Bias against DOs in the orthopedic world?

[Orthojoe]

Hey all,
As I've just recently gone through the fellowship process (for ortho) I wanted to give you all a heads up as this topic of Bias against DOs is often discussed and the recent ACGME/AOA merger was supposed to resolve the conflict (yes i know we are early in the process). I truly don't care about the bias but I am also realistic that it does exist.

I personally emailed all the fellowship programs I was interested in before I applied (many were major academic centers with high reputations) asking them as a D.O. if I would be considered for their fellowship. I had three programs flat out say that I would not be considered since I had not taken the USLME step 3 (I've taken USMLE step 1-2) - this obviously is not consistent with the merger agreement since technically COMLEX 3 is a "comparable exam" (yes many of us know it truly isnt, i'm not arguing semantics here).

Also during each interview I asked the physicians if they had any concerns with my D.O degree and had they ever taken a D.O as a fellow (easy to find, usually on their website). In the majority of cases they had nothing but positive things to say despite many programs never matching a DO before. A few had mentioned that the merger allowed them to open the application process to DOs and they had been impressed by many of the applications. I did 14 interviews, and in all but five there were other DO applicants interviewing at the same time. 80% of the time the program I interviewed at had never taken a DO as a fellow.

There were 3-4 attendings who were negative, asking me why I went D.O with a negative comment here and there, and why I didn't have any MD letter of reccs (which wasn't true, the guy just didn't read my applications). It was interesting because those programs where I had a few negative comments had taken DOs before as fellows.

So overall I feel that the fellowship process was very positive for us Osteopathic Physicians and only in rare circumstances did I feel there was any bias. Obviously I haven't matched yet (another 2 weeks) so maybe they were blowing smoke and I'll be left high and dry, but honestly I had some great feedback and response..

I feel the ACGME/AOA merger has opened doors for fellowship opportunities in the orthopedic world. So thanks to our leadership.

Keep working hard, in previous posts I spoke about research so get some publications in whatever field you are in, make connections, meet people and enjoy your field of work. You'll go far! The future is open wide for us (my humble opinion).

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[SurgDoc95]

Hey all,
As I've just recently gone through the fellowship process (for ortho) I wanted to give you all a heads up as this topic of Bias against DOs is often discussed and the recent ACGME/AOA merger was supposed to resolve the conflict (yes i know we are early in the process). I truly don't care about the bias but I am also realistic that it does exist.

I personally emailed all the fellowship programs I was interested in before I applied (many were major academic centers with high reputations) asking them as a D.O. if I would be considered for their fellowship. I had three programs flat out say that I would not be considered since I had not taken the USLME step 3 (I've taken USMLE step 1-2) - this obviously is not consistent with the merger agreement since technically COMLEX 3 is a "comparable exam" (yes many of us know it truly isnt, i'm not arguing semantics here).

Also during each interview I asked the physicians if they had any concerns with my D.O degree and had they ever taken a D.O as a fellow (easy to find, usually on their website). In the majority of cases they had nothing but positive things to say despite many programs never matching a DO before. A few had mentioned that the merger allowed them to open the application process to DOs and they had been impressed by many of the applications. I did 14 interviews, and in all but five there were other DO applicants interviewing at the same time. 80% of the time the program I interviewed at had never taken a DO as a fellow.

There were 3-4 attendings who were negative, asking me why I went D.O with a negative comment here and there, and why I didn't have any MD letter of reccs (which wasn't true, the guy just didn't read my applications). It was interesting because those programs where I had a few negative comments had taken DOs before as fellows.

So overall I feel that the fellowship process was very positive for us Osteopathic Physicians and only in rare circumstances did I feel there was any bias. Obviously I haven't matched yet (another 2 weeks) so maybe they were blowing smoke and I'll be left high and dry, but honestly I had some great feedback and response..

I feel the ACGME/AOA merger has opened doors for fellowship opportunities in the orthopedic world. So thanks to our leadership.

Keep working hard, in previous posts I spoke about research so get some publications in whatever field you are in, make connections, meet people and enjoy your field of work. You'll go far! The future is open wide for us (my humble opinion).

Very encouraging post thank you!! Hope you get the fellowship you're looking for

 

[Dr. Rafiki]

Very encouraging. Thanks @Orthojoe

 

[MADD!!!]

Hey all,
As I've just recently gone through the fellowship process (for ortho) I wanted to give you all a heads up as this topic of Bias against DOs is often discussed and the recent ACGME/AOA merger was supposed to resolve the conflict (yes i know we are early in the process). I truly don't care about the bias but I am also realistic that it does exist.

I personally emailed all the fellowship programs I was interested in before I applied (many were major academic centers with high reputations) asking them as a D.O. if I would be considered for their fellowship. I had three programs flat out say that I would not be considered since I had not taken the USLME step 3 (I've taken USMLE step 1-2) - this obviously is not consistent with the merger agreement since technically COMLEX 3 is a "comparable exam" (yes many of us know it truly isnt, i'm not arguing semantics here).

Also during each interview I asked the physicians if they had any concerns with my D.O degree and had they ever taken a D.O as a fellow (easy to find, usually on their website). In the majority of cases they had nothing but positive things to say despite many programs never matching a DO before. A few had mentioned that the merger allowed them to open the application process to DOs and they had been impressed by many of the applications. I did 14 interviews, and in all but five there were other DO applicants interviewing at the same time. 80% of the time the program I interviewed at had never taken a DO as a fellow.

There were 3-4 attendings who were negative, asking me why I went D.O with a negative comment here and there, and why I didn't have any MD letter of reccs (which wasn't true, the guy just didn't read my applications). It was interesting because those programs where I had a few negative comments had taken DOs before as fellows.

So overall I feel that the fellowship process was very positive for us Osteopathic Physicians and only in rare circumstances did I feel there was any bias. Obviously I haven't matched yet (another 2 weeks) so maybe they were blowing smoke and I'll be left high and dry, but honestly I had some great feedback and response..

I feel the ACGME/AOA merger has opened doors for fellowship opportunities in the orthopedic world. So thanks to our leadership.

Keep working hard, in previous posts I spoke about research so get some publications in whatever field you are in, make connections, meet people and enjoy your field of work. You'll go far! The future is open wide for us (my humble opinion).

I'm assuming you did an AOA Ortho residency and now applying for an ACGME fellowship?

 

[ParallelLines]

If fellowship PDs are becoming more open towards taking DOs, would this mean that some residency PDs are as well?

 

[SlugMD]

@Orthojoe so basically all future ortho fellowship applicants should take USMLE step 3 in residency to maximize their chances and minimize bias?

I plan to take USMLE 1,2 CK/CS, and 3 obviously in addition to the whole comlex series. Basically, I don't want any stone left unturned so if a program (in any specialty) had bias, they won't try wiggle around a technicality.

 

[Mr Roboto]

@Orthojoe so basically all future ortho fellowship applicants should take USMLE step 3 in residency to maximize their chances and minimize bias?

I plan to take USMLE 1,2 CK/CS, and 3 obviously in addition to the whole comlex series. Basically, I don't want any stone left unturned so if a program (in any specialty) had bias, they won't try wiggle around a technicality.

Your username is quite misleading.

 

[DarkHorizon]

Hey all,
As I've just recently gone through the fellowship process (for ortho) I wanted to give you all a heads up as this topic of Bias against DOs is often discussed and the recent ACGME/AOA merger was supposed to resolve the conflict (yes i know we are early in the process). I truly don't care about the bias but I am also realistic that it does exist.

I personally emailed all the fellowship programs I was interested in before I applied (many were major academic centers with high reputations) asking them as a D.O. if I would be considered for their fellowship. I had three programs flat out say that I would not be considered since I had not taken the USLME step 3 (I've taken USMLE step 1-2) - this obviously is not consistent with the merger agreement since technically COMLEX 3 is a "comparable exam" (yes many of us know it truly isnt, i'm not arguing semantics here).

Also during each interview I asked the physicians if they had any concerns with my D.O degree and had they ever taken a D.O as a fellow (easy to find, usually on their website). In the majority of cases they had nothing but positive things to say despite many programs never matching a DO before. A few had mentioned that the merger allowed them to open the application process to DOs and they had been impressed by many of the applications. I did 14 interviews, and in all but five there were other DO applicants interviewing at the same time. 80% of the time the program I interviewed at had never taken a DO as a fellow.

There were 3-4 attendings who were negative, asking me why I went D.O with a negative comment here and there, and why I didn't have any MD letter of reccs (which wasn't true, the guy just didn't read my applications). It was interesting because those programs where I had a few negative comments had taken DOs before as fellows.

So overall I feel that the fellowship process was very positive for us Osteopathic Physicians and only in rare circumstances did I feel there was any bias. Obviously I haven't matched yet (another 2 weeks) so maybe they were blowing smoke and I'll be left high and dry, but honestly I had some great feedback and response..

I feel the ACGME/AOA merger has opened doors for fellowship opportunities in the orthopedic world. So thanks to our leadership.

Keep working hard, in previous posts I spoke about research so get some publications in whatever field you are in, make connections, meet people and enjoy your field of work. You'll go far! The future is open wide for us (my humble opinion).

Great post, sounds like you're in F&A or Sports match.

I'll give you guys my perspective. I am also an Ortho resident and just matched Ortho Trauma fellowship at a pretty good program with lots of history and big names with pedigree in trauma. They have trained a couple of DOs before, last one around 10 years ago.

With that being said, Ortho fellowships are wide open, unless you're doing Hand or Joints. My understanding is that those two are pretty competitive. As long as you're not too selective, you will match. I applied to 22 programs and received 12 interviews. However, I got shut out by all of the percieved top programs except two, one of which interviewed every applicant I think. My letter writers are pretty well connected in the OTA and wrote pretty nice letters, still no cigar. So there's definitely a bias. There's at least one program that has never taken a DO before, and another one who trained a DO in the 90s and does not list him as their alum (He has since passed away and was a huge name in DO ortho trauma)

There are some DOs that have managed to get some excellent fellowships, Harborview took their first DO as a trauma fellow, he is currently there. They interviewed at least one more DO this year, he ended up matching at another top program. There have been DOs at Shock Trauma and Vandy, so yes its attainable, but you have to remember that trauma wasn't all that competitive a few years ago, so it may be easier at that time.

Couple of things to remember:
1) Ortho fellowships is not where the bottleneck is, the bottleneck is to get into ortho. Often times there are more spots than applicants for fellowships. Therefore, if you're reasonable, you will likely match...unless it's hand or Joints. Plenty of unmatched DOs in those two fields last two years.

2) The bias is really when DOs try to get in as faculty members after fellowship training. Most places are happy to train you, but you'll hardly find a DO that trained through the AOA route for residency at large academic center as faculty, regardless of their fellowship pedigree. I can count the DOs trained through AOA route on one hand that are currently faculty at Large academic ACGME programs.

Bottom line, if you are lucky enough to match ortho, you will most likely get the fellowship in your desired field as a DO, there will def be some bias at top programs. However, if you're set on having an academic practice at a large ACGME center, you'd have a hard time. Of course this is my observation and some anecdotes, therefore n is pretty small, but I find it to be pretty accurate.

 

[DarkHorizon]

@Orthojoe so basically all future ortho fellowship applicants should take USMLE step 3 in residency to maximize their chances and minimize bias?

I plan to take USMLE 1,2 CK/CS, and 3 obviously in addition to the whole comlex series. Basically, I don't want any stone left unturned so if a program (in any specialty) had bias, they won't try wiggle around a technicality.

I wouldn't worry about it, the programs that use that excuse basically don't want to take DOs and will use that excuse to shut your out. DOs are matching just fine in every ortho specialty. Besides, you have other things to worry about, such as grades and step 1, so you can first get into ortho.

 

[Ioannes Paulus]

Great post, sounds like you're in F&A or Sports match.


Couple of things to remember:
1) Ortho fellowships is not where the bottleneck is, the bottleneck is to get into ortho. Often times there are more spots than applicants for fellowships. Therefore, if you're reasonable, you will likely match...unless it's hand or Joints. Plenty of unmatched DOs in those two fields last two years.

^^ This x100
Quick question.
What do you think about "gap years" during med schools for research to help beef up an average application? Worth it or nah

 

[DarkHorizon]

^^ This x100
Quick question.
What do you think about "gap years" during med schools for research to help beef up an average application? Worth it or nah

I think with the merger, research is becoming more valued at DO programs. When you'll apply, likely all the programs will have merged, or will have shut down, therefore, research may even be more important. I don't think it'll hurt you at all, it'll help immensely if you can make it a productive research year with a lot of publications. The key will still be your audition rotation, I don't think that will change with the merger. DO programs would still mainly take rotators.

 

[SlugMD]

Your username is quite misleading.

Yeah I get that comment from time to time. I made this account before I knew what osteopathic medicine was. I don't think you can change your SDN username can you?

 

[IslandStyle808]

Yeah I get that comment from time to time. I made this account before I knew what osteopathic medicine was. I don't think you can change your SDN username can you?

Yes you can, not sure how it works though.

 

[Mr. D.O.five]

Great information, bumping for others to see. I know I'm just an incoming DO student, but I due to experiences, ortho is one (of quite a few on my mind) of my choices that I'm considering.

 

[DrfluffyMD]

Competitiveness is all about how many spots versus applicants.

I guarantee you if there are 200 derm applicants and 400 derm spots next year, derm residencies will fly you out to interview you as long as you have a pulse.

Where as if OMM suddenly pays 1 million a year, you will have OMM pd looking at highschool grades try to tease things apart.

This way, you can look at where you went to school as something like your step 1. It's one variable. Just like a low score, a preceived (and often wrong) weakness in education get you filtered out if the field is vastly competitive even at a fellowship level.

 

[Mr Roboto]

Yeah I get that comment from time to time. I made this account before I knew what osteopathic medicine was. I don't think you can change your SDN username can you?

If you're a donor then you can change it like once or twice, can't remember the specifics.

 

[TheOther]

@Orthojoe @DarkHorizon

Thank you both for the insight! Much appreciated. Do either of you know how competitive peds ortho is?

 

[Orthojoe]

@Orthojoe @DarkHorizon

Thank you both for the insight! Much appreciated. Do either of you know how competitive peds ortho is?

75% of applicants get there #1 spot and 90% top 2. However it is becoming more competitive. There are two big name DOs that lead the way and I'd definitely try to get to know them. Dr Melmed at Cincinnati childrens and Dr Gerardi at Valley Children's. Both DOs that can make connections for you. Don't bother applying to CHOP, DuPont as they are open about not taking DOs.

 

[TheOther]

75% of applicants get there #1 spot and 90% top 2. However it is becoming more competitive. There are two big name DOs that lead the way and I'd definitely try to get to know them. Dr Melmed at Cincinnati childrens and Dr Gerardi at Valley Children's. Both DOs that can make connections for you. Don't bother applying to CHOP, DuPont as they are open about not taking DOs.

Thanks for the response! I appreciate it. Are you applying for peds?

 

[Orthojoe]

Great post, sounds like you're in F&A or Sports match.

I'll give you guys my perspective. I am also an Ortho resident and just matched Ortho Trauma fellowship at a pretty good program with lots of history and big names with pedigree in trauma. They have trained a couple of DOs before, last one around 10 years ago.

With that being said, Ortho fellowships are wide open, unless you're doing Hand or Joints. My understanding is that those two are pretty competitive. As long as you're not too selective, you will match. I applied to 22 programs and received 12 interviews. However, I got shut out by all of the percieved top programs except two, one of which interviewed every applicant I think. My letter writers are pretty well connected in the OTA and wrote pretty nice letters, still no cigar. So there's definitely a bias. There's at least one program that has never taken a DO before, and another one who trained a DO in the 90s and does not list him as their alum (He has since passed away and was a huge name in DO ortho trauma)

There are some DOs that have managed to get some excellent fellowships, Harborview took their first DO as a trauma fellow, he is currently there. They interviewed at least one more DO this year, he ended up matching at another top program. There have been DOs at Shock Trauma and Vandy, so yes its attainable, but you have to remember that trauma wasn't all that competitive a few years ago, so it may be easier at that time.

Couple of things to remember:
1) Ortho fellowships is not where the bottleneck is, the bottleneck is to get into ortho. Often times there are more spots than applicants for fellowships. Therefore, if you're reasonable, you will likely match...unless it's hand or Joints. Plenty of unmatched DOs in those two fields last two years.

2) The bias is really when DOs try to get in as faculty members after fellowship training. Most places are happy to train you, but you'll hardly find a DO that trained through the AOA route for residency at large academic center as faculty, regardless of their fellowship pedigree. I can count the DOs trained through AOA route on one hand that are currently faculty at Large academic ACGME programs.

Bottom line, if you are lucky enough to match ortho, you will most likely get the fellowship in your desired field as a DO, there will def be some bias at top programs. However, if you're set on having an academic practice at a large ACGME center, you'd have a hard time. Of course this is my observation and some anecdotes, therefore n is pretty small, but I find it to be pretty accurate.

Agreed, as I usually do with your posts. However I can double fist count how many DOs I know in pure academia. LOL.

 

[AlteredScale]

2) The bias is really when DOs try to get in as faculty members after fellowship training. Most places are happy to train you, but you'll hardly find a DO that trained through the AOA route for residency at large academic center as faculty, regardless of their fellowship pedigree. I can count the DOs trained through AOA route on one hand that are currently faculty at Large academic ACGME programs.

This always struck me oddly. Suppose a DO goes AOA for their residency but then lands a strong ACGME fellowship where there are resources to push out scholarly work, I wonder what exactly is the barrier that limits them to land appointments. Is it the lack of funding awards?

 

[FistLength]

This always struck me oddly. Suppose a DO goes AOA for their residency but then lands a strong ACGME fellowship where there are resources to push out scholarly work, I wonder what exactly is the barrier that limits them to land appointments. Is it the lack of funding awards?

I think the tendency of medical students is not to do academia/research and judging from my classmates/recent threads this is magnified in the DO population. We don't have mentors in research, so to get the ball rolling is significantly more difficult, add into the mix such a small number going into ortho fellowship, it makes sense not many are in academic positions. I would be curious to know if people are legitimately shut out because DO status.

 

[Lexdiamondz]

I think the tendency of medical students is not to do academia/research and judging from my classmates/recent threads this is magnified in the DO population. We don't have mentors in research, so to get the ball rolling is significantly more difficult, add into the mix such a small number going into ortho fellowship, it makes sense not many are in academic positions. I would be curious to know if people are legitimately shut out because DO status.

Per the PD survey only 5% regularly interview and rank DOs.

 

[gyngyn]

Yeah I get that comment from time to time. I made this account before I knew what osteopathic medicine was. I don't think you can change your SDN username can you?

Donors Only: Member Name Change

 

[DarkHorizon]

This always struck me oddly. Suppose a DO goes AOA for their residency but then lands a strong ACGME fellowship where there are resources to push out scholarly work, I wonder what exactly is the barrier that limits them to land appointments. Is it the lack of funding awards?

I'll tell you why I think that is. Surgery, or at least Ortho, is full of people who are big on pedigree and prestige for whatever reason. Academic jobs give you the kind of street cred that a lot of elitists desire (even tho the pay is pretty awful). Therefore, most academic jobs have many applicants with loaded CVs from high powered places. I would say that an MD resident from a small community program would also struggle to find a academic job in Ortho compared to a resident from a large academic program. Again, prestige and pedigree.

As a DO, research is not heavily emphasized. Therefore, you're behind the eight ball (although this is rapidly changing with ACGME takeover) when it comes to these jobs. I can tell you that most residents (including MDs) care very little for research and rather be operating, but MD programs and ACGME (at least the Ortho residency review committee) almost forces you to participate.

We just underwent ACGME review for accreditation and got shot down. Two of the citations were a) lack of faculty participation in research and b) too much operating by residents. First one makes some sense. However, It's almost baffling to me that ACGME rather have us do research than be learning how to operate. But that's just how things are going to be going forward. I can tell you that lack of DOs in orthopedic academia doesn't really reflect on our clinical capabilities. I would say most DO Ortho residents are much better surgeons by the time they graduate than their MD counterparts, because we operate early and often.

 

[AlteredScale]

I'll tell you why I think that is. Surgery, or at least Ortho, is full of people who are big on pedigree and prestige for whatever reason. Academic jobs give you the kind of street cred that a lot of elitists desire (even tho the pay is pretty awful). Therefore, most academic jobs have many applicants with loaded CVs from high powered places. I would say that an MD resident from a small community program would also struggle to find a academic job in Ortho compared to a resident from a large academic program. Again, prestige and pedigree.

As a DO, research is not heavily emphasized. Therefore, you're behind the eight ball (although this is rapidly changing with ACGME takeover) when it comes to these jobs. I can tell you that most residents (including MDs) care very little for research and rather be operating, but MD programs and ACGME (at least the Ortho residency review committee) almost forces you to participate.

We just underwent ACGME review for accreditation and got shot down. Two of the citations were a) lack of faculty participation in research and b) too much operating by residents. First one makes some sense. However, It's almost baffling to me that ACGME rather have us do research than be learning how to operate. But that's just how things are going to be going forward. I can tell you that lack of DOs in orthopedic academia doesn't really reflect on our clinical capabilities. I would say most DO Ortho residents are much better surgeons by the time they graduate than their MD counterparts, because we operate early and often.

Thank you so much for the great explanation. These were things that I was kind of expecting with ACGME taking over. See any possibility down the road of having to consider MD applicants who have stronger research experiences than the DO applicants?

 

[DarkHorizon]

Thank you so much for the great explanation. These were things that I was kind of expecting with ACGME taking over. See any possibility down the road of having to consider MD applicants who have stronger research experiences than the DO applicants?

This is happening already. There are 5 programs currently that have been able to achieve initial accreditation so far. One of them took residents through the ACGME match. I don't know who they took, but hard to imagine that they didn't at least take one MD. Also, the plan is for everyone to switch over to one match at some point. I think at that point we will see the full effects of this, but I suspect that at least some programs will start to take MDs who have better CVs than DOs. Most programs will still prefer DOs tho. It would also be interesting to see how existing MD programs will respond to high number of DO applicants in the match. Hopefully, in a few years it'll even out.

 

[AnatomyGrey12]

Per the PD survey only 5% regularly interview and rank DOs.

Lol.... just stop. You aren't making the point you think you are making.

 

[Lexdiamondz]

Lol.... just stop. You aren't making the point you think you are making.

Enlighten me then, oh wise premed.

 

[AnatomyGrey12]

You're trying to make the point that DOs are heavily discriminated against in the ortho fellowship world. This entire thread is ortho residents saying that isn't the case.

 

[Lexdiamondz]

You're trying to make the point that DOs are heavily discriminated against in the ortho fellowship world. This entire thread is ortho residents saying that isn't the case.

That isn't the point I was trying to make at all. I was responding to a particular post about medical students, research and why you don't see DOs in academia in ortho. Nothing to do with fellowships.

lol you know that old saying about assumptions...

 

[SunnyDO]

Enlighten me then, oh wise premed.

So unnecessary.

In regards to the thread -
Didn't really know much about this topic before stumbling upon this thread, so thanks to the individuals who had productive input.

 

[NurWollen]

I'll tell you why I think that is. Surgery, or at least Ortho, is full of people who are big on pedigree and prestige for whatever reason. Academic jobs give you the kind of street cred that a lot of elitists desire (even tho the pay is pretty awful). Therefore, most academic jobs have many applicants with loaded CVs from high powered places. I would say that an MD resident from a small community program would also struggle to find a academic job in Ortho compared to a resident from a large academic program. Again, prestige and pedigree.

As a DO, research is not heavily emphasized. Therefore, you're behind the eight ball (although this is rapidly changing with ACGME takeover) when it comes to these jobs. I can tell you that most residents (including MDs) care very little for research and rather be operating, but MD programs and ACGME (at least the Ortho residency review committee) almost forces you to participate.

We just underwent ACGME review for accreditation and got shot down. Two of the citations were a) lack of faculty participation in research and b) too much operating by residents. First one makes some sense. However, It's almost baffling to me that ACGME rather have us do research than be learning how to operate. But that's just how things are going to be going forward. I can tell you that lack of DOs in orthopedic academia doesn't really reflect on our clinical capabilities. I would say most DO Ortho residents are much better surgeons by the time they graduate than their MD counterparts, because we operate early and often.

That is indeed absolutely baffling. Do they mean too much operating at the expense of research? Or just too much operating? Is your program going to make adjustments and try again?


Sent from my SM-G930V using SDN mobile

 

[DrfluffyMD]

I think I can chime in here. In the old days, an IR fellow used to be able to come in and do procedures without attending in house. Great for training, but you need to bail yourself out if you run into problem at 3am.

Now we need to have attending inhouse for every call case. It's better for patient safety but worse for training.

Perhaps that poster means this when he/she said "resident operating too much"

Acgme doesnt care how much you operate. Acgme cares when there isn't enough attendings to cover all cases.

 

[Pisiform]

bit off topic here, but this whole ACGME single accreditation will level the playing field for DOs in long term view (decades down the line) but at the same time would not be advantageous to them in short term. My core university hospital just switched from AOA to ACGME, they recruited 3 DOs and 2 MDs this year. Competition will get fierce for DOs as USMD and IMGMD will compete for the same spot which was once only available for DOs. What advantage does a DO get? Pretty much none, they still have to take USMLE to be looked at by MD programs, would have to do research, their school name would not be well renowned etc.

 

[DarkHorizon]

That is indeed absolutely baffling. Do they mean too much operating at the expense of research? Or just too much operating? Is your program going to make adjustments and try again?


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Too much operating at the expense of research and didactics. We have made changes to our education schedule and are trying to incorporate more research (residents and attendings alike). We will be reapplying. We are not the only DO program in this predicament.

 

[LongDucDong]

Too much operating at the expense of research and didactics. We have made changes to our education schedule and are trying to incorporate more research (residents and attendings alike). We will be reapplying. We are not the only DO program in this predicament.

As you said above, only 5 programs have been able to achieve Initial Accreditation, and as far as I can tell from looking at the ACGME Accreditation Data System, 37 AOA programs have Pre-Accreditation status.

Do you have any idea of those 37 that currently have Pre-Accreditation, a rough estimate of how many will survive the merge (assuming that those who already have Initial Accreditation will definitely survive)? I think there were something like 43 AOA orthopedic surgery programs pre-merge, so I am just trying to gauge how many of those will realistically be able to attain ACGME accreditation and will remain open post-merge. All? Most? Half?

 

[ChiDO]

Most programs won't achieve full accred and will close or have to merge with ACGME programs in the area. Small ortho programs in small towns will probably cease to exist even if they applied for accred.

 

[DarkHorizon]

As you said above, only 5 programs have been able to achieve Initial Accreditation, and as far as I can tell from looking at the ACGME Accreditation Data System, 37 AOA programs have Pre-Accreditation status.

Do you have any idea of those 37 that currently have Pre-Accreditation, a rough estimate of how many will survive the merge (assuming that those who already have Initial Accreditation will definitely survive)? I think there were something like 43 AOA orthopedic surgery programs pre-merge, so I am just trying to gauge how many of those will realistically be able to attain ACGME accreditation and will remain open post-merge. All? Most? Half?

It's hard to say, I would say probably half the programs at the time have the resources to achieve initial accreditation. It's kind of interesting that programs like Cuyahoga falls and Grand Rapids have gained initial accreditation, yet bigger programs like Columbus, PCOM, Genisys, and Riverside have not been able to.

I think some programs will definitely have trouble and will need to merge with ACGME programs or shut down because they either don't have the resources or th volume to keep up with ACGME standards. Rest of the programs will eventually gain initial accreditation once they use their resources to fulfill ACGME requirements.

 

[Ioannes Paulus]

It's hard to say, I would say probably half the programs at the time have the resources to achieve initial accreditation. It's kind of interesting that programs like Cuyahoga falls and Grand Rapids have gained initial accreditation, yet bigger programs like Columbus, PCOM, Genisys, and Riverside have not been able to.

I think some programs will definitely have trouble and will need to merge with ACGME programs or shut down because they either don't have the resources or th volume to keep up with ACGME standards. Rest of the programs will eventually gain initial accreditation once they use their resources to fulfill ACGME requirements.

Yeah. I was shocked to learn how Millcreek (LECOM's program) which operates out of a tiny hospital that only has 130 beds and isn't even a trauma center, has initial accreditation while huge programs in Michigan that haven been operating for decades still haven't passed the initial steps.

 

[DarkHorizon]

Yeah. I was shocked to learn how Millcreek (LECOM's program) which operates out of a tiny hospital that only has 130 beds and isn't even a trauma center, has initial accreditation while huge programs in Michigan that haven been operating for decades still haven't passed the initial steps.

Not sure if you're talking about Ortho, because Milcreek does not have initial accreditation for Ortho.
The only 5 programs so far are Broward, plain view, Cuyahoga falls, Grand Rapids, and Lansing. Lansing is approved for initial accreditation but it's pending Sponsoring institution accreditation.

 

[NurWollen]

I've also been surprised at which programs have and have not been able to gain initial accreditation. I don't know much about ortho, but there is an AOA derm program run from a private practice derm office in my state that has initial accreditation. Likewise Larkin in FL (one of SDN's most maligned institutions) has initial accreditation in anesthesia and I think radiology. Of course, I assume different specialities have different requirements for research, didactics, etc

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[MJS4878]

Most programs won't achieve full accred and will close or have to merge with ACGME programs in the area. Small ortho programs in small towns will probably cease to exist even if they applied for accred.

It's hard to say, I would say probably half the programs at the time have the resources to achieve initial accreditation. It's kind of interesting that programs like Cuyahoga falls and Grand Rapids have gained initial accreditation, yet bigger programs like Columbus, PCOM, Genisys, and Riverside have not been able to.

I think some programs will definitely have trouble and will need to merge with ACGME programs or shut down because they either don't have the resources or th volume to keep up with ACGME standards. Rest of the programs will eventually gain initial accreditation once they use their resources to fulfill ACGME requirements.

@ChiDO & @DarkHorizon Thanks for all of your input on this thread guys. What do you think about current third years applying to DO ortho? Should they continue to set up auditions, apply as usual and hope that the programs they went to will make it through ACGME accreditation? My biggest concern is doing 5 auditions and by the time the match comes around only 2 of them will be available in the match.

 

[ChiDO]

I'd go about business as usual. Tough to predict what would happen, but I'd try to hit up those programs with initial accred. Obv those programs have things going for them that others don't.

 

[TheOther]

@ChiDO & @DarkHorizon Thanks for all of your input on this thread guys. What do you think about current third years applying to DO ortho? Should they continue to set up auditions, apply as usual and hope that the programs they went to will make it through ACGME accreditation? My biggest concern is doing 5 auditions and by the time the match comes around only 2 of them will be available in the match.

I remember seeing a post last week with an update that programs that don't get accredited by 2020 will be able to finish up their residents and get them AOA board certified. I'll have to search for the update.

 

[Orthojoe]

As you said above, only 5 programs have been able to achieve Initial Accreditation, and as far as I can tell from looking at the ACGME Accreditation Data System, 37 AOA programs have Pre-Accreditation status.

Do you have any idea of those 37 that currently have Pre-Accreditation, a rough estimate of how many will survive the merge (assuming that those who already have Initial Accreditation will definitely survive)? I think there were something like 43 AOA orthopedic surgery programs pre-merge, so I am just trying to gauge how many of those will realistically be able to attain ACGME accreditation and will remain open post-merge. All? Most? Half?

The ACGME Board meets twice a year for accreditation/re-accreditation approval. The most recent cycle all DO Ortho programs were rejected. The cycle before was when the initial 5 were approved. Some speculate that there was a blanket rejection since there were so many programs to review. Like Dark Horizon our program was pre-accredited but was rejected due to lack of faculty supported research and participation. We now have a permanent research intern (usually someone who was a great ortho candidate but the chips didn't fall his/her way in the match) and research requirements have been instituted. I've been actively involved in the accreditation process so I think the majority of the programs will eventually become ACGME. There has been one program closed(absorbed by the MD ortho program), I anticipate 4-5 more not able to meet the requirements.

Second, from a previous post about the merger causing DOs to lose spots -- - I love the competition aspect and I will go up against any MD counterpart. Our Ortho program scored in the top 2% in North American on the OITE scores. The merger will allow us to be judged more fairly and equally and gain more respect. My opinion.

 

[AlteredScale]

The ACGME Board meets twice a year for accreditation/re-accreditation approval. The most recent cycle all DO Ortho programs were rejected. The cycle before was when the initial 5 were approved. Some speculate that there was a blanket rejection since there were so many programs to review. Like Dark Horizon our program was pre-accredited but was rejected due to lack of faculty supported research and participation. We now have a permanent research intern (usually someone who was a great ortho candidate but the chips didn't fall his/her way in the match) and research requirements have been instituted. I've been actively involved in the accreditation process so I think the majority of the programs will eventually become ACGME. There has been one program closed(absorbed by the MD ortho program), I anticipate 4-5 more not able to meet the requirements.

Second, from a previous post about the merger causing DOs to lose spots -- - I love the competition aspect and I will go up against any MD counterpart. Our Ortho program scored in the top 2% in North American on the OITE scores. The merger will allow us to be judged more fairly and equally and gain more respect. My opinion.

Can you elaborate more on the research requirements? Will that research have a stronger opportunity and chance to enter your ortho residency after their year is done?


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[DarkHorizon]

Just wanted to update this thread. Orthopedic sports medicine fellowship match was yesterday. Everyone that I know matched one of their top choices but an interesting trend was noticed. There were quite a few spots open after the match, many at very very competitive programs, including Kerlan Jobe, SCOI, HSS, and MGH. All of these programs are considered to be top programs in sports medicine from what I understand. The fact that made it interesting was that these programs didn't interview any DO applicants (told by my DO friends in the match) and chose to go unfilled. I can only infer that they rather pick from unmatched MD applicants (and there aren't that many as sports medicine has one of the highest match rates) than take a lowly DO. I thought I'd share it here as I found it interesting.

 

[Munchkinman1]

Just wanted to update this thread. Orthopedic sports medicine fellowship match was yesterday. Everyone that I know matched one of their top choices but an interesting trend was noticed. There were quite a few spots open after the match, many at very very competitive programs, including Kerlan Jobe, SCOI, HSS, and MGH. All of these programs are considered to be top programs in sports medicine from what I understand. The fact that made it interesting was that these programs didn't interview any DO applicants (told by my DO friends in the match) and chose to go unfilled. I can only infer that they rather pick from unmatched MD applicants (and there aren't that many as sports medicine has one of the highest match rates) than take a lowly DO. I thought I'd share it here as I found it interesting.

Could an unmatched DO grad scramble in similar to residency?

 

[DarkHorizon]

Could an unmatched DO grad scramble in similar to residency?

Theoretically sure, realistically? If they didn't even interview one for the match, doubt they'll take one in scramble.