doc said:
I think you might be underestimating what the CVs of the grads of top allo schools going into derm, optho, ortho look like. To some extent having their own residencies sheltered some top DOs from trying to compete with the absurdly high board scores and extensive number of research publications some of the more competitive specialties see from their "average" allo applicants. Now to get those spots they will have to hope for built in biases of osteo PDs and the low hurdle of needing a couple week rotation to learn OMM. I predict this merger is better for the DO grad applying in a noncompetitive field but a much harder road if you are osteo and want something competitive, at least in the short term. But there really was no choice here -- allo programs were growing at a rate that would have otherwise boxed DOs out of most allo residencies. Now they are part of the combined group that will box out the IMG/FMG crowd in a few years. So it was a capitulation-- a hostile takeover of a small business by a much larger one. But it was more needed by the osteopathic world than the allopathic, and surrender terms were set accordingly. At the end, there will now be no MD or DO distinction or bias, which is a good thing. But those in top osteo programs now might feel some pains of moving from being big fish in small ponds to a very small fish in a big one. Osteo programs often don't have the research opportunities or the top USMLE scores so the closed door residencies they had first crack at might now go to the research heavy guy at an Ivy who otherwise couldn't get derm.
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While I agree that the average allopathic medical student has a better undergraduate CV, I believe you are underestimating what the CVs of top osteopathic grads look like. While research opportunities are not as really available, they still exist. In addition, many osteopathic students find other ways of enriching their CVs. I realize it may sound like I'm going on the defensive, but I'm not. All I am saying is that if you actually believe that allo medical students' CVs are overwhelmingly better than your DO counterparts', you're in for a surprise.
 
Law2Doc said:
You misunderstand. 93%-94% of allo grads match each year. Another 5% successfully scramble/soap. The numbers of allo grads has been going up each year, but those rates have stayed constant. So you don't have to be a Mathematician to see that as the number if allo grads reaches the number of allo residency slots, as is projected to happen in just a few years, everyone else gets squeezed out. This deal was a self preservation move by DO to ensure that they wouldn't be one of the groups squeezed out.
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Do I think it was wrong for the AOA/COCA to open more schools while being reliant upon the ACGME to provide their graduates with residency spots? Absolutely, but over 1/2 of DO graduates match ACGME and roughly the other 45% match AOA. The overall match rates are about the same with several programs failing to fill all of their spots. We were not exactly being squeezed out at this point. You sir are making assumptions.
 
rjgennarelli said:
While I agree that the average allopathic medical student has a better undergraduate CV, I believe you are underestimating what the CVs of top osteopathic grads look like. While research opportunities are not as really available, they still exist. In addition, many osteopathic students find other ways of enriching their CVs. I realize it may sound like I'm going on the defensive, but I'm not. All I am saying is that if you actually believe that allo medical students' CVs are overwhelmingly better than your DO counterparts', you're in for a surprise.
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Would you say that the CV of the best student from Drexel is of similar quality to the CV of the best student from HMS?

Or, if you're more familiar with DO schools. Is the CV of the best student from KYCOM similar to the CV of the best student from MSUCOM?
 
There is a push for more doctors to be trained so there are several new MD schools opening up (I believe it's about 11 in the next few years) and there are several current MD schools that are increasing their class sizes. There has not been a commensurate increase in residency spots. Who do you think that PDs in allopathic programs are going to choose? US MD students or DOs and IMGs? The reality is that most people who attend DO schools do so because they could not get into an MD school. This doesn't mean that they can't shine in medical school or that they will necessarily have lesser CVs that prevent them from matching well but the average quality of DO students is lower.
 
rjgennarelli said:
The overall match rates are about the same with several programs failing to fill all of their spots. We were not exactly being squeezed out at this point. You sir are making assumptions.
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You seem to be taking offense where L2D meant none and are being very defensive about this. L2D isn't posting any conspiracy theories or insider info.

Residency spots are staying static. US MD schools are (a) increasing enrollment by ~20% and (b) opening about 10 new programs within the next five years. Barring something changing in the residency climate (unlikely given recent political trends), there is going to be a squeeze.
 
rjgennarelli said:
While I agree that the average allopathic medical student has a better undergraduate CV, I believe you are underestimating what the CVs of top osteopathic grads look like. While research opportunities are not as really available, they still exist. In addition, many osteopathic students find other ways of enriching their CVs. I realize it may sound like I'm going on the defensive, but I'm not. All I am saying is that if you actually believe that allo medical students' CVs are overwhelmingly better than your DO counterparts', you're in for a surprise.
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You realize that the school you went to and the initials after your name are part of your CV, right? Do you think that program directors are going to suddenly change their attitudes because a governing body mandates it? The programs that have been friendly to DOs will continue to be, and the ones that have shut them out will do the same for awhile to come.
 
Wordead said:
You realize that the school you went to and the initials after your name are part of your CV, right? Do you think that program directors are going to suddenly change their attitudes because a governing body mandates it? The programs that have been friendly to DOs will continue to be, and the ones that have shut them out will do the same for awhile to come.
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To add on to this, while residencies will be under the auspice of ACGME, any qualms PDs may have about AOA standards versus LCME curriculum/rotation/research standards will still exist.
 
rjgennarelli said:
Do I think it was wrong for the AOA/COCA to open more schools while being reliant upon the ACGME to provide their graduates with residency spots? Absolutely, but over 1/2 of DO graduates match ACGME and roughly the other 45% match AOA. The overall match rates are about the same with several programs failing to fill all of their spots. We were not exactly being squeezed out at this point. You sir are making assumptions.
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"at this point" -- are the key words in your post. The writing was on the wall. That's why the AOA felt the need to come to the table.
 
Law2Doc said:
You misunderstand. 93%-94% of allo grads match each year. Another 5% successfully scramble/soap. The numbers of allo grads has been going up each year, but those rates have stayed constant. So you don't have to be a Mathematician to see that as the number if allo grads reaches the number of allo residency slots, as is projected to happen in just a few years, everyone else gets squeezed out. This deal was a self preservation move by DO to ensure that they wouldn't be one of the groups squeezed out.
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You seem a little misinformed. The numbers of allo students aren't even close to approaching the number of allo spots. I believe what you're basing your info on is the article that implied that by ~2018/2020 the total number of allo and osteo grads would be equal to the total number of allo ONLY spots.

The thing that article failed to take into account is that 45% of osteo grads had and would have (if not for the merger) continued to match in AOA residencies. So regardless there would be a buffer of >2000 spots. Now if MD schools expanded by another 10%, something that wasn't really in the works as even their projected 30% expansion (which is what the jama article was based on) was falling a bit short (I believe its actually closer to 20%), then there would be a problem. But that kind of expansion would take longer still. I doubt it would happen in the next 4-5 years. It would likely take another decade or so.

Those >2000 spots by the way would continue to be filled by IMGs/FMGs just as they currently fill the surplus 6000-some odd spots.
 
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hallowmann said:
You seem a little misinformed. The numbers of allo students aren't even close to approaching the number of allo spots. I believe what you're basing your info on is the article that implied that by ~2018/2020 the total number of allo and osteo grads would be equal to the total number of allo ONLY spots.

The thing that article failed to take into account is that 45% of osteo grads had and would have (if not for the merger) continued to match in AOA residencies. So regardless there would be a buffer of >2000 spots. Now if MD schools expanded by another 10%, something that wasn't really in the works as even their projected 30% expansion was falling a bit short, then there would be a problem. But that kind of expansion would take longer still.

Those >2000 spots by the way would continue to be filled by IMGs/FMGs just as they currently fill the surplus 6000-some odd spots.
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Just keep extrapolating that graph line a few years further. The growth of allo schoolS continues to be robust and the number of residency slots is stagnant. This merger was all about ensuring a share of residency lots. Without it the AOA was SOL. Do you really think the osteo leadership decided to capitulate if there was no threat looming?
 
Law2Doc said:
Just keep extrapolating that graph line a few years further. The growth of allo schoolS continues to be robust and the number of residency slots is stagnant. This merger was all about ensuring a share of residency lots. Without it the AOA was SOL. Do you really think the osteo leadership decided to capitulate if there was no threat looming?
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There was a threat looming. For one the ACGME had made it clear that DOs who complete AOA internships and residencies would not receive credit for that training if they applied for ACGME residencies/fellowships. When the merger failed, that was the next step. That quite frankly was enough to make it harder for DOs (especially in IM) to subspecialize and further incentivizes DOs to not go to AOA programs. That was an inherent threat.

Besides, the current merger doesn't solve the problem you are describing as the sole purpose the AOA agreed to the merger. MD and DO schools are still expanding, as you pointed out, and residencies are still stagnant. If a merger would in any way affect this, it would have less to do with "securing DOs ACGME spots" (last I checked there is no real stipulation in this regard for the merger) and more to do with being able to jointly lobby for residency expansion (given now that one body, the ACGME, would control all residencies with backing of the AMA, AAMC, AOA, AACOM, and other boards).
 
hallowmann said:
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Besides, the current merger doesn't solve the problem you are describing as the sole purpose the AOA agreed to the merger. MD and DO schools are still expanding, as you pointed out, and residencies are still stagnant. If a merger would in any way affect this, it would have less to do with "securing DOs ACGME spots" (last I checked there is no real stipulation in this regard for the merger) and more to do with being able to jointly lobby for residency expansion (given now that one body, the ACGME, would control all residencies with backing of the AMA, AAMC, AOA, AACOM, and other boards).
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Um, The growth of med school without growing residencies isn't a "problem". It's actually the unstated goal. The AAMC/ACGME wants US med schools to fill US needs. It wants to drive everyone else it doesn't control out of the game. Forcing osteo back into the fold is a Big step in doing this. Now osteo growth is allo growth. One group (allo) controls it. The offshore schools are F'ed. Residency expansion would be counterproductive -- allo medicine doesn't even want this at this time. This is what you need to understand to appreciate the allo side of the deal. We don't want residencies to expand.
 
I dunno. It was more of a two-step "whoa" since I didn't know about the merger and just incidentally found out bridge programs even exist. As long as I get ~my~ residency, anyone else can take whatever path they want...
 
To be fair, residency positions haven't been completely stagnant as many here are claiming. The AOA has been working hard to increase post-graduate positions and has added over 1,100 positions, including 75 new programs, just in the last year. They went from 9,300 to 12,000+ total positions in just the last couple years. It will be interesting to see how this growth continues now that there is a joined accrediting system.

Also, the annual NRMP match positions grew from 25,520 in 2010 to 29,171 in 2013.
In comparison, annual AOA match positions grew from 2,443 to 2,900 in that same time period.

Sources:
http://www.osteopathic.org/inside-aoa/Pages/student-faq-august-2013.aspx
https://www.osteopathic.org/inside-aoa/Education/Pages/new-aoa-approved-ogme-programs.aspx
NRMP 2010: http://b83c73bcf0e7ca356c80-e8560f4...ontent/uploads/2013/08/resultsanddata2010.pdf
NRMP 2013: http://b83c73bcf0e7ca356c80-e8560f4...ontent/uploads/2013/08/resultsanddata2013.pdf
https://natmatch.com/aoairp/aboutstats.html
 
SnowDoggy44 said:
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Also, the annual NRMP match positions grew from 25,520 in 2010 to 29,171 in 2013...]
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Actually, I suspect a lot of these were simply reallocations of existing historically "prematch" spots into match spots due to the enactment of the "all in" rule. Not new spots.

Residency growth has been very nominal (but true, not zero) when you compare it to the much greater growth of med school enrollment.
 
SnowDoggy44 said:
To be fair, residency positions haven't been completely stagnant as many here are claiming. The AOA has been working hard to increase post-graduate positions and has added over 1,100 positions, including 75 new programs, just in the last year. They went from 9,300 to 12,000+ total positions in just the last couple years. It will be interesting to see how this growth continues now that there is a joined accrediting system.

Also, the annual NRMP match positions grew from 25,520 in 2010 to 29,171 in 2013.
In comparison, annual AOA match positions grew from 2,443 to 2,900 in that same time period.

Sources:
http://www.osteopathic.org/inside-aoa/Pages/student-faq-august-2013.aspx
https://www.osteopathic.org/inside-aoa/Education/Pages/new-aoa-approved-ogme-programs.aspx
NRMP 2010: http://b83c73bcf0e7ca356c80-e8560f4...ontent/uploads/2013/08/resultsanddata2010.pdf
NRMP 2013: http://b83c73bcf0e7ca356c80-e8560f4...ontent/uploads/2013/08/resultsanddata2013.pdf
https://natmatch.com/aoairp/aboutstats.html
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Increased positions in the match does not reflect an increase in residency spots. Those were spots saved for people who wanted to change fields, people who were hired through unofficial channels, etc. That large increase was a one time thing.
 
ulikedaggers said:
Would you say that the CV of the best student from Drexel is of similar quality to the CV of the best student from HMS?

Or, if you're more familiar with DO schools. Is the CV of the best student from KYCOM similar to the CV of the best student from MSUCOM?
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Not 100% sure of what your point is with this post, but Drexel had a guy match into Harvard Derm last year. If the point is that the top of each class can match into the best residencies, regardless of school name, then I agree.
 
Law2Doc said:
It's a material term of the agreement, and actually the term on which the deal fell apart previously. This is the big ticket item osteo had to sell to make this deal happen. (allo wanted this to be part of the deal, osteo said no -- wanted this to vaguely be a "to be discussed" kind of issue. Then osteo left the negotiation table for a few months, and finally cane back and Essentially said "you win, all spots are open". Do you really think it's not going to be policed?
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I honestly don't unless it's going to go both ways....let me know when Vandy (for example) starts taking DOs and then I'll start to believe the acgme is doing it's job as a watchdog
 
Makati2008 said:
I honestly don't unless it's going to go both ways....let me know when Vandy (for example) starts taking DOs and then I'll start to believe the acgme is doing it's job as a watchdog
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We are talking competitive residencies not whole hospital systems. ("Vandy" probably already has some DOs in its noncompetitive programS -- I'm guessing). A ton of osteo grads already go to allo noncompetitive residencies so I'm not sure how much policing is going to impact both directions -- it has been a one way valve up to now. It's certainly a popular view that DOs are being discriminated against, but for the noncompetitive fields they've made quite a few inroads already.

For the competitive fields very few osteopathic grads will have both the board scores and the research (as most DO programs aren't research opportunity heavy), and few will show up with LORs from big shots in the field, so it's going to be a tough nut to crack even if the underlying degree gets ignored. Having served on enough committees I can tell you that the CVs of the more competitive US applicants are objectively very hard to compete with even ignoring their underlying med school. We are talking pages of first author publications, letters from the guys who wrote the text books, and USMLE scores much higher than the absurd numbers people throw around as "great" scores on SDN. But most competitive fields won't have a problem looking at that one or two exceptional osteo grads that meet this mark if their peers are also doing likewise. No competitive program wanted to be the one with the reputation of not being able to fill with top US allo grads such that it had to look elsewhere. (opinions of peer programs and future applicants weighed heavily on who programs could safely consider). The merger changes this, and puts osteo grads into the same applicant pool, at least eventually.

But until osteo schools beef up research and attract the big name faculty, they simply will have less of the things competitive programs covet (research, letters from big shots in the specialty, plus top USMLE scores) to offer. And so I think the policing here will be mostly one way because the "prerequisites" going the other way are already such a high hurdle. Allo programs will be happy to consider those few osteo grads who match their typical allo credentials, but I think there are plenty of people that simply won't make the grade even when their degree is taken out if the equation, and will find that it was less of an MD- DO bias and more if a bias driven by the underlying opportunities and contacts available. In short, I think a lot of competitive osteo grads who believe they were discriminated against because of DO are vastly underestimating what the CV of their allo grad counterpart who lands a good derm or plastics spot looks like.
 
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"policing" the match would be a very new role for the ACGME. It's not like they go around now looking at match lists and saying "hey - you didn't match anyone from UAB in the past 7 years". The ACGME has never dictated who or how a program makes up their rank list; I'd be shocked if this agreement had the teeth to let them start doing it now.
 
ulikedaggers said:
What's worse?
Fewer physicians, but all trained to ACGME standards.
More physicians, some trained by programs that the ACGME would deem sub-par.

Just curious. I don't know where I stand on the question.
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I don't understand how or if residency programs are graded, but it they were anything like how U.S. News or QS grades "Best Medical Schools" or "Best Colleges" I think it would depend on which aspect said programs were sub-par in. If a program was sub-par because theres not enough research being done, I wouldn't worry much about those physicians being trained there.
 
I'm almost certain the L2D is absolutely correct in his assessment. The real question for me at this point is how many of the AOA programs will get ACGME approval? Are all of these programs up to snuff? Sure, the more consistently matched and prestigious of them will, but how about all those smaller community mix-in programs? Make no mistake about it, the ACGME can be quite ruthless and they absolutely will (and do) shut down and place programs on probation (happened to a FM program very close to here recently).
 
Launcelot said:
I don't understand how or if residency programs are graded, but it they were anything like how U.S. News or QS grades "Best Medical Schools" or "Best Colleges" I think it would depend on which aspect said programs were sub-par in. If a program was sub-par because theres not enough research being done, I wouldn't worry much about those physicians being trained there.
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There is a huge difference between how programs are "graded" by services like USNWR, and how they are accredited by the ACGME.

There is a huge document full of particulars for accreditation by the ACGME, and an other huge document full of specialty specific particulars for each subspecialty's RRC. On top of that fun-ness, the ACGME is in the process of overhauling their accreditation system (both in terms of the language and requirements on paper, and in the method in which they conduct site reviews). To be accredited, a program has to meet all these requirements on paper, and pass an in person site review (which in the future will be a JCAHO style site review where they give you less than a weeks' notice that they are coming, then conduct a 2-3 day review of your departments' records, practices, and facilities).
 
Law2Doc said:
Um, The growth of med school without growing residencies isn't a "problem". It's actually the unstated goal. The AAMC/ACGME wants US med schools to fill US needs. It wants to drive everyone else it doesn't control out of the game. Forcing osteo back into the fold is a Big step in doing this. Now osteo growth is allo growth. One group (allo) controls it. The offshore schools are F'ed. Residency expansion would be counterproductive -- allo medicine doesn't even want this at this time. This is what you need to understand to appreciate the allo side of the deal. We don't want residencies to expand.
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So you're now stating a DO Student is equivalent to an MD Student, There is only 1 reason the ACGME allowed this merger , they wanted there (DO) Top Tier Residency positions for MD students case closed
 
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one of the driving forces for this unification was that the ACGME was threatening not to allow graduates of DO programs (non-ACGME programs) to apply for ACGME accredited fellowships. this, of course, would have been extremely disruptive for DO residents.
in the short term, it will be a challenge for some existing DO programs to meet the requirements of ACGME, but in the long run it is probably good to have one set of standards for residencies.
 
I'm just curious since many of you seem to think AOA residencies just won't be up to par with those of the ACGME: why would the ACGME want a merger if they didn't think AOA residencies would not, at least given the appropriate 5 year transitional time, meet their criteria?
 
rjgennarelli said:
I'm just curious since many of you seem to think AOA residencies just won't be up to par with those of the ACGME: why would the ACGME want a merger if they didn't think AOA residencies would not, at least given the appropriate 5 year transitional time, meet their criteria?
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Because it means that the ACGME will have control over all of graduate medical education and can enforce a uniform set of standards.
 
what medical class would this affect? the class of 2019? or the class of 2020?
 
psychic_hearts said:
what medical class would this affect? the class of 2019? or the class of 2020?
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Based on this timeline, Class of 2016 should see some change if the process stays on schedule (yay me!), and 2017 even more. From our limited position as medical students, it is impossible to confidently foresee which of the upcoming classes between now and 2020 will see the biggest change or effect.

While it does seem to be significant in extent, we don't even know what the specific prerequisites are for MDs earning eligibility to enter a residency with osteopathic recognition beyond the following:

Prior to matriculation, residents meeting the requirements for V.A.2. or V.A.3. above must be prepared to demonstrate competence in osteopathic principles and practice approaching that of a graduating fourth-year student as established by the American Association of Colleges of Osteopathic Medicine (AACOM), including the following knowledge, skills, or behaviors:
V.B.1. osteopathic philosophy, history, terminology and code of ethics;
V.B.2. anatomy and physiology related to osteopathic medicine;
V.B.3. indications, contraindications, and safety issues associated with the use of osteopathic manipulative treatment; and,
V.B.4. palpatory diagnosis, osteopathic structural examination, and osteopathic manipulative treatment (OMT).
V.C. Competence must be demonstrated through achievement of prerequisite osteopathic principles and practice Milestones, including those specific to the specialty.

https://www.acgme.org/acgmeweb/Portals/0/PDFs/osteopathic-principles.pdf
 
SnowDoggy44 said:
Based on this timeline, Class of 2016 should see some change if the process stays on schedule (yay me!), and 2017 even more. From our limited position as medical students, it is impossible to confidently foresee which of the upcoming classes between now and 2020 will see the biggest change or effect.

While it does seem to be significant in extent, we don't even know what the specific prerequisites are for MDs earning eligibility to enter a residency with osteopathic recognition beyond the following:

Prior to matriculation, residents meeting the requirements for V.A.2. or V.A.3. above must be prepared to demonstrate competence in osteopathic principles and practice approaching that of a graduating fourth-year student as established by the American Association of Colleges of Osteopathic Medicine (AACOM), including the following knowledge, skills, or behaviors:
V.B.1. osteopathic philosophy, history, terminology and code of ethics;
V.B.2. anatomy and physiology related to osteopathic medicine;
V.B.3. indications, contraindications, and safety issues associated with the use of osteopathic manipulative treatment; and,
V.B.4. palpatory diagnosis, osteopathic structural examination, and osteopathic manipulative treatment (OMT).
V.C. Competence must be demonstrated through achievement of prerequisite osteopathic principles and practice Milestones, including those specific to the specialty.

https://www.acgme.org/acgmeweb/Portals/0/PDFs/osteopathic-principles.pdf
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when are we going to admit that basically no osteopaths even embody this crap? what's the percent of DOs who even practice OMT, like 10%?
 
TeddyMeddy said:
Are board exam scores analagous to the MCAT in differentiating people between these schools? Can a very strong DO candidate (published papers, extremely high board scores, great personal qualities, recommendations, etc) land a residency in a field like orthopaedics (not necessarily an academic/research track residency but a strong community med one)? If they're the same thing on paper now, is it possible in the near future that the DO degree will just become MD?
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Down the road, given the merger, a DO with the same on paper stats/board scores as an MD will have an equal shot at an ortho residency. Currently, as I mentioned above, it's extremely hard for DO grads to have the same kind of research and letters from ortho big-shots, so even if we took the MD- DO degree name out of the equation (which hasn't happened yet), that field will continue to be dominated by allo in the near term. I'm not sure the difference in credentials between academic and community in the more competitive fields is as big a range as you seem to be suggesting.
 
TeddyMeddy said:
I have a national conference abstract (non ortho) that may become published...if I went DO and didn't do any more research could I have a shot at ortho based on that research record alone?
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Uh, definitely no. You want Ortho? You do Ortho/bone-related research.
 
TeddyMeddy said:
I have a national conference abstract (non ortho) that may become published...if I went DO and didn't do any more research could I have a shot at ortho based on that research record alone?
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Premed research isn't deemed as meaningful as med school research so I wouldn't rest on my laurels with that. But no, I think banking on things changing in the shorter term is unrealistic.
 
Law2Doc said:
We are talking competitive residencies not whole hospital systems. ("Vandy" probably already has some DOs in its noncompetitive programS -- I'm guessing). A ton of osteo grads already go to allo noncompetitive residencies so I'm not sure how much policing is going to impact both directions -- it has been a one way valve up to now. It's certainly a popular view that DOs are being discriminated against, but for the noncompetitive fields they've made quite a few inroads already.

For the competitive fields very few osteopathic grads will have both the board scores and the research (as most DO programs aren't research opportunity heavy), and few will show up with LORs from big shots in the field, so it's going to be a tough nut to crack even if the underlying degree gets ignored. Having served on enough committees I can tell you that the CVs of the more competitive US applicants are objectively very hard to compete with even ignoring their underlying med school. We are talking pages of first author publications, letters from the guys who wrote the text books, and USMLE scores much higher than the absurd numbers people throw around as "great" scores on SDN. But most competitive fields won't have a problem looking at that one or two exceptional osteo grads that meet this mark if their peers are also doing likewise. No competitive program wanted to be the one with the reputation of not being able to fill with top US allo grads such that it had to look elsewhere. (opinions of peer programs and future applicants weighed heavily on who programs could safely consider). The merger changes this, and puts osteo grads into the same applicant pool, at least eventually.

But until osteo schools beef up research and attract the big name faculty, they simply will have less of the things competitive programs covet (research, letters from big shots in the specialty, plus top USMLE scores) to offer. And so I think the policing here will be mostly one way because the "prerequisites" going the other way are already such a high hurdle. Allo programs will be happy to consider those few osteo grads who match their typical allo credentials, but I think there are plenty of people that simply won't make the grade even when their degree is taken out if the equation, and will find that it was less of an MD- DO bias and more if a bias driven by the underlying opportunities and contacts available. In short, I think a lot of competitive osteo grads who believe they were discriminated against because of DO are vastly underestimating what the CV of their allo grad counterpart who lands a good derm or plastics spot looks like.
Click to expand...

long post, but sadly this is all based on a faulty assumption that top programs would consider top DO applicants the same as MD applicants. This is just not true. I've been told by an ENT resident first-hand that they just filter all DO/IMG applications out without even looking at their file.

You can also see that policy posted on NYU's IM program.
 
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