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DrBender79

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I am a MSIII in an osteopathic school, hoping to go into Gen Surg. I want to know if allopathic general surgery residency programs are inherently better than osteopathic programs in terms of actual surgical experience.

In other words, I'm NOT talking about location, prestige, fellowship opportunities, etc... I am just wondering if ACGME programs have different training requirements than AOA programs for Surgery.
For example, is there a difference in the # of required cases and procedures? Is there even such a requirement for residents at all?
And if I might add another question- is there a difference in hospital practice rights between AOA and ACGME trained surgeons? (particularly in NY)
 
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They might be better.

But : the 'best', big name general surgery programs tend to be malignant. Do you really end up a better surgeon if you have to work long hours way past the cap that you don't even remember afterwards?

If you study for the USMLE as well as your regular boards, that diverts a lot of your resources away from other things that you could be using to maximize your chances of success. If you'll notice, your odds are not good for matching any ACGME programs at all. The match has gotten a lot more competitive, and being osteopathic is going to count against you lots of places.

You're trying to steal a spot from an allopathic student. Your own organization won't allow allopathic students to compete for AOA spots. It's not just that PDs will thinking you must have been academically weaker if you're osteopathic, they'll think it is unfair to be giving you a spot when there are so many well qualified allopathic students also competing for the same seat.

But the big reason : there are a whole bunch of AOA ortho spots. Rethink general surgery, will you? Orthopods work better hours, do lots of cool cases, make more money, and commonly known to be happier.
 

thedrjojo

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This post is wrong IMHO for many reasons

They might be better.
Thats very helpful... it is also solely opinion based which the OP said they didn't want.. they were asking about differences in requirements of the programs


But : the 'best', big name general surgery programs tend to be malignant. Do you really end up a better surgeon if you have to work long hours way past the cap that you don't even remember afterwards?
Quite a big sweeping generalization that I mostly disagree with, but since neither of us did residency at the 'best' big name programs (you might have done it at one)... And you also claim that this does make you a better surgeon, which also might be a falsehood, but if it is true, then there are definately people out there that are willing to put in the "extra" work if it makes them a better surgeon...

If you study for the USMLE as well as your regular boards, that diverts a lot of your resources away from other things that you could be using to maximize your chances of success. If you'll notice, your odds are not good for matching any ACGME programs at all. The match has gotten a lot more competitive, and being osteopathic is going to count against you lots of places.
This is just a weird statement... not all ACGME programs require USMLE scores, and if they do, they don't require COMLEX scores... plus, unfortunately one of the biggest things they look at is your USMLE score (as well as LOR, but you don't look for LOR's when you are studying for Step 1 which is much more valuable than Step 2 in the process)... so, to divert energy for 4-6 weeks to maximize your Step 1 score is one of the best investments to match competitively

You're trying to steal a spot from an allopathic student. Your own organization won't allow allopathic students to compete for AOA spots. It's not just that PDs will thinking you must have been academically weaker if you're osteopathic, they'll think it is unfair to be giving you a spot when there are so many well qualified allopathic students also competing for the same seat.
Up until this paragraph it seemed like you were an DO student with a grudge against the process against you. Now it seems like you are an MD student with a grudge against DO students who enter the Allopathic match. Not all PDs out there think of DO as academically weaker than MD programs, because frankly they aren't. There are the notions that pre-med you were weaker by going to DO (but not all DO students are those that failed to get into MD schools), and typically PDs don't have the notion of entitlement for Allopathic students to get allopathic residencies, at academic centers they feel they are stronger applicants, but most community programs have no issue... some might have a bias against non US citizens (which you can look at the NRMP/ERAS forum for several threads about the debate on how the match is run and whether it should exclude non Allo students).

But the big reason : there are a whole bunch of AOA ortho spots. Rethink general surgery, will you? Orthopods work better hours, do lots of cool cases, make more money, and commonly known to be happier.
This is also a weird and unusual statement. I am going into gen surgery, and would HATE to do ortho. Surgery is not just about how cool the cases you do are. I like the pathophysiology, the diagnosis, the management, and the finese of general surgery, most of which is lost in ortho in exchange for power tools, brute force, and little else (ortho onc is slightly different). I also don't think they necessarily work better hours and i don't know if it is commonly known they are happier. There might also be a bias against a DO orthopod too? Maybe.
 

Khirurg

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in NY, any allopathic program is DEFINITELY better than any osteopathic one
 

SLUser11

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There are the notions that pre-med you were weaker by going to DO (but not all DO students are those that failed to get into MD schools)...
I disagree......I'm sure there are some exceptions, but the vast majority of students in DO schools are there because they were not accepted by allopathic schools. I don't think there's any question about that. Some of them were likely rejected, while others did not apply due to fear of rejection.

and typically PDs don't have the notion of entitlement for Allopathic students to get allopathic residencies, at academic centers they feel they are stronger applicants, but most community programs have no issue...
I disagree. The bias against DOs is very prevalent in community and university programs alike.

Being in the midwest, I've interacted with a large number of osteopaths across most specialties...OB, IM, FP, Anesthesia, Rads, Ortho, G. Surg, etc. In general, I've found them to be just as talented and successful as the MDs I've met along the way. I've also met plenty of crappy DOs and MDs in approximately equal distribution.

However, there's no doubt that a bias against DOs exists in general surgery. It's not quite as strong as the bias against Caribbean grads, but it's there. The DO students that are able to match despite that bias are usually the cream of the crop, and typically do very well for themselves in allopathic residency.
 

DrBender79

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in NY, any allopathic program is DEFINITELY better than any osteopathic one
This is the kind of worthless statement that bugs me. WHY? Why do you say that? If I'm going to go for the MD match, it's a huge commitment and I need good reasons. I would have to schedule USMLE step 1 real soon and start studying for that on top of shelf exams and COMLEX 2. I'm not a super genius unfortunately, so my COMLEX 2 score would take a hit if I'm splitting my efforts like that. I would also have to find new rotations and cancel my scheduled ones so that I can "audition" at allopathic programs.
I'm not going to do all that just because somebody says they think MD programs are better. I need to know if the difference in training and job prospects is real, and I just don't know where to find that information.
 
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How would you even create such a comparison objectively? There probably ARE significant differences, but the only way to know would be to repeat your whole life in several residency programs.

Here's some things to consider : right or wrong, unless you ARE a super genius you aren't going to get into a top tier allopathic general surgery residency as a D.O. It may not be fair, but that's how it is. So, at best, you're thinking of lowering your chances of matching at all for a chance of getting into a lower tier allopathic residency.

Doesn't sound like it's worth it. I would take the route that has the maximum chance of you becoming a surgeon at all. Worst case scenario, you can learn whatever you missed in a fellowship or as an attending. They always say you learn the best without any training wheels at all. In the long run (5 years after finishing residency) your level of skill probably reaches a level limited by your innate talents, not where you did residency.

I'd still think hard about Ortho. Go shadow some attendings : they do procedures that involve subtle repairs and careful work...it isn't all sawing and grinding.
 

funshi baba

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DrBender, i am a 4th yr DO students that went thru NRMP match for gen surg and didnt match. Not even a prelim surg. I took step 1 and 2CK, did audition rotation only in allopathic progs (UNC, MSSM, Loyola etc). I had what would be considered low USMLE scores (216, 210) but passed on first try atleast.

To some extend i have the same ques as u did, also have some bitterness towards DO world as a whole mostly becuase of my experience with my sch. But thats besides the story. I am set to do a traditional rotating internship now and reapply next yr, figured its better than sitting at home.

While there's truely no way to tell if MD surgery makes u a better surgeon that DO surgery, it is sometimes based on how well u can squeeze the best out of d situation u find urself. My advice to u is, take USMLE irrespective of what u end up doing. there might be some debate abt which is better, but there's is definitely more opportunities or fellowship in the MD world. More is definitely better when u dont know exactly what u going to end up doing. taking USMLE might help u create that option.

Based on ur USMLE score, u will have to decide if u wanna take that risk. If ur USMLE score is in the 220s, i would give more consideration to DO progs. I would only consider community MD progs. Dont get over ambitious abt ur chances. Go towards the least resistant path. Thats where ur best chance is.

At the end of the day, repetition is the mother of learning. No matter where u end up, i think if u have the case vol that affords u lots of operating time, u should be fine.
 

glade

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I think the reason most people think of DO programs as weaker is because they're not at academic hospitals (that I know of). Basically everyone DO is getting trained at a community-level program. And even MD to MD, there is a huge bias against community programs as being weaker. Also, my understanding, which may be incorrect, is that it is much easier for DOs to match into various specialties than MDs. So, for example, as someone said a DO can become an Ortho much easier than an MD can. Someone can correct me please if I'm wrong.
 
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I think the reason most people think of DO programs as weaker is because they're not at academic hospitals (that I know of). Basically everyone DO is getting trained at a community-level program. And even MD to MD, there is a huge bias against community programs as being weaker. Also, my understanding, which may be incorrect, is that it is much easier for DOs to match into various specialties than MDs. So, for example, as someone said a DO can become an Ortho much easier than an MD can. Someone can correct me please if I'm wrong.
Most desirable specialties, it's statistically easier to match as an MD. For a few specialties, such as Ortho, it's as easy or easier to match as a DO.

Another element that is hard to quantify is that if you are a top of the line student and you go DO, then it might be easier to beat out your DO peers for a high end DO residency since the competition is weaker. Elite students tend to go to elite MD schools, but occasionally the system screws up and an elite student has to go to a DO school.

For instance, there are fewer DO neurosurgery positions than there are DO students, but it still might be easier to get into one of those spots as a DO than to beat out the geniuses if you are competing as an MD student.
 

s42brown

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As a DO in an allopathic residency I think these are all very good points. I guess I am an exception to the rule; I scored very well on the MCAT and only applied to osteopathic schools. Since that time I have done well in my residency and have scored high on the ABSITE each year. I was the foolish premed that thought I wanted to do family medicine, so DO to me made sense. I recently completed several months of surgical research at a prestigious academic medical center in the Midwest, and I can honestly say if I could do it all over again I would go MD. I don't feel my DO degree limits me now that I am completing an ACGME approved residency, and God willing I will be ABS certified and a fellow of the American College (FACS), but I have a few more hurdles to jump than my MD colleges. I use to buy into the Osteopaths have more to offer B.S., but now that I am interested in a career in academic medicine I realize that I have to work a bit harder. Truth be told, my kids will be going to the best allopathic medical school they can get into, unless they want to be lawyer:(.

P.S. I blame the bottle of Cabernet on my spelling and grammatical errors
 
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I like the pathophysiology, the diagnosis, the management, and the finese of general surgery, most of which is lost in ortho in exchange for power tools, brute force, and little else (ortho onc is slightly different).
Wow, you bash someone for making sweeping generalizations, and then do the same thing yourself.

Although I don't blame you, I blame medical schools for neglecting exposure to musculoskeletal health, despite it being one of the leading reasons for patients to seek medical care.
 

skiz knot

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Wow, you bash someone for making sweeping generalizations, and then do the same thing yourself.

Although I don't blame you, I blame medical schools for neglecting exposure to musculoskeletal health, despite it being one of the leading reasons for patients to seek medical care.
Agreed. I feel orthopaedics should be a required rotation as a medical student. Every physician will be confronted by a patient with an orthopaedic complaint and the level of mismanagement by them is sometimes astounding (this works both ways. I'm am surely guilty of being a ******* in other specialty knowledge, and I am not claiming superiority). I recently saw a patient with septic arthritis of her distal interphalangeal joint due to a dermatologist who "lanced" a mucous cyst in their clinic. Another patient recently had a full work up including MRI of the Thoracic and Lumbar Spine. Reason for test: Numbness and tingling of her hand. No imaging of the C-spine was performed. I can't remember where the nerves to the hand come from, but I don't think its the T or L spine:rolleyes:. The patient had carpal and cubital tunnel syndrome.

Plus, the original poster states ortho is all about power tools "except ortho onc" shows she has little/no experience in the orthopaedics or ortho-onc world. Onc has some of the largest "whacks" out there and as long as you stay out of the tumor itself you can often be "more aggressive" surgically.
 

MossPoh

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I think the reason most people think of DO programs as weaker is because they're not at academic hospitals (that I know of). Basically everyone DO is getting trained at a community-level program. And even MD to MD, there is a huge bias against community programs as being weaker. Also, my understanding, which may be incorrect, is that it is much easier for DOs to match into various specialties than MDs. So, for example, as someone said a DO can become an Ortho much easier than an MD can. Someone can correct me please if I'm wrong.
Is there any particular reason there is a bias against community programs? Is it just the natural tendency of some academics that rubs off on others? I've heard of some excellent surgeons coming from these programs who simply didn't have an interest in the research side of things.
 

Khirurg

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This is the kind of worthless statement that bugs me. WHY? Why do you say that? If I'm going to go for the MD match, it's a huge commitment and I need good reasons. I would have to schedule USMLE step 1 real soon and start studying for that on top of shelf exams and COMLEX 2. I'm not a super genius unfortunately, so my COMLEX 2 score would take a hit if I'm splitting my efforts like that. I would also have to find new rotations and cancel my scheduled ones so that I can "audition" at allopathic programs.
I'm not going to do all that just because somebody says they think MD programs are better. I need to know if the difference in training and job prospects is real, and I just don't know where to find that information.
So that you have a reason, i will tell you, that having personally dealt with residents from few NY osteo programs and having few friends in other ones, the quality of those programs is not the best. The case volume, case diversity and level of training is not on par with any allopathic program in NY. Not to say, that any graduate from osteopathic program is incapable of being a surgeon. Not at all. But the quality is just way lower. If you have a chance at being in allopathic program, do it. Fellowship placement is also much, much easier coming out of allopathic program.