Being a DO in a MD residency

[TheSeanieB]

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Just curious how it is if you match into a MD residency as a DO. Are you required to wear a labcoat in which patients ask what a DO is? Do any patients make an issue about the designation? Also, if you wanted to do an osteopathic assessment and do OMT, could you? Thanks.

 

[peppy]

DO in an MD psych residency here.

White coats are optional much of the time as a psych doc, but my coat does say DO. Many of my ID badges (and my electronic signature in the computer system) call me an "MD" just because the hospitals use that as the default for any doctor. Nobody notices or cares.

Over the entire course of medical career (counting med school), I think maybe 3 or 4 patients have noticed my DO title and said something to me about it. (There was also a time that a lady in the elevator at the hospital noticed I was a DO and said something about how she used to have a DO PCP that she loved, but she was not a patient).
To most patients, if you act like a doctor, you're a doctor and that's the end of it (although sometimes older patients think I'm a nurse because I'm female). I can't count the number of patients I've had who referred to their NP or PA as "my doctor". Most patients don't notice the small details like DO vs. MD.

Not sure about OMT. I've never even considered doing an OMT assessment in residency since it would be wildly inappropriate for a psychiatrist to be touching patients that way in most situations. If your attending was a DO and was comfortable with supervising you, I don't see any reason why you couldn't do OMT in residency. Not sure about if you had an MD attending. If OMT is something that's important to you, that might be a reason to consider a DO residency.

 

[NotAProgDirector]

If you're in an allopathic residency, your supervisors will be unable to supervise you doing OMT. If you want to do OMT, you should either 1) do a DO residency; or 2) you can often do an OMT fellowship after completing residency.

 

[gutonc]

If you're in an allopathic residency, your supervisors will be unable to supervise you doing OMT. If you want to do OMT, you should either 1) do a DO residency; or 2) you can often do an OMT fellowship after completing residency.

What he said. And while there are lots of questions of "quality" this is really the only major difference between an AOA and an ACGME residency. If you do an ACGME residency and do OMT on your patients, prepare to find yourself in a world of hurt (and probably out of a job and any further training options).

 

[Winged Scapula]

Just curious how it is if you match into a MD residency as a DO. Are you required to wear a labcoat in which patients ask what a DO is?

Required? I doubt it. Whether or not you wear a lab coat is totally hospital and program dependent. What is embroidered on the coat is generally up to you.

Do any patients make an issue about the designation?

I think you will find most patients know what a DO is, especially in some parts of the country, and few will care. There is still some stigma out there. My partner is a DO and I can attest to the fact that over the years, there have been a handful of patients who switched to me, upon hearing she was a DO. It has not been a big issue AFAIK. Frankly, if you are female, you may find that being mistaken for a nurse is far more common than the DO/MD issue.

Also, if you wanted to do an osteopathic assessment and do OMT, could you? Thanks.

I would not, for the reasons listed above. You would be offering a treatment which you have little to no way of being supervised and if there was a problem, you can better believe the Allopathic physicians will be the first to throw you under the bus (if you did OMT without being supervised or approved to offer such treatments). Better to do a DO residency.

 

[thecampuslegend]

I've had 1% patients ask me, "So what can you actually do as a DO? Are you a doctor?"
And then I've had 95% patients not even ask about the difference.
And then I've had 4% of patients who go out of their way to say they know what a DO is or have had one work with them in the past.

All I can say is that, we have made our lot in life by going the osteopathic route. This inherently means that you will have to explain what and who you are to people who don't understand. Don't get irritated or annoyed, it's just part of the fabric we have woven.

If you are in an MD setting, don't do OMT. There's a reason we have our own residencies - if OMT is what you want to do, then go down that path.

And I greatly dislike wearing a white coat, I would rather wear a suit everyday than deal with the lamecoat. It really just depends on your program. Some residents wear scrubs and no coat or scrubs + coat or jean shorts + lab coat.

 

[jackieMD2007]

I'm in a dually accredited program and our DO's rock. The patients ask us sometimes and we back up the DO's on our team. It is also fun to you know, learn how to do a great musculoskeletal exam from the DO's. 🙂

 

[KnuxNole]

I've had 1% patients ask me, "So what can you actually do as a DO? Are you a doctor?"
And then I've had 95% patients not even ask about the difference.
And then I've had 4% of patients who go out of their way to say they know what a DO is or have had one work with them in the past.

All I can say is that, we have made our lot in life by going the osteopathic route. This inherently means that you will have to explain what and who you are to people who don't understand. Don't get irritated or annoyed, it's just part of the fabric we have woven.

If you are in an MD setting, don't do OMT. There's a reason we have our own residencies - if OMT is what you want to do, then go down that path.

And I greatly dislike wearing a white coat, I would rather wear a suit everyday than deal with the lamecoat. It really just depends on your program. Some residents wear scrubs and no coat or scrubs + coat or jean shorts + lab coat.

Here, here.

White coats blow.

 

[EMquest3]

If you're in an allopathic residency, your supervisors will be unable to supervise you doing OMT. If you want to do OMT, you should either 1) do a DO residency; or 2) you can often do an OMT fellowship after completing residency.

I don't think this is always the case. As a third year allo student I rotated through a hospital and the residency was ACGME. They had some DO attendings and they had weekly OMM rounds that we were all invited to attend. In that type of situation wouldn't the DO attendings be able to supervise?

 

[NotAProgDirector]

The RRC rules regarding faculty includes this:

II.B.2 The physician faculty must have current certification in the specialty by the American Board of Internal Medicine, or possess qualifications judged acceptable to the Review Committee.

You might think this would leave some wiggle room, as perhaps ABOIM certification would count as being "acceptable". The FAQ goes on to say this:

Q: Can an osteopathic physician serve as an attending of record or a teaching attending on an internal medicine teaching service?
A: Yes, an osteopathic physician can serve in such a role if he or she has completed an ACGME-accredited internal medicine residency.

So, it's not the degree that counts. Anyone trained in an ACGME accredited program, allo MD, DO, or IMG, can supervise IM residents in an ACGME program. If a DO completes a joint AOA/ACGME residency, they could train in OMM and then supervise IM residents.