Are we screwed for future matches?

[Chibucks15]

What people on here seem to think is that any specialty is guaranteed. The vast majority of people will go into primary care, because there are more slots. Not everybody gets to be a super surgeon with a 220 step from a lower DO school. Sometimes life ain’t fair.

---

Members don't see this ad.

 

[Chibucks15]

Because of AOA to ACGME conversion? Please do even one second of research before you spew your uneducated nonsense.

Haha lot of angst outta you real quick. Theoretically even with the conversion the rate shouldn’t change, or it should even go down due to additional competition from MDs and IMGs. And yet it went up.

The sky isn’t falling and it’s exhausting to see the same recycled crap

 

[Angus Avagadro]

Haha lot of angst outta you real quick. Theoretically even with the conversion the rate shouldn’t change, or it should even go down due to additional competition from MDs and IMGs. And yet it went up.

The sky isn’t falling and it’s exhausting to see the same recycled crap

These threads always go the same way. Some anxious pre med or OMS starts wringing their hands about being discriminated against for "competetive" allopathic residencies due to the AOA and ACGME merger or just good old discrimination against DOs. When the truth be told, said pre med wasnt a"competetive" applicant for allopathic schools, or they would be at one right now. So if you are set on a competetive residency, get busy NOW and construct a competetive application and apply to residencies who have taken DOs in the past. You'll need to be in the top third, preferably the top 10% of your class, have appropriate research/publications, and Step score at or above the programs average. It's not all doom and gloom. We had a very good match this year. As I said earlier, one of my students is now a CT surgery fellow at a very good program

 

[madiso30]

I guess it’s probably just the nature of having a group of people who have always been at the top of the achievements curve. But I wonder, why does everyone seem to need to go into a specialty as a Med-school undergrad?

I’d burn out so fast if I had to do a focused specialty for the rest of my life. A big part of what keeps me going is the wide variety of stuff I see and do on a regular basis.

My job really does kick-ass, but the field isn’t “competitive” so people on these threads always think it’s somehow below them.

I’m in FM; and the overwhelming majority of my colleagues are USMD’s BTW. It’s not a DO plague to go into primary care.

I think part of it is prestige that a lot of Premeds needlessly worry about. They read too much dumb stuff on the internet.

I have a friend I grew up with who will is in my DO class that absolutely refuses to do FM no matter what even though she hasn't got a clue what the field is like. I used to hate the idea of FM because my family soc growing up seemed to never care about my problems and just refer me out every time I saw him for something outside the sniffle. Then I shadowed a rural primary care clinic and other PCPs at regular clinics in college. I got some experience seeing these guys juggle complex chronic conditions along side a huge variety of other cases and I loved it.

I just think Premeds havent got the slightest clue what real family medicine is. Combine that with *****ic TV dramas that only depict surgery and EM as glamorous and obsession with prestige, then maybe you get to the root of why they, stupidly, look down on FM.

Alright, rambling over.

 

[SLC]

I think part of it is prestige that a lot of Premeds needlessly worry about. They read too much dumb stuff on the internet.

I have a friend I grew up with who will is in my DO class that absolutely refuses to do FM no matter what even though she hasn't got a clue what the field is like. I used to hate the idea of FM because my family soc growing up seemed to never care about my problems and just refer me out every time I saw him for something outside the sniffle. Then I shadowed a rural primary care clinic and other PCPs at regular clinics in college. I got some experience seeing these guys juggle complex chronic conditions along side a huge variety of other cases and I loved it.

I just think Premeds havent got the slightest clue what real family medicine is. Combine that with *****ic TV dramas that only depict surgery and EM as glamorous and obsession with prestige, then maybe you get to the root of why they, stupidly, look down on FM.

Alright, rambling over.

It’s hard to write a gripping drama about the MI that a patient never had because their Family Doc managed their statins, HTN, blood sugar and got them to quit smoking; all in one visit during a hectic day at the office.

I.E. “Family Med must be boring/unimportant/easy/[insert adjective of choice]; and I’m too good for that.”

 

[Chibucks15]

My favorite are the people with absolutely no clinical experience who come in and are die hard into one specialty (most of the time based on TV and/or salary charts).

It just doesn’t make sense when you haven’t seen a thing about it in real life. Then to come in and dump on every other specialty as ‘inferior’ just looks terrible

 

[madiso30]

My favorite are the people with absolutely no clinical experience who come in and are die hard into one specialty (most of the time based on TV and/or salary charts).

It just doesn’t make sense when you haven’t seen a thing about it in real life. Then to come in and dump on every other specialty as ‘inferior’ just looks terrible

The same friend I mentioned that is in my DO class is, unironically, deadset, on pediatric cardiothoracic surgery. I really wish I was joking.

 

[Rekt]

Haha lot of angst outta you real quick. Theoretically even with the conversion the rate shouldn’t change, or it should even go down due to additional competition from MDs and IMGs. And yet it went up.

The sky isn’t falling and it’s exhausting to see the same recycled crap

Overall placement fell last year and will again this year. "Match rate" for DOs means nothing until 2020.

 

[Chibucks15]

Overall placement fell last year and will again this year. "Match rate" for DOs means nothing until 2020.

There will always be problems for the bottom of the barrel applicants or the straight up delusional ones. This won't change and I never said it would.

If you're applying strictly gen surg in the northeast with a 200 step score and average grades from a low DO school, I don't really have pity for you. The bottom applicants will always have a problem, and DO students are at the bottom of US grads. It is what it is. Don't be that person who fails and be realistic in your chances (even if its primary care *gasp*) and you won't have a problem 90% of the time. Just because you get to medical school doesn't mean you automatically get to do what you want to do, no matter how special of a snowflake the applicant may be

 

[Hippocrates II]

I'm pretty confident if you went back into the archives and looked at threads from the first month SDN was online, someone, somewhere, was questioning the future of primary care physicians, CRNAs replacing anesthesiologists, and whether or not a DO can match outside of the dreaded family medicine. And yet primary care demand continues to rise, anesthesiologists continue to earn money hand over fist, and DOs still aren't mopping the bathroom floors at Walmart. I can't even take SDN seriously anymore because it sounds like the vast majority of people who post on here have absolutely zero real-life experience outside of school and just parrot the same doom and gloom stories or a match list that surely predicts the fall of the DO degree.

Work hard and see where the chips may fall. No one can predict the future, but no one is going to shed a tear for you if you're sentenced to the absolute horrors of being a mere family medicine minion making 200k+/year. A terrible fate, I know.

This isn't directed at anyone in particular, but it's the same thing over and over again on here.

 

[Ho0v-man]

My favorite are the people with absolutely no clinical experience who come in and are die hard into one specialty (most of the time based on TV and/or salary charts).

It just doesn’t make sense when you haven’t seen a thing about it in real life. Then to come in and dump on every other specialty as ‘inferior’ just looks terrible

You’ve described everyone gunning for interventional radiology/most surgical subspecialties

 

[Chibucks15]

You’ve described everyone gunning for interventional radiology/most surgical subspecialties

Like I get that it sounds cool, and by all means say you’re interested because of that and you want to learn more haha but telling people they’re inferior because they want to do primary care drives me nuts.

This website is great to blow off steam and get in random arguments over nothing, but damn it’s a cesspool too

 

[Norwood-Sano]

The same friend I mentioned that is in my DO class is, unironically, deadset, on pediatric cardiothoracic surgery. I really wish I was joking.

Bahahahaha has your friend even seen a procedure before? I have a strong passion for congenital cardiac surgery as well so I get the appeal, it’s fascinating. But I even know it’s laughable to be this way and say that I’m completely certain I’m going into the highly complex field that will demand me to be a PGY 8-9+. And this after seeing several Norwoods, Fontans, ASDs, VSDs, switches etc.

 

[EmilKraepelin55]

Like I get that it sounds cool, and by all means say you’re interested because of that and you want to learn more haha but telling people they’re inferior because they want to do primary care drives me nuts.

This website is great to blow off steam and get in random arguments over nothing, but damn it’s a cesspool too

I agree. What I also don’t like are people who come in gung-ho for primary care and then do the bare minimum to pass their classes because PC is relatively easy to match into. Coming from a new school with no board score data, this is very disheartening. It’s that type of thinking that I think could potentially adversely affect school reputation and future match opportunities. Of course I know that the individual matters more, but school reputation must count for something. Not only that, but we of course want the best docs we can get. Just work hard, no matter the grades.

 

[Chibucks15]

I agree. What I also don’t like are people who come in gung-ho for primary care and then do the bare minimum to pass their classes because PC is relatively easy to match into. Coming from a new school with no board score data, this is very disheartening. It’s that type of thinking that I think could potentially adversely affect school reputation and future match opportunities. Of course I know that the individual matters more, but school reputation must count for something. Not only that, but we of course want the best docs we can get. Just work hard, no matter the grades.

While I agree with that sentiment, it still takes a lot of work to just pass, unless you’re brilliant. I think where you really get the differences are the people willing to put in the extra 12 hours for the last 5% boost to get them into the A range. And for me, as well as a lot of others, that isn’t worth it.

I don’t think a few people coasting affects reputation though, because they won’t even be applying to the same residencies as the driven people, so in effect they’re unknown. It’s all the individual when you’re from a DO school, unless you’re at a big original one and applying to a regional residency where the school is at least known a little, and even then it’s more on you than the school

 

[Neopolymath]

If you have any ambition at all, the fact that Step 1 could/will go P/F is a far greater threat to achieving anything remotely competitive from a ****ty new DO school. As it stands, good students, even at bad new schools, still stand to match ok, but that hinges on showing programs they got what it takes on Step 1. Take that away and you are just like everyone else at your school and that's a really bad thing.

 

[eberge3]

The amount of new DO schools opening has little impact on you as a student and applicant. You need to do the best you can academically and be a good applicant. If done you will be fine.

 

[SLC]

I agree. What I also don’t like are people who come in gung-ho for primary care and then do the bare minimum to pass their classes because PC is relatively easy to match into.

...Not only that, but we of course want the best docs we can get. Just work hard, no matter the grades.

I agree 100% with this mentality. I don’t care about school reputation though. Med school is a business; full stop. They can figure out their own reputation. When they charge me $40,000+ per year for tuition, I don’t recon I owe them anything.

But I do hate the mentality some people have when they come in knowing they want primary care, so they don’t work as hard.

Primary care is the one field where you have to know your $&@%; no exceptions. You can get literally anything coming through that door, you’re the first line of defense so to speak; and how you handle that first encounter with a patient for a complaint can easily make or break their outcome.

Today I’ve only worked a half day, and already I’ve had encounters covering the following disciplines: Psych, ENT, Endocrine, Podiatry/Ortho, Derm, Cardiology, Pulm, General peds, GenSurg, Gyn.

This afternoon I’ve got 11 more to see, spanning some of those areas, and others.

Last week I even had a case that ended up involving neurosurgery. Kid that wrecked on an ATV without a helmet, walked in with his parent to get checked out. Seemed OK, but for a scalp hematoma and a head lac. I assessed him quickly, discovered he’d lost consciousness during the crash, and felt he had a moderate to high chance for further significant injury (head bleed, skull fracture, severe concussion etc) so I bandaged the lac and transferred him by ambulance to the ED.

Once there he had all of the above despite walking and talking and appearing grossly normal in my clinic. He decompensated promptly in the ED, and a CT found a skull fracture and epidural hematoma. He got flown to the pediatric trauma center in the city.

If I’d farted around in Neuro block, it would have been easy to lack the knowledge base to get the most out of my ED training in Med school and residency; and it might have then been tempting to send this kid home with some stitches since he “looked OK”. Had I done that, he probably would have died.

I don’t have the luxury of letting my knowledge of medicine outside a narrow specialty focus atrophy. And people who don’t learn their stuff in Med-school are less equipped to do this job well. And that leads to them passing bogus referrals, treating improperly, and generally just sucking. This perpetuates the notion that primary care docs are a class of Med—school flunkies.

While it’s true that you learn to “practice” medicine (I.e. the day to day duties of physicianhood) in residency and not Med-school. You need a solid foundation of clinically applicable knowledge to treat patients properly in residency and beyond. Nowhere is this more true than in general primary care.

 

[Angus Avagadro]

I agree 100% with this mentality. I don’t care about school reputation though. Med school is a business; full stop. They can figure out their own reputation. When they charge me $40,000+ per year for tuition, I don’t recon I owe them anything.

But I do hate the mentality some people have when they come in knowing they want primary care, so they don’t work as hard.

Primary care is the one field where you have to know your $&@%; no exceptions. You can get literally anything coming through that door, you’re the first line of defense so to speak; and how you handle that first encounter with a patient for a complaint can easily make or break their outcome.

Today I’ve only worked a half day, and already I’ve had encounters covering the following disciplines: Psych, ENT, Endocrine, Podiatry/Ortho, Derm, Cardiology, Pulm, General peds, GenSurg, Gyn.

This afternoon I’ve got 11 more to see, spanning some of those areas, and others.

Last week I even had a case that ended up involving neurosurgery. Kid that wrecked on an ATV without a helmet, walked in with his parent to get checked out. Seemed OK, but for a scalp hematoma and a head lac. I assessed him quickly, discovered he’d lost consciousness during the crash, and felt he had a moderate to high chance for further significant injury (head bleed, skull fracture, severe concussion etc) so I bandaged the lac and transferred him by ambulance to the ED.

Once there he had all of the above despite walking and talking and appearing grossly normal in my clinic. He decompensated promptly in the ED, and a CT found a skull fracture and epidural hematoma. He got flown to the pediatric trauma center in the city.

If I’d farted around in Neuro block, it would have been easy to lack the knowledge base to get the most out of my ED training in Med school and residency; and it might have then been tempting to send this kid home with some stitches since he “looked OK”. Had I done that, he probably would have died.

I don’t have the luxury of letting my knowledge of medicine outside a narrow specialty focus atrophy. And people who don’t learn their stuff in Med-school are less equipped to do this job well. And that leads to them passing bogus referrals, treating improperly, and generally just sucking. This perpetuates the notion that primary care docs are a class of Med—school flunkies.

While it’s true that you learn to “practice” medicine (I.e. the day to day duties of physicianhood) in residency and not Med-school. You need a solid foundation of clinically applicable knowledge to treat patients properly in residency and beyond. Nowhere is this more true than in general primary care.

My neighbor is a middle aged lady who went to her family doctor complaining of fatigue and weakness. He noticed the heliotrope rash on her hands and was immediately on the phone with a rheumatologist demanding that she be seen that day. She was paralyzed from the waist down within a week. Testing confirmed the Family Doctors diagnosis of Dermatomyositis. Certainly not someone who just scraped by in med school

 

[SLC]

So this afternoon I had a young guy walk in as we were closing the clinic, he’s presenting with less than 24hrs of sore throat. Endorsed fever and chills overnight, but none during the day today. Throat pain came on suddenly; progressed rapidly and by the time he showed up today there was trismus, dysphasia to liquids, huge neck adenopathy, and tonsillar edema and exudates. Voice muffled and rates pain at 7/10. Rapid strep negative, monospot negative. Tachycardia to 120’s, clammy skin, tonsils nearly kissing.

Sent him to the ED. Thinking possible peritonsillar or possibly even retropharyngeal abscess. Called ED provider (who’s FM, and my clinic partner) and signed out the case and my impressions. In the ED: CT shows bilateral tonsillar abscesses, WBC’s 23, CRP 19, creatinine elevated.

That’s severe sepsis folks.

He’s been admitted, might need the abscesses drained. But once again, if I hadn’t been paying attention in Med school it might have been easy to miss or overlook the VS abnormalities; and not have a proper differential dx and send the guy home with Abx and Prednisone; once again he could have decompensated at home, lost his airway, and died waiting for the volunteer ambulance crew here in the rurals.

Primary care ain’t bad!

 

[Select All That Apply]

@SLC Out of curiosity what was lactate like? With those symptoms definitely hits more than a couple of the SIRS criteria. I would have so much anxiety doing FM, there's just so many resources that I feel are lacking that you have available to you when you're working within a hospital.

 

[SLC]

@SLC Out of curiosity what was lactate like? With those symptoms definitely hits more than a couple of the SIRS criteria. I would have so much anxiety doing FM, there's just so many resources that I feel are lacking that you have available to you when you're working within a hospital.

Lactate was 3.6.

I have a hospital 15 mins away; the key is having the chops to know who should go there from clinic, and who can stay home.

A good knowledge base; experience, and solid residency training can get you there, and help you feel comfortable with it. If you’re missing those things you send people who have no business in the ED, or you risk missing the ones that should.

I’ve seen people take patients like mine and not recognize signs of impending airway compromise, try to blame tachycardia on pain response, see that there’s no fever and not think about the fact that everyone loads up on Tylenol and Motrin etc.

 

[EmilKraepelin55]

I agree 100% with this mentality. I don’t care about school reputation though. Med school is a business; full stop. They can figure out their own reputation. When they charge me $40,000+ per year for tuition, I don’t recon I owe them anything.

But I do hate the mentality some people have when they come in knowing they want primary care, so they don’t work as hard.

Primary care is the one field where you have to know your $&@%; no exceptions. You can get literally anything coming through that door, you’re the first line of defense so to speak; and how you handle that first encounter with a patient for a complaint can easily make or break their outcome.

Today I’ve only worked a half day, and already I’ve had encounters covering the following disciplines: Psych, ENT, Endocrine, Podiatry/Ortho, Derm, Cardiology, Pulm, General peds, GenSurg, Gyn.

This afternoon I’ve got 11 more to see, spanning some of those areas, and others.

Last week I even had a case that ended up involving neurosurgery. Kid that wrecked on an ATV without a helmet, walked in with his parent to get checked out. Seemed OK, but for a scalp hematoma and a head lac. I assessed him quickly, discovered he’d lost consciousness during the crash, and felt he had a moderate to high chance for further significant injury (head bleed, skull fracture, severe concussion etc) so I bandaged the lac and transferred him by ambulance to the ED.

Once there he had all of the above despite walking and talking and appearing grossly normal in my clinic. He decompensated promptly in the ED, and a CT found a skull fracture and epidural hematoma. He got flown to the pediatric trauma center in the city.

If I’d farted around in Neuro block, it would have been easy to lack the knowledge base to get the most out of my ED training in Med school and residency; and it might have then been tempting to send this kid home with some stitches since he “looked OK”. Had I done that, he probably would have died.

I don’t have the luxury of letting my knowledge of medicine outside a narrow specialty focus atrophy. And people who don’t learn their stuff in Med-school are less equipped to do this job well. And that leads to them passing bogus referrals, treating improperly, and generally just sucking. This perpetuates the notion that primary care docs are a class of Med—school flunkies.

While it’s true that you learn to “practice” medicine (I.e. the day to day duties of physicianhood) in residency and not Med-school. You need a solid foundation of clinically applicable knowledge to treat patients properly in residency and beyond. Nowhere is this more true than in general primary care.

Now I am just saying if this isn’t inspiring to DO students, who tend to be more likely to match PC on average, then why are you even in med school? It’s time to stop the whining all day about what we want, and focus more on what we can do for the patient no matter where we end up. Medicine is a field of purpose, and that inherent purpose is maintained across the board of possible careers we can enter. This is such an amazing privilege we have to even be in the position of a medical student, and this is no time to squander it.

 

[hallowmann]

Overall placement fell last year and will again this year. "Match rate" for DOs means nothing until 2020.

DO placement rate went up in 2019 (98.48%) compared to 2018 (98.16%), although both are less than 2017 (99.34%). Sure, placement rate has gone down a bit with the merger (and a ton of school expansion, which has likely kept some people on the mainland that would've have gone Carib), but honestly that's for a lot of reasons that can be addressed with a smart residency app.

Also, match rate absolutely does mean something. <14% matched/placed AOA this year, yet despite this and huge graduate seat growth, there was still an increase in match rate range this year compared to last year. Saying it "means nothing until 2020" isn't really accurate. Sure, it doesn't mean as much, but let's not pretend information can't be gleaned from that data point. We'll see what next year brings, maybe the match rate will go down a lot, maybe it'll be stable. I suspect it'll be closer to the latter, but honestly your guess is as good as mine.

DO Match Rate 2019

A few things: -Here are the 2016-2018 threads for reference - DO match rate 2016, DO match rate 2017, DO match rate 2018 -These numbers are all based on published reports. Reports sometimes have errors. Either way, hopefully this is useful. -This says nothing about the type of GME attained. Some...

forums.studentdoctor.net

Lactate was 3.6.

I have a hospital 15 mins away; the key is having the chops to know who should go there from clinic, and who can stay home.

A good knowledge base; experience, and solid residency training can get you there, and help you feel comfortable with it. If you’re missing those things you send people who have no business in the ED, or you risk missing the ones that should.

I’ve seen people take patients like mine and not recognize signs of impending airway compromise, try to blame tachycardia on pain response, see that there’s no fever and not think about the fact that everyone loads up on Tylenol and Motrin etc.

It takes a lot to be good at FM. Constant studying, experience, and a broad differential. Not to say that good docs don't miss things, but the idea that you can just skate through FM and be a referral machine without putting in that kind of constant work is ridiculous. Sure, you can do that if you don't care about patients, but delaying, referring, and brushing off signs of significant illness because its hard can mean someone's life. It may not be the bread and butter of FM, but recognizing acuity or urgency (or the lack thereof) in a patient can change their life.

 

[Sleepingdoc]

I guess it’s probably just the nature of having a group of people who have always been at the top of the achievements curve. But I wonder, why does everyone seem to need to go into a specialty as a Med-school undergrad?

I’d burn out so fast if I had to do a focused specialty for the rest of my life. A big part of what keeps me going is the wide variety of stuff I see and do on a regular basis.

My job really does kick-ass, but the field isn’t “competitive” so people on these threads always think it’s somehow below them.

I’m in FM; and the overwhelming majority of my colleagues are USMD’s BTW. It’s not a DO plague to go into primary care.

Exactly, Majority of MD schools produce FM's and IM's... Not sure what this craze is as an undergrad. I understand the need to keep the options open.. Good, keep it open if you can get in and maintain a high scores in classes, boards and clinicals to get into Derm, but the reality is that not everyone goes into Derm.

About residency and matching.. dont worry about it as long as you do your part about being a good student and you try your best. You cant go to residency if you dont finish med school.

 

[Rekt]

DO placement rate went up in 2019 (98.48%) compared to 2018 (98.16%), although both are less than 2017 (99.34%). Sure, placement rate has gone down a bit with the merger (and a ton of school expansion, which has likely kept some people on the mainland that would've have gone Carib), but honestly that's for a lot of reasons that can be addressed with a smart residency app.

Also, match rate absolutely does mean something. <14% matched/placed AOA this year, yet despite this and huge graduate seat growth, there was still an increase in match rate range this year compared to last year. Saying it "means nothing until 2020" isn't really accurate. Sure, it doesn't mean as much, but let's not pretend information can't be gleaned from that data point. We'll see what next year brings, maybe the match rate will go down a lot, maybe it'll be stable. I suspect it'll be closer to the latter, but honestly your guess is as good as mine.

I guess I didn't realize it was so late in the year and didn't realize 2019 placement data was out. Surprising that it went up, so I'll concede from that standpoint. I think just logically, it has to go down overtime with the amount of schools opening. If not, then we'll have much worse problems with supply and demand, for some specialties anyway.

 

[Hippocrates II]

I guess I didn't realize it was so late in the year and didn't realize 2019 placement data was out. Surprising that it went up, so I'll concede from that standpoint. I think just logically, it has to go down overtime with the amount of schools opening. If not, then we'll have much worse problems with supply and demand, for some specialties anyway.

My guess is that there will be a slight decline in placements as more and more students graduate, but there will also be a bit of a 'Darwinian selection' as weaker and weaker students are culled from the herd. Not sure how to put this delicately but DO schools already dip fairly low in who they'll accept, but ultimately, you need to put up and prove yourself or you're out. One of my friends in school is a very nice guy and would make a good doctor, but he was admitted with a near-3.0 GPA and a 490s MCAT and has struggled all year. He's in remediation this summer and I'm not sure if he'll continue forward. I think these newer schools will continue to fill up with students just like this. Many will rise to the occasion, but a good amount won't make it through.

In the end, I suspect we will see more and more students getting accepted that fail out before the match, and the remaining students will often either be:

1) Uncompetitive applicants who will fill the vast amount of FM/IM residencies out there

2) Competitive applicants that will overall increase the competition for DO-friendly residencies, slightly driving down the overall match rate.

Personally, I don't think we're going to see a huge change because I think category #1 is what we'll largely see - many 'lower tier' applicants vying for the FM/IM spots that go unfilled now. Just my $0.02 on the matter, but I'm not all doom and gloom yet.

 

[Sleepingdoc]

My guess is that there will be a slight decline in placements as more and more students graduate, but there will also be a bit of a 'Darwinian selection' as weaker and weaker students are culled from the herd. Not sure how to put this delicately but DO schools already dip fairly low in who they'll accept, but ultimately, you need to put up and prove yourself or you're out. One of my friends in school is a very nice guy and would make a good doctor, but he was admitted with a near-3.0 GPA and a 490s MCAT and has struggled all year. He's in remediation this summer and I'm not sure if he'll continue forward. I think these newer schools will continue to fill up with students just like this. Many will rise to the occasion, but a good amount won't make it through.

In the end, I suspect we will see more and more students getting accepted that fail out before the match, and the remaining students will often either be:

1) Uncompetitive applicants who will fill the vast amount of FM/IM residencies out there

2) Competitive applicants that will overall increase the competition for DO-friendly residencies, slightly driving down the overall match rate.

Personally, I don't think we're going to see a huge change because I think category #1 is what we'll largely see - many 'lower tier' applicants vying for the FM/IM spots that go unfilled now. Just my $0.02 on the matter, but I'm not all doom and gloom yet.

If MCAT and GPA are the measure of student's performance, then these schools are gonna replace the IMG's and Caribbean.

 

[Hippocrates II]

If MCAT and GPA are the measure of student's performance, then these schools are gonna replace the IMG's and Caribbean.

I don't think MCAT and GPA are a measure of a student's performance, but they're probably the best indicator that we have of future performance. I personally have a better GPA in medical school than I did in undergrad, so I hesitate to say anyone with a bad GPA/MCAT will struggle in med school. But, probably the best predictor we have.

 

[Mad Jack]

It really sucks we have to worry about possibly being pigeon-holed into any specialty. I'm not against FM, it's one of my top choices. But I hate that at the end it may be too far fetched to do anything else. Guess we all gotta crush boards!

Most people who end up forced into FM find themselves there because of board score issues and the like. Work hard and you should be fine

 

[Sardonix]

So this afternoon I had a young guy walk in as we were closing the clinic, he’s presenting with less than 24hrs of sore throat. Endorsed fever and chills overnight, but none during the day today. Throat pain came on suddenly; progressed rapidly and by the time he showed up today there was trismus, dysphasia to liquids, huge neck adenopathy, and tonsillar edema and exudates. Voice muffled and rates pain at 7/10. Rapid strep negative, monospot negative. Tachycardia to 120’s, clammy skin, tonsils nearly kissing.

Sent him to the ED. Thinking possible peritonsillar or possibly even retropharyngeal abscess. Called ED provider (who’s FM, and my clinic partner) and signed out the case and my impressions. In the ED: CT shows bilateral tonsillar abscesses, WBC’s 23, CRP 19, creatinine elevated.

That’s severe sepsis folks.

He’s been admitted, might need the abscesses drained. But once again, if I hadn’t been paying attention in Med school it might have been easy to miss or overlook the VS abnormalities; and not have a proper differential dx and send the guy home with Abx and Prednisone; once again he could have decompensated at home, lost his airway, and died waiting for the volunteer ambulance crew here in the rurals.

Primary care ain’t bad!

This is like my 4th time saying something like this, but your practice is exactly what I want.

 

[DrStephenStrange]

My guess is that there will be a slight decline in placements as more and more students graduate, but there will also be a bit of a 'Darwinian selection' as weaker and weaker students are culled from the herd. Not sure how to put this delicately but DO schools already dip fairly low in who they'll accept, but ultimately, you need to put up and prove yourself or you're out. One of my friends in school is a very nice guy and would make a good doctor, but he was admitted with a near-3.0 GPA and a 490s MCAT and has struggled all year. He's in remediation this summer and I'm not sure if he'll continue forward. I think these newer schools will continue to fill up with students just like this. Many will rise to the occasion, but a good amount won't make it through.

In the end, I suspect we will see more and more students getting accepted that fail out before the match, and the remaining students will often either be:

1) Uncompetitive applicants who will fill the vast amount of FM/IM residencies out there

2) Competitive applicants that will overall increase the competition for DO-friendly residencies, slightly driving down the overall match rate.

Personally, I don't think we're going to see a huge change because I think category #1 is what we'll largely see - many 'lower tier' applicants vying for the FM/IM spots that go unfilled now. Just my $0.02 on the matter, but I'm not all doom and gloom yet.

My school is a new school, and our averages have been going up every class. I guess it might depend on the school and the location.

 

[Cranjis McBasketball]

This is like my 4th time saying something like this, but your practice is exactly what I want.

Ive said that to him probably 4 or 5 times as well haha

 

[SurgeDO]

I’m a resident in a subspecialty.

I definitely know who the good PCPs in the town are. Our service constantly gets bull **** referrals from the terrible PCPs around town who just collect their pay checks. Truly takes a lot to be a great PCP. I don’t think I could do it.

 

[Goro]

If MCAT and GPA are the measure of student's performance, then these schools are gonna replace the IMG's and Caribbean.

Something I just realized, based upon a post earlier in the thread, is that DO schools, even weak ones, have a vested interest in student success, unlike the Carib, where their business model is to fail out a as many students as they can so that they don't overbook their rotation slits.

Therefore, more resources will be available to struggling students at DO schools who would have otherwise gone to a Carib threshing mill.

I fully agree that how weak DO schools approach helping their weakest students is less than optimal. Talking to you Nova and LMU.

 

[Sleepingdoc]

Something I just realized, based upon a post earlier in the thread, is that DO schools, even weak ones, have a vested interest in student success, unlike the Carib, where their business model is to fail out a as many students as they can so that they don't overbook their rotation slits.

Therefore, more resources will be available to struggling students at DO schools who would have otherwise gone to a Carib threshing mill.

I fully agree that how weak DO schools approach helping their weakest students is less than optimal. Talking to you Nova and LMU.

I do not consider MCAT, as flawed of a test that is ... as a measure of a student success. But anyways, that is the hoop to jump through, so students need to do it to get through. You are completely correct that DO schools have interest in student success unlike a lot of carribean schools. But some people fail to realize that all DO students/US trained students go through a lot of testing and the boards, so I am confident that a majority of students who pass are ready to move on to their internships. They have performance committee if they fail any classes to help them with their weakness, if not they are usually filtered. If they dont pass the boards, they are usually kicked out after three tries or earlier if they are not motivated to complete it.

 

[ciestar]

Exactly, Majority of MD schools produce FM's and IM's... Not sure what this craze is as an undergrad. I understand the need to keep the options open.. Good, keep it open if you can get in and maintain a high scores in classes, boards and clinicals to get into Derm, but the reality is that not everyone goes into Derm.

About residency and matching.. dont worry about it as long as you do your part about being a good student and you try your best. You cant go to residency if you dont finish med school.

My MD school had ~70 matches into IM which is >25% of the class.

What a lot don’t understand is that just because you go into IM, doesn’t mean you’ll be doing outpatient ambulatory care. So many subspecialize and IM gives you so much room to do so.

 

[anthony78001]

take usmle 1 and 2 in addition to comlex and score average to above average youll be fine

 

[Isoval]

Didn't read.

No.

Stop pretending that the sky is falling for the 700th time.

 

[Sardonix]

I’m a resident in a subspecialty.

I definitely know who the good PCPs in the town are. Our service constantly gets bull **** referrals from the terrible PCPs around town who just collect their pay checks. Truly takes a lot to be a great PCP. I don’t think I could do it.

You say that. But having gone through my surgery rotation (I know, try not to be too impressed) I can safely say there is no dimension where I could ever hack it as a surgeon.

 

[Sleepingdoc]

You say that. But having gone through my surgery rotation (I know, try not to be too impressed) I can safely say there is no dimension where I could ever hack it as a surgeon.

Right.. Just because you have a high score on USMLE does not mean you could be a great surgeon. I know I dont have the mindset of a surgeon. Thats not what most premeds think when they are applying to schools. MD or DO- it does not matter, if you really wanted to be what you want to be, you could. For a DO, the road might be a little more bumpy(due to bias) but I know many DO's that are great surgeons, orthos, derms, ophthalmologist.

 

[hallowmann]

I guess I didn't realize it was so late in the year and didn't realize 2019 placement data was out. Surprising that it went up, so I'll concede from that standpoint. I think just logically, it has to go down overtime with the amount of schools opening. If not, then we'll have much worse problems with supply and demand, for some specialties anyway.

We'll see what happens. I could see a bit of a dip happening, but will consider it a win if 2020 has >98% DO placement.

This is like my 4th time saying something like this, but your practice is exactly what I want.

So in all honesty what he described in that post that you replied to could literally happen in any FM clinic. There may be other aspects that are unique, but seriously, some people almost die before being willing to come see the doctor... and others come in after 36 hrs of only rhinorrhea asking for antibiotics.

 

[Sardonix]

So in all honesty what he described in that post that you replied to could literally happen in any FM clinic. There may be other aspects that are unique, but seriously, some people almost die before being willing to come see the doctor... and others come in after 36 hrs of only rhinorrhea asking for antibiotics.

I get that. My statement was more an admission of:
-longing to be done with medical school and enter FM practice
-creepy admiration for the SLC's practice that has grown each time he gives more information.

As someone who has wanted to do FM since college, seeing newly established FM docs happy and capable in a thriving practice tends turn me into a fanboy I guess.

 

[hallowmann]

I get that. My statement was more an admission of:
-longing to be done with medical school and enter FM practice
-creepy admiration for the SLC's practice that has grown each time he gives more information.

As someone who has wanted to do FM since college, seeing newly established FM docs happy and capable in a thriving practice tends turn me into a fanboy I guess.

Haha, fair enough. Gotta love that primary care clinic life.

 

[SLC]

This is like my 4th time saying something like this, but your practice is exactly what I want.

If you’re location flexible; stay in touch and perhaps there’ll be a need after your residency.

 

[Feelgood MD]

If you’re location flexible; stay in touch and perhaps there’ll be a need after your residency.

Now thats the Network part of SDN at play. How refreshingly/starkly different that is from the usual garbage.

 

[SLC]

Now thats the Network part of SDN at play. How refreshingly/starkly different that is from the usual garbage.

This place, dark as it’s been at times; has been a good resource to me. I didn’t have any college graduates in my family, much less people who’d been to medical or any other professional school. I got some good advice here, and have felt the camaraderie, though a bit superficial since it’s only online, of having folks going through the same process as me.

I intend to pay it forward as long as I can.

 

[InternistDO]

Now thats the Network part of SDN at play. How refreshingly/starkly different that is from the usual garbage.

SDN is a wretched hive of scum and villainy, but without it there's no way I'd have gotten into med school and no way I'd have known how to study for the USMLEs, so I always have a soft spot for it and I think it serves an overall good purpose.

 

[WhereMyLiberalsAt]

If you’re location flexible; stay in touch and perhaps there’ll be a need after your residency.

The hell?!?

I thought you told me I could have that spot...

 

[SLC]

The hell?!?

I thought you told me I could have that spot...

Ha ha, you too.

PS, we really need to try to do lunch before you head off to school.