Applying to Allo Residencies with a DO

[QofQuimica]

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Since many of you are clearly interested in discussing this topic, and concern was raised about hijacking the OP's advice thread, I am splitting off this discussion into its own thread. As long as it stays civil, by all means, carry on.

 

[loveoforganic]

DO schools are generally not as selective as MD, nor do they tend to place as large a percent into certain specialties. To match into MD specialties, I also believe you have to take USMLE in addition to COMLEX. You can be very pro-DO and still recognize that there are deficits.

 

[ShyRem]

DO schools are generally not as selective as MD, nor do they tend to place as large a percent into certain specialties. To match into MD specialties, I also believe you have to take USMLE in addition to COMLEX. You can be very pro-DO and still recognize that there are deficits.

This is why you should be very wary of listening to pre-meds give advice about medical resident information. You do NOT - I repeat you do NOT NOT NOT - have to take the USMLE to apply and get into MD residencies. There are, however, some programs that will be more difficult to get into, and some darn near impossible (derm) without absolutely stellar everything (including USMLE scores). Heck, they're almost impossible to get into as an MD student.

We had a DO student last year who was offered a pre-match to Johns Hopkins for anesthesiology. I don't think they took the USMLE, but they were an outstanding applicant.

 

[loveoforganic]

That's why I add an 'I believe' when I'm not postive it's true 😉 Fact checking is always advised!

 

[NTF]

You do NOT - I repeat you do NOT NOT NOT - have to take the USMLE to apply and get into MD residencies.

Wow. I've been misinformed as well. Why do so many DO applicants take the USMLE then? (A bunch of my DO buddies have complained to me about scheduling and studying for both.)

 

[DrMidlife]

Wow. I've been misinformed as well. Why do so many DO applicants take the USMLE then? (A bunch of my DO buddies have complained to me about scheduling and studying for both.)

Competitive ACGME residencies want the USMLE.

 

[ShyRem]

People do because the believe it will help their chances with an ACGME residency. If you do VERY VERY well, they may be right. But more often than not, they do the same or worse on the USMLE than on COMLEX. Most ACGME residencies will accept COMLEX scores. But med students get notoriously poor guidance and counseling (meaning basically none) during med school and thus study for both exams.

If you are a good applicant, it won't matter what exams you take. If, however, you do poorly on the USMLE, you've just shot yourself in the foot for an ACGME residency, because you are REQUIRED to release your USMLE score if you apply for ACGME residency as a DO student.

There are some residencies out there that still insist on the USMLE. But if they are so insistent on the exam, are you sure you want to go there? Even Johns Hopkins, Cleveland Clinic, and Mayo don't require USMLE and will accept COMLEX.

 

[ShyRem]

Competitive ACGME residencies want the USMLE.

As in Derm, Ophtho. These are extremely difficult for MD students to get into as well.

 

[DrMidlife]

Most ACGME residencies will accept COMLEX scores.

Source? I know that COMLEX is acceptable at lots of residencies. Most? I'm skeptical. Should it be? Who benefits from the existence of both?

There are some residencies out there that still insist on the USMLE. But if they are so insistent on the exam, are you sure you want to go there?

If taking a 2nd exam gives you a chance at a desirable residency in a desirable location, why would you not prioritize doing well on it?

Even Johns Hopkins, Cleveland Clinic, and Mayo don't require USMLE and will accept COMLEX.

For IM & FM, maybe psych & PM&R, I believe this. Beyond that I think you're making way too big a statement.

 

[DrMidlife]

As in Derm, Ophtho. These are extremely difficult for MD students to get into as well.

Difficulty getting in is a different argument than exams required to be considered. The top OMS-IV in the country should be able to get into any residency they want, right? Would you advise them to go after Cleveland Clinic derm without taking the USMLE?

 

[Velocity]

Competitive ACGME residencies want the USMLE.

Does this mean that some MD residencies would accept the COMLEX? I mean, aside from your school evaluations and the USMLE, how else would they gauge a candidates' value?

 

[ShyRem]

DrMidlife, I've gone through match. I've rotated at a Cleveland Clinic hospital. I've had discussions with PDs at several hospitals in several specialties - including ACGME ophtho.

But PLEASE... if you are so absolutely sure of your experience and information, PLEASE go ahead and inform the current med students.

My advice? Cultivate relationships. Do well on your exams, whichever they are. Do research if going into a competitive residency. And try to rotate at whichever ultra-competitive residency you hope to get into. Believe in yourself and package yourself well. But if your exam scores aren't fabulous, if your application isn't fabulous, don't blame your failure on being a DO. At least take responsibility for your own successes - and your own failures. And a poor or even average USMLE score (or worse, a mismatch) is far more detrimental than a fabulous COMLEX score.

 

[DrMidlife]

Does this mean that some MD residencies would accept the COMLEX? I mean, aside from your school evaluations and the USMLE, how else would they gauge a candidates' value?

They gauge COMLEX performance - if a program gets a ton of DO candidates (particularly if it has accepted them in the past) then that program has roughly the same confidence in a COMLEX score as in a USMLE score.

 

[DrMidlife]

DrMidlife, I've gone through match. I've rotated at a Cleveland Clinic hospital. I've had discussions with PDs at several hospitals in several specialties - including ACGME ophtho.

But PLEASE... if you are so absolutely sure of your experience and information, PLEASE go ahead and inform the current med students.

I'm not at all sure of my experience and information beyond what I can cite. I'm challenging statements you're making that are misleading. You have boatloads more credibility here than I do, and you're a mod, so I don't understand (a) why you're saying that the COMLEX is accepted at most ACGME residencies without citing a source, and (b) why an attempt to clarify facts is pissing you off.

My advice? Cultivate relationships. Do well on your exams, whichever they are. Do research if going into a competitive residency. And try to rotate at whichever ultra-competitive residency you hope to get into. Believe in yourself and package yourself well. But if your exam scores aren't fabulous, if your application isn't fabulous, don't blame your failure on being a DO. At least take responsibility for your own successes - and your own failures. And a poor or even average USMLE score (or worse, a mismatch) is far more detrimental than a fabulous COMLEX score.

And do well on the USMLE if you want to compete with MDs for many popular residencies. Do you disagree?

 

[ShyRem]

Ok. Let's discuss JHU, Mayo, and Cleveland Clinic.


Mayo Dermatology definitely does accept COMLEX only.

Cleveland Clinic's derm program doesn't mention any required test scores at all. However, the Cleveland Clinic IM program does accept COMLEX in lieu of USMLE, so it's possible. Plus, CCF is extremely DO and IMG-friendly, so I'd be really surprised if *any* of their programs required a USMLE score of DO applicants. They have at least one osteopathic hospital in their consortium, so they are intimately familiar with the COMLEX.

Johns Hopkins's derm program requires the USMLE and doesn't mention COMLEX,You'd need to contact them to find out. I know for a fact their anesthesiology program will accept COMLEX only. A quick look shows they do not have any DOs on their derm residency roster. Whether this is because they just haven't selected any or no DOs have applied, we don't know because they don't say. Any supposition that a DO *must* have applied is ridiculous because we don't have those records available to us.

Doing well on any test is good. Doing published research is always good. I will NEVER say that have a fabulous test score, fabulous research, and fabulous LORs is not a good idea. But it's not necessary to have USMLEs for a majority of ACGME residency programs.

 

[FilipinoAmMD]

Question... i have read so many about derm.... but have always wondered about surgery? Such as cardio vascular? Do they accept comlex or do i still have to do usmle?

 

[ShyRem]

cardiovascular? That's fellowship. Not initial residency. Now if you want to do interventional cardiology, that takes IM first. If you want to do vascular surgery, you need gen surg first. Congenital cardiac surgery? Need thoracic surgery first.

Gen Surg isn't very competitive as a residency. But you need to figure out what you're asking about first.

Also, as a pre-med, you don't even know what you want to do yet. Over 80% of all med students change their minds about what specialty they want to do. Don't get ahead of yourself. Get into med school first. Then figure out what you want to do.

 

[Law2Doc]

Competitive ACGME residencies want the USMLE.

Many competitive allo residencies do want the USMLE. Not all, but many.
Which is why so many DO students who are hoping for allopathic residencies will sit for it. It's not simply a tactical error of misinformed folks thinking they know what programs want. It's what many programs actually want.
You guys (Dr Midlife, ShyRem) both get out onto thin ice with blanket statements in this thread. DO has made very significant inroads into certain residencies and geographic locations, but by no means has it hit the point where you can safely make a statement about all parts of the US or all specialties. Similarly, competitive allo residencies don't all have the same playbook, and what's true for rads in Michigan may not be true for optho in Mississippi. The one truth is that for certain specialties and in certain geographic locations, as of today, MD still has a leg up over DO in securing allo residencies. And for certain specialties and in certain geographic locations, the USMLE is a requirement for many such allo residencies. The PDs of these programs don't have enough experience with COMLEX to be comfortable with it, so they make folks take the test they are most comfortable with. The competitive fields are in the drivers seat and can force this, the less competitive things have more of a need to make themselves more attractive to applicants and so may be more flexible.

 

[Old Grunt]

Wow. I've been misinformed as well. Why do so many DO applicants take the USMLE then? (A bunch of my DO buddies have complained to me about scheduling and studying for both.)

Yeah. Me too.

I am not in a DO program, so I'll profess further ignorance on the COMLEX.

Is OMM factored into your overall score? If that's the case, it would seem to provide some padding as opposed to the USMLE.

 

[Instatewaiter]

This is why you should be very wary of listening to pre-meds give advice about medical resident information. You do NOT - I repeat you do NOT NOT NOT - have to take the USMLE to apply and get into MD residencies.

No you do not have to take the USMLE if you are a DO student. At the same time, many program will have no idea how to interpret a COMLEX score and taking the USMLE gives them a metric to compare you to their other applicants.

If you are a good applicant, it won't matter what exams you take. If, however, you do poorly on the USMLE, you've just shot yourself in the foot for an ACGME residency, because you are REQUIRED to release your USMLE score if you apply for ACGME residency as a DO student.

There are some residencies out there that still insist on the USMLE. But if they are so insistent on the exam, are you sure you want to go there? Even Johns Hopkins, Cleveland Clinic, and Mayo don't require USMLE and will accept COMLEX.

Your main stats for a residency program are your third year grades and your board scores. When a program is unfamiliar with your school they don't have much to compare you to with regards to your clinical rotations. If in addition they dont know what your COMLEX score is, they really have no idea where you stand. If this is the case, there is no way you're gonna match there.

I think a good metric would be whether a program has had DOs in the past, especially from your school. If they haven't, you better err on the safe side and take the USMLE.

 

[ShyRem]

I agree there are some PDs who have no idea how to view COMLEX scores. But many do. There are plenty of DOs who match into allopathic residencies of all kinds (ok, I don't know any derm ones, but see above for derm requirements for 3 high-name programs) with only the COMLEX and not the USMLE. But to tell all DO students they *have* to take the USMLE is ridiculous. Do your homework for your residency programs. If you really want a program that refuses to acknowledge the COMLEX, then yes, you should/must take the USMLE. And I would notify the AOA immediately since they are being very proactive at this point about educating PDs how to interpret a COMLEX score and will lobby and work on your behalf. (one of the few things the AOA does for us.)

I wonder how the COMLEX will be viewed as it has no aspirations at this time to merge step 1 and 2 as USMLE has proposed. I know residency programs are VERY upset at the possibility of no board scores on their residency applications for USMLE students (the step 1 and step 2 are proposed to be merged into one exam taken after 3rd year). If a DO student takes level 1 COMLEX after second year and then level 2 after third year, the PDs will have a gauge against which to measure applicants. Wonder if that will change their learning more about the exam? Or even give a leg up to DO students as they have already had an objective measuring stick of their knowledge?

Just thinking.

 

[Old Grunt]

I agree there are some PDs who have no idea how to view COMLEX scores. But many do. There are plenty of DOs who match into allopathic residencies of all kinds (ok, I don't know any derm ones, but see above for derm requirements for 3 high-name programs) with only the COMLEX and not the USMLE. But to tell all DO students they *have* to take the USMLE is ridiculous. Do your homework for your residency programs. If you really want a program that refuses to acknowledge the COMLEX, then yes, you should/must take the USMLE. And I would notify the AOA immediately since they are being very proactive at this point about educating PDs how to interpret a COMLEX score and will lobby and work on your behalf. (one of the few things the AOA does for us.)

I wonder how the COMLEX will be viewed as it has no aspirations at this time to merge step 1 and 2 as USMLE has proposed. I know residency programs are VERY upset at the possibility of no board scores on their residency applications for USMLE students (the step 1 and step 2 are proposed to be merged into one exam taken after 3rd year). If a DO student takes level 1 COMLEX after second year and then level 2 after third year, the PDs will have a gauge against which to measure applicants. Wonder if that will change their learning more about the exam? Or even give a leg up to DO students as they have already had an objective measuring stick of their knowledge?

Just thinking.

Shy,

I really have no dog in this fight. My aspirations are towards primary care in my current institution, which has equal numbers of DOs/MDs.

This is just a general knowledge question about the COMLEX. Does OMM count towards your overall score or is it considered separate?

 

[ShyRem]

There are OMM questions on the COMLEX. All questions count equally towards your score (except the experimental questions).

 

[Old Grunt]

There are OMM questions on the COMLEX. All questions count equally towards your score (except the experimental questions).

Okay. Thanks for the info.

 

[Law2Doc]

...
I wonder how the COMLEX will be viewed as it has no aspirations at this time to merge step 1 and 2 as USMLE has proposed. I know residency programs are VERY upset at the possibility of no board scores on their residency applications for USMLE students (the step 1 and step 2 are proposed to be merged into one exam taken after 3rd year). If a DO student takes level 1 COMLEX after second year and then level 2 after third year, the PDs will have a gauge against which to measure applicants. Wonder if that will change their learning more about the exam? Or even give a leg up to DO students as they have already had an objective measuring stick of their knowledge?

Just thinking.

I actually see this as being disastrous for DO students, because allo residencies are going to likely find something else upon which to base decisions once the USMLE is taken out of the equation (if this ever happens) and whatever this something else is isn't going to be the comlex and will be yet another thing folks coming from DO may have to pick up, which may prove more difficult to obtain than the USMLE. Instead of a leg up, expect it to be a disadvantage IMHO. The PDs want a single set of credentials, and if the USMLE isn't part of that, they will find something else that allo folks will have that will be. And I can pretty much guaranty it won't be comlex.

These proposed changes to USMLE are still a ways off though.

 

[EdLongshanks]

I know I'm premature to be discussing specialties, since I am only applying to med school this summer. But I want to make sure that the path that I am going down is the correct one.

I'm going to present my understanding of the DO vs MD facts as a set of propositions that you all can confirm to deny.

Prop 1) MD schools are slightly more selective that DO schools.

A quick lookover of http://www.eduers.com/mcat/Average_MCAT_Scores.htm shows that the DO schools tend to cluster toward the bottom of the list. The highest Osteopathic is Texas COM at 27.3, while the lowest MD school is Howard at 24.6. The highest Med school is Washington @St Louis - 37.5. Most allopathic schools average MCAT's at around 29-32, while the DO's hover around 26-29. Not a huge difference, but a difference.

Prop 2) MD's have a better chance of getting MD residencies than DO's do.

This is shown by the differences between the match rates for MD's and DO's in the AOA figures (which I don't have and can't find right now). But there is a significant, although not overwhelming, difference

Prop 3) DO's who do compete in the AOA have a not inconsiderable chance of matching.

Prop 4) DO's do not have to take USMLE as well as the COMLEX in order to compete for MD residencies, but it can improve their chances to match into some residencies

Prop 5) DO's get a second bite at the apple if they do not match in the AOA competition. They can compete for DO-only residencies

Prop 6) There is a more limited selection of DO residencies and DO's are more likely to practice in the less competitive specialties.

If these propositions are true, then here is my concusion.

I, as a person, have a given amount ability and talent which I can and will dedicate to whichever school accepts me and that I attend. The education at any quality school will prepare me similarly for medical practice. Any residency that I match too (should I graduate and match) will depend on my good-looks, glad-handing, speaking ability, educational attainments, and test scores (not necessarily in that order ).

Therefore, as long as I attend a quality school. My residency will be SOMEWHAT affected by the school that I attend, but GREATLY affected by the amount of ability, dedication, and effort that I put into my own education. Therefore, the school that best fits my personality, life-situation, and finances, is the one that I should desire to attend.

 

[ShyRem]

True. And one extra thing you should add is you can apply in the AOA match for dually accredited residencies. So you can get into an ACGME residency in the AOA match. Not all specialties have dually accredited residencies. If you are looking at fellowships after IM, I would look into dually accredited residencies.