Breaking down DO stigma in residency apps (Possible useful info for DO stakeholders, check out this thread if you are)

[Chibucks15]

Such a cop out defense. This is like the ultimate osteopathic apologist argument.

You can just go ahead and argue that every measurement of school strength is relative (I think this is a better word to use than subjective), including Step scores, by suggesting something sensational like "the students could have matched into a lot of various programs and specialties, but decided to match largely into Pediatrics and FM in community programs in the rural midwest, and that is why they decided to only just pass Step 1, they got exactly what they wanted, it is all relative, man"...

I mean I never said anything of the sort. You’re just pulling out nonsense haha people with high step scores and high grades go FM all the time. I never once said that people “just pass because I’m doing FM”. What the hell do you read when you’re in here?

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[gyngyn]

How so? I saw quite a bit of my classmates and they were almost all carbon copies.

Smart. A smiling head shot, I hope.

 

[Ho0v-man]

That's a good idea and valid concern, I think. Maybe a system that divides applicants to AMG (MD and DO) or IMG could fix your concern? Let me know what you think.

I think it’s unrealistic. If we advocated for a system to divide us from IMGs, then the MD side would want to divide us from them. Then we’re back to square one. If there was LCME takeover of DO schools then it would be fair to consider this.

 

[Dr.Bruh]

In the majority of the country, it doesn’t really affect anything if you have the scores. But to each their own

This is the sad part about prestige whoring. Prestige literally means nothing to anybody other than the people who run these ivory tower programs, and maybe a few gunner applicants. CC and Hopkins take a ton of DOs and they have no shortage of insanely competitive applications in droves each year. And no matter how many DOs they take thats not going to change. I worked in a rural midwest ER as a scribe in undergrad and there were MDs from Washu and Hopkins, DOs and Carrib grads. Nobody cared. And I think its so funny how people think DOs make a program look less quality. When I see a DO in a big name program my first thought it "damn this person must a God to have matched here". Its actually a testament to how quality the program is. If a DO matched there they must have been a superstar applicant to outcompete other MDs.

We shouldn't be arguing if the DO degree is prestigious or not. Compared to USMD its obviously less prestigious and that won't change. We should be arguing about the utility of prestige whoring. How it actually leads to screening out of potentially better quality applicants based on school or degree type. And ignore the fact that nobody in the real world cares about how many DOs or MDs you have in your program.

 

[putmeincoach]

I think it’s unrealistic. If we advocated for a system to divide us from IMGs, then the MD side would want to divide us from them. Then we’re back to square one. If there was LCME takeover of DO schools then it would be fair to consider this.

True, that may happen. I think we could engage with MDs why they may feel that way and addess concerns accordingly. I guess too, I'm sure there's a large number (i hope) of MD students who will support the cause, and we could encourage them to advocate for us from the inside.

 

[putmeincoach]

This is the sad part about prestige whoring. Prestige literally means nothing to anybody other than the people who run these ivory tower programs, and maybe a few gunner applicants. CC and Hopkins take a ton of DOs and they have no shortage of insanely competitive applications in droves each year. And no matter how many DOs they take thats not going to change. I worked in a rural midwest ER as a scribe in undergrad and there were MDs from Washu and Hopkins, DOs and Carrib grads. Nobody cared. And I think its so funny how people think DOs make a program look less quality. When I see a DO in a big name program my first thought it "damn this person must a God to have matched here". Its actually a testament to how quality the program is. If a DO matched there they must have been a superstar applicant to outcompete other MDs.

I think it's great that our superstar DOs are getting the shot they deserve. I don't want to be too negative or anything, but I hope we could change the system so that our future superstars won't have to worry as much or apply to much more programs to ensure a match.

 

[sab3156]

I mean I never said anything of the sort. You’re just pulling out nonsense haha people with high step scores and high grades go FM all the time. I never once said that people “just pass because I’m doing FM”. What the hell do you read when you’re in here?

The strawman army is on full alert.

This is the sad part about prestige whoring. Prestige literally means nothing to anybody other than the people who run these ivory tower programs, and maybe a few gunner applicants. CC and Hopkins take a ton of DOs and they have no shortage of insanely competitive applications in droves each year. And no matter how many DOs they take thats not going to change. I worked in a rural midwest ER as a scribe in undergrad and there were MDs from Washu and Hopkins, DOs and Carrib grads. Nobody cared. And I think its so funny how people think DOs make a program look less quality. When I see a DO in a big name program my first thought it "damn this person must a God to have matched here". Its actually a testament to how quality the program is. If a DO matched there they must have been a superstar applicant to outcompete other MDs.

We shouldn't be arguing if the DO degree is prestigious or not. Compared to USMD its obviously less prestigious and that won't change. We should be arguing about the utility of prestige whoring. How it actually leads to screening out of potentially better quality applicants based on school or degree type. And ignore the fact that nobody in the real world cares about how many DOs or MDs you have in your program.

All you are doing is overstating things that really don't make much sense and aren't even relevant to the bigger picture. The fact is that the "real world" reputations of these programs are largely determined by the academic world, and we know how that goes. It is an absolute fact that applicants in competitive specialties and programs pay attention to pedigree of the current and past residents. Cleveland Clinic, as has been repeatedly stated here, depending on program/department, isn't necessarily going to be a highly sought after residency program. And Hopkins takes "tons" of DOs? Since when, and in what specialties? Can you be specific instead of just throwing out a bunch of generic and unverifiable claims?

 

[Angus Avagadro]

The strawman army is on full alert.



All you are doing is overstating things that really don't make much sense and aren't even relevant to the bigger picture. The fact is that the "real world" reputations of these programs are largely determined by the academic world, and we know how that goes. It is an absolute fact that applicants in competitive specialties and programs pay attention to pedigree of the current and past residents. Cleveland Clinic, as has been repeatedly stated here, depending on program/department, isn't necessarily going to be a highly sought after residency program. And Hopkins takes "tons" of DOs? Since when, and in what specialties? Can you be specific instead of just throwing out a bunch of generic and unverifiable claims?

One of my students matched at Hopkins last year. Not family med either.
To the OP. I think the horse is out of the barn with respect to DO stigma and residency matching. Remember why DO students were thrown out of acgme match several years ago? 500 MD students didnt match after the scramble. Parents and alums went ballistic because DOs were matching and their students were not.(Personal communication with one of my Deans)
AOA did the politically expedient thing by allowing merger to occur as AOA did not have enough slots for all DO grads. This has been discussed ad nauseam on SDN. What to do? As I said, I think the horse is out of the barn. Either DO degree will become MD, or it will represent a degree for primary care.
As for better clinicals? Big training hospitals are closing. Drexel and Wheeling to name 2. Big teaching hospitals are not being built. In our area, smaller, overnight hospitals are being built where very acute cases are sent to the regional center. I dont see an opportunity for inpatient resident medical training. Since Acgme in essence owns us, we are at their mercy
I agree with dropping enrollment by 33%. I'm frankly getting tired of twisting myself into a pretzel to get the bottom third to pass boards. As far as better clinicals,DO schools need to build/buy hospitals and convert them to teaching. It's not like they are in need of money.

 

[Dr.Bruh]

The strawman army is on full alert.



All you are doing is overstating things that really don't make much sense and aren't even relevant to the bigger picture. The fact is that the "real world" reputations of these programs are largely determined by the academic world, and we know how that goes. It is an absolute fact that applicants in competitive specialties and programs pay attention to pedigree of the current and past residents. Cleveland Clinic, as has been repeatedly stated here, depending on program/department, isn't necessarily going to be a highly sought after residency program. And Hopkins takes "tons" of DOs? Since when, and in what specialties? Can you be specific instead of just throwing out a bunch of generic and unverifiable claims?

Its an absolute fact? talk about being generic with unverifiable claims. I have a dozen MD friends applying competitive specialties next year and I can tell you the thought of DOs in the program has not crossed their mind. What has, and for most normal people, is things like geography (people care much more about being close to friends/family than they do about being in a program with a DO), and access to fellowships/research etc. You seem to live in a fantasy world were these prestige snobs and elites makes up the majority of applicants and programs. They don't. Its a significant minority.

Also Hopkins PM&R program is almost 1/2 DOs, DOs in their EM and gas programs too.

 

[scoopdaboop]

And Hopkins takes "tons" of DOs? Since when, and in what specialties? Can you be specific instead of just throwing out a bunch of generic and unverifiable claims?

I think his main point was that, Hopkins, often regarded as a top university takes DO's yearly. They have some in anesthesia and EM, and yet the "prestige" of John Hopkins is not any less for that. And, another argument I see popping up is: well they don't take DO's because of their poor clinical training!! Well, if you've never taken a DO how can you possibly judge their clinical training? Auditions? Many programs already make it difficult or more costly for DO's to get auditions anyways, so clearly even if a DO does do well during auditions, it matters not compared to a MD who does just as well if not worse, because they basically say "look at the price for you DO student, you really shouldn't bother with the audition no matter how well you think you'll do".

So all that said, what it basically comes down to is this: Did you get a high enough undergraduate GPA and MCAT. If you did, well you got to go MD, you then got to get a 235 Step to match into many competitive specialties, but the student with a lower GPA and MCAT who had to go DO, who got a 245 step has a substantially harder time matching into said specialty, even though he clearly outperformed the MD counterpart where it matters (aka boards).

 

[DrStephenStrange]

This is the sad part about prestige whoring. Prestige literally means nothing to anybody other than the people who run these ivory tower programs, and maybe a few gunner applicants. CC and Hopkins take a ton of DOs and they have no shortage of insanely competitive applications in droves each year. And no matter how many DOs they take thats not going to change. I worked in a rural midwest ER as a scribe in undergrad and there were MDs from Washu and Hopkins, DOs and Carrib grads. Nobody cared. And I think its so funny how people think DOs make a program look less quality. When I see a DO in a big name program my first thought it "damn this person must a God to have matched here". Its actually a testament to how quality the program is. If a DO matched there they must have been a superstar applicant to outcompete other MDs.

We shouldn't be arguing if the DO degree is prestigious or not. Compared to USMD its obviously less prestigious and that won't change. We should be arguing about the utility of prestige whoring. How it actually leads to screening out of potentially better quality applicants based on school or degree type. And ignore the fact that nobody in the real world cares about how many DOs or MDs you have in your program.

This exactly what I argued earlier. Nobody replied to my comment because they know it's true. Competition should be based on numbers not letters.

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[gyngyn]

Yes. I had some pretty oddballs in my class and even they had a normal pic. Everyone I saw had a normal, simple headshot.

How often do you encounter otherwise?

Often enough.

 

[putmeincoach]

This exactly what I argued earlier. Nobody replied to my comment because they know it's true. Competition should be based on numbers not letters.

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Yup, I agree. If by law, DO=MD=physician, then they should compete based on objective medical school performance/metrics (eg. boards, etc). We shouldn't penalize students for who they were in the past, such as not getting their **** together freshman year undergrad and going DO. But by who they are NOW.

 

[jurassicpark]

Yup, I agree. If by law, DO=MD=physician, then they should compete based on objective medical school performance/metrics (eg. boards, etc). We shouldn't penalize students for who they were in the past, such as not getting their **** together freshman year undergrad and going DO. But by who they are NOW.

If wishes were fishes we'd all cast nets. The argument you're making is the same one the folks at the Caribbean forum have been making for years too. They all have the same MD and take the same board exams so why does it matter that they're IMG and not from Harvard?

Outside of the DOs who went DO by first choice, your statement is that for some reason or another one COULDN'T get into an MD school and had to go DO school. If that's the case, why can't there be some form of snobbery for those who had their act together or whatever for all four years instead of arbitrarily three?

That being said, I'm a great supporter of DO. The DOs I work with there is no difference in patient care. Only their debt load is much higher, and quite frankly a lot of them are a lot better looking. But then, to get where they were and to overcome the above said discrimination I'm sure they had to work their tail feathers off, just like some of the IMGs I work with.

 

[Ho0v-man]

Yup, I agree. If by law, DO=MD=physician, then they should compete based on objective medical school performance/metrics (eg. boards, etc). We shouldn't penalize students for who they were in the past, such as not getting their **** together freshman year undergrad and going DO. But by who they are NOW.

This is only acceptable if DO schools make the adjustments mentioned on the first day age though. Most PDs know there are rockstar DOs out there. There’s absolute rockstars at every med school. However, part of the bias is that graduates of a school aren’t judged by their best students, they’re judged by their worst. I think we all know that most of our classmates can go toe-to-toe with any random state MD student. But the bottom quintile students at our schools can’t hold a candle to the bottom quintile MD students. I’m talking about the folks who just rewatched sketchy micro and did maybe half of combank and just went for it on comlex. Then they picked a preceptor only 3rd year site bc they heard it was chill.

Taking it easy like that isn’t possible at an MD program.

And I’m not faulting the students who want to take it easy and just get through. I’m faulting the schools for making it possible.

 

[putmeincoach]

This is only acceptable if DO schools make the adjustments mentioned on the first day age though. Most PDs know there are rockstar DOs out there. There’s absolute rockstars at every med school. However, part of the bias is that graduates of a school aren’t judged by their best students, they’re judged by their worst. I think we all know that most of our classmates can go toe-to-toe with any random state MD student. But the bottom quintile students at our schools can’t hold a candle to the bottom quintile MD students. I’m talking about the folks who just rewatched sketchy micro and did maybe half of combank and just went for it on comlex. Then they picked a preceptor only 3rd year site bc they heard it was chill.

Taking it easy like that isn’t possible at an MD program.

And I’m not faulting the students who want to take it easy and just get through. I’m faulting the schools for making it possible.

True, that's a good point to advocate for smaller class sizes, in addition to sentiments from @Angus Avagadro. Perhaps smaller but stronger classes could uplift how DOs are perceived. But to be fair though, the people set on PC and decide to cruise, make a big impact too by addressing the PC shortage. It's hard lol, but I'm with you on not knocking our colleagues who decide to chill.

 

[Ho0v-man]

True, that's a good point to advocate for smaller class sizes, in addition to sentiments from @Angus Avagadro. Perhaps smaller but stronger classes could uplift how DOs are perceived. But to be play devil's advocate, the people set on PC and just cruise, make a big impact too by addressing the PC shortage. It's hard lol, but I'm with you on not knocking our colleagues who decide to chill.

But to play Devils-er advocate, people can pursue PC and still hold themselves to MD standards. MD students do it all the time. Of course, if given the option, those students would do the same as the DO students if given the option. It’s just human nature.

 

[deleted1020563]

That's a good idea and valid concern, I think. Maybe a system that divides applicants to AMG (MD and DO) or IMG could fix your concern? Let me know what you think.

The AOA proposed something like this: https://osteopathic.org/wp-content/uploads/200-Series_Educational-Affairs.pdf under resolution 230.

 

[BorntobeDO?]

One of my students matched at Hopkins last year. Not family med either.
To the OP. I think the horse is out of the barn with respect to DO stigma and residency matching. Remember why DO students were thrown out of acgme match several years ago? 500 MD students didnt match after the scramble. Parents and alums went ballistic because DOs were matching and their students were not.(Personal communication with one of my Deans)
AOA did the politically expedient thing by allowing merger to occur as AOA did not have enough slots for all DO grads. This has been discussed ad nauseam on SDN. What to do? As I said, I think the horse is out of the barn. Either DO degree will become MD, or it will represent a degree for primary care.
As for better clinicals? Big training hospitals are closing. Drexel and Wheeling to name 2. Big teaching hospitals are not being built. In our area, smaller, overnight hospitals are being built where very acute cases are sent to the regional center. I dont see an opportunity for inpatient resident medical training. Since Acgme in essence owns us, we are at their mercy
I agree with dropping enrollment by 33%. I'm frankly getting tired of twisting myself into a pretzel to get the bottom third to pass boards. As far as better clinicals,DO schools need to build/buy hospitals and convert them to teaching. It's not like they are in need of money.

This has to be one of my favorite posts in a while.

 

[BorntobeDO?]

This exactly what I argued earlier. Nobody replied to my comment because they know it's true. Competition should be based on numbers not letters.

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Disagree, I think letters of referance are very important some students are complete turds.

Oh you meant degree letters. Sure, carry on.

 

[sab3156]

You seem to live in a fantasy world were these prestige snobs and elites makes up the majority of applicants and programs. They don't. Its a significant minority.

This thread is almost entirely about the most competitive specialties and programs. In these fields and programs, yes, pedigree is overwhelmingly a huge deal and if you really have to downplay that with an irrelevant rant to feel better about it, go ahead. Doesn't change anything.

 

[BorntobeDO?]

Yup, I agree. If by law, DO=MD=physician, then they should compete based on objective medical school performance/metrics (eg. boards, etc). We shouldn't penalize students for who they were in the past, such as not getting their **** together freshman year undergrad and going DO. But by who they are NOW.

Lol, how else you gonna separate 1000s of qualified applicants when you can only interview a hundred or two hundred of them? Looking at the school they got into gives me some idea of thier long term performance, and if an MD has been performing at a higher level for longer than by default they should be considered a safer pick. Sucks for us, but I really don't think its unfair.

 

[BorntobeDO?]

This is only acceptable if DO schools make the adjustments mentioned on the first day age though. Most PDs know there are rockstar DOs out there. There’s absolute rockstars at every med school. However, part of the bias is that graduates of a school aren’t judged by their best students, they’re judged by their worst. I think we all know that most of our classmates can go toe-to-toe with any random state MD student. But the bottom quintile students at our schools can’t hold a candle to the bottom quintile MD students. I’m talking about the folks who just rewatched sketchy micro and did maybe half of combank and just went for it on comlex. Then they picked a preceptor only 3rd year site bc they heard it was chill.

Taking it easy like that isn’t possible at an MD program.

And I’m not faulting the students who want to take it easy and just get through. I’m faulting the schools for making it possible.

You can definately cruise at some MDs also, in fact many of them make it easier to do it with pass fail and true non-mandatory attendance.

I would also argued that the bottom quintile that would really sucks tend to get kicked out at DO schools. We fail way more people.

 

[Dr.Bruh]

This thread is almost entirely about the most competitive specialties and programs. In these fields and programs, yes, pedigree is a overwhelmingly a huge deal and if you really have to downplay that with an irrelevant rant to feel better about it, go ahead. Doesn't change anything.

You almost never direct respond to peoples criticisms of your post/claim, and instead revert back to a generic statement about how "pedigree is a huge deal". Dude, nobody is arguing it isn't. Context matters though and is situation specific. Also, if you went to a DO school expecting to match in the most competitive speciality and most competitive program thats on you for being a dumb dumb and not doing an iota of research. The general knowledge is to make sure before going DO you rule out those things as your career goals. So most of your arguments are moot because this is generally knowledge that any Pre med student should know and be aware of before going DO. Majority of DO students are not going into 4th year completely blind sided by the fact the top programs won't interview them or that they likely won't match neurosurgery. You points are targeted towards a very very small portion of the DO student population.

 

[Ho0v-man]

You can definately cruise at some MDs also, in fact many of them make it easier to do it with pass fail and true non-mandatory attendance.

I would also argued that the bottom quintile that would really sucks tend to get kicked out at DO schools. We fail way more people.

I was referring to those that make it to residency applications. But to be fair, I’m pulling “quintile” out of my ***. Could be less.

 

[sab3156]

You almost never direct respond to peoples criticisms of your post/claim, and instead revert back to a generic statement about how "pedigree is a huge deal". Dude, nobody is arguing it isn't. Context matters though and is situation specific. Also, if you went to a DO school expecting to match in the most competitive speciality and most competitive program thats on you for being a dumb dumb and not doing an iota of research. The general knowledge is to make sure before going DO you rule out those things as your career goals. So most of your arguments are moot because this is generally knowledge that any Pre med student should know and be aware of before going DO. Majority of DO students are not going into 4th year completely blind sided by the fact the top programs won't interview them or that they likely won't match neurosurgery. You points are targeted towards a very very small portion of the DO student population.

Thank you for your rant, but it is irrelevant to this thread. I really don't know what you are even talking about at this point, so I am going to call it a day.

 

[Dr.Bruh]

Thank you for your rant, but it is irrelevant to this thread. I really don't know what you are even talking about at this point, so I am going to call it a day.

Exhibit A

 

[deleted859689]

People here are so heated. I like Goro’s analogy that matching being more competitive and having to take comlex (for most people in conjunction with USMLE) is a tax on not having the stats to get into MD school. I mean we chose the DO route. As non-trad starting next year there’s so much doom and gloom, and for a good reason. Wanna breakdown the stigma in residency apps for DO? Most you can do is 700+ COMLEX 270+ step 1, get multiple pubs in reputable journals, and from what I gather the door may still closed to some programs. However, I bet a PD will look at your app twice. Didn’t someone from Campbell match to neurosurg with ridiculous scores?

See Who Has Matched in Neurosurgical Residency Programs

www.aans.org

Funny how some DO grads have MD next to their name.

I’m not naive enough to think that DOs are on the same playing field as MD in terms of matching in a competitive specialty, and I’m okay with that. I have to work harder if I want to match to a competitive specialty. This is why I’m worried about Step 1 or Comlex going P/F. Then DOs will really be relegated to primary care. So, to break down stigma a little when applying to competitive specialties - become a super star applicant. If you don’t want a competitive specialty, then congrats, you’re going to be what you want, earn the same amount as your MD counterparts, and treat patients. Just maybe not in the ideal location or program.

 

[Kardio]

quite frankly a lot of them are a lot better looking.

D.O.s: Bringing swag to primary care since 1892

 

[jurassicpark]

D.O.s: Bringing swag to primary care since 1892

I think it's important we have our priorities straight.

 

[AnatomyGrey12]

True, that's a good point to advocate for smaller class sizes, in addition to sentiments from @Angus Avagadro. Perhaps smaller but stronger classes could uplift how DOs are perceived. But to be fair though, the people set on PC and decide to cruise, make a big impact too by addressing the PC shortage. It's hard lol, but I'm with you on not knocking our colleagues who decide to chill.

The time for this has passed. The DO leadership had their chance about 10 years ago to elevate the DO degree, and it’s grads, to greater prominence and really change the stigma. DO school averages were rising, DO grads were matching better more consistently, and there was opportunity to grab this and run with it. They should have started encouraging schools to incorporate research, should have improved the overall level of clinical education, and started advocating for their best students and highlighting their successes.

Instead they sold us all out for a quick buck and decided to flood the market with half baked grads coming out of old Walmarts that got their clinical training in the Surgery Shack.

 

[medwriter87]

This is easily answered.

Change the DO degree to MD. Make it easier for patients and the international community. If this isn’t easy, make the former “DO’s” into “MD, OMM”. OMM to signify they’ve learnt it.

DO to some people sounds like you just specialize in something “osteo” bone related. It’s just confusing. How can we call an “MD” a medical doctor and a DO we can’t? It’s simply confusing, especially when they do the same thing in practice.

There’s no need to take hundreds of additional steps like raising awareness, etc. when the problem can be easily solved. The general public doesn’t care enough about these different titles and usually just looks for “MD” when they need a doctor to go to.

Hopefully someone can work on this in the future.

 

[DrStephenStrange]

This is easily answered.

...The general public doesn’t care enough about these different titles and usually just looks for [anyone with a white coat including NPs and PAs]...

FTFY

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[medwriter87]

FTFY

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But if they're looking online for a provider, and its someone from the older generation (which is the generation that usually needs docs), they'll prolly look for the 'MD' title along with the other usual marketing. If they're searching online and see 20 MD's and 1 DO in the area, they are likely to think the DO means something else if unfamiliar.

This is why DO needs to be converted to MD, to make it simple for patients and the world.

The fact that half the countries in the world don't even recognize DO's or award them practice rights in those countries is disappointing, and stems from the unfamiliarity and unnecessary confusion.

Why fight to raise awareness, something that will take hundreds of years, when the problem can be solved with a very simple and agreeable fix?

 

[BorntobeDO?]

But if they're looking online for a provider, and its someone from the older generation (which is the generation that usually needs docs), they'll prolly look for the 'MD' title along with the other usual marketing. If they're searching online and see 20 MD's and 1 DO in the area, they are likely to think the DO means something else if unfamiliar.

This is why DO needs to be converted to MD, to make it simple for patients and the world.

The fact that half the countries in the world don't even recognize DO's or award them practice rights in those countries is disappointing, and stems from the unfamiliarity and unnecessary confusion.

Why fight to raise awareness, something that will take hundreds of years, when the problem can be solved with a very simple and agreeable fix?

I hear for an easy 50k AUA will give you that MD you so want after DO school.

 

[67552931811]

But if they're looking online for a provider, and its someone from the older generation (which is the generation that usually needs docs), they'll prolly look for the 'MD' title along with the other usual marketing. If they're searching online and see 20 MD's and 1 DO in the area, they are likely to think the DO means something else if unfamiliar.

This is why DO needs to be converted to MD, to make it simple for patients and the world.

The fact that half the countries in the world don't even recognize DO's or award them practice rights in those countries is disappointing, and stems from the unfamiliarity and unnecessary confusion.

Why fight to raise awareness, something that will take hundreds of years, when the problem can be solved with a very simple and agreeable fix?

Stop saying provider. I didn’t attend provider school.

 

[Kardio]

Why fight to raise awareness, something that will take hundreds of years, when the problem can be solved with a very simple and agreeable fix?

The AOA doesn’t find that to be an agreeable solution. They tried getting it converted to “MD, DO” (Diplomat in Osteopathy) a few years ago and it failed.

To become impactful within the AOA, allegedly you have to be a True Believer.

Furthermore, I don’t think it would be as impactful as you think. People who care about pedigree (like some PDs) will still know the nature of the school you went to.

 

[AlteredScale]

What do you think are the causes of the stigma and what are your ideas/actionable steps we can take as future DOs to eradicate it?

-improve research opps so that students who want it can easily get it
- increase GME contribution and make it as uniform across all DO schools as much as possible
-Reduce class sizes and improve faculty/student ratio. Or, make sure there's GME available first to accomodate the class.
-Advocate for a national system where resident rosters are seen as Dr. X MD/DO, school hidden
-Blind PDs from what school someone is from prior to the interview, only classify as CMG/AMG or IMG
-Advocate for a unified board exam to objectively compare ALL schools (MD/DO) and rank accordingly annually
-Promote a media campaign that physicians are MD/DO and promote unity within the house of medicine.
-Promote the idea that what truly matters and one should be judged on, is one's skill as a physician and how well you serve patients/humanity. Not place a large emphasis, if at all, on what school you came from.
-Only open schools if research and quality clinical rotations are set up
-Advocate for COCA and LCME to work together to ensure the highest standards possible.
-Get rid of non-evidence based parts of OMM or at least, have a disclaimer and let those parts be optional.
-Have mentors available for every specialty as early as first year.

To address some of OP's points:
-Research: very difficult to do without hiring successful researchers with strong EXTRAMURAL funding (I've seen so many internally funded researchers at DO schools). IMO, the initiative that will be needed is to create strong collaborations with MD schools who have the infrastructure to handle research needs (large biomedical research facilities which is difficult for many DO schools to find funding for at this time).
-GME: very difficult thing to do this as GME positions are dictated by funding as well as hospital resources.
-Resident roster: can see most department chiefs, PD's, and residency leadership not agreeing with this
-COCA: COCA will not work with the LCME as they will absolutely push that the goals of opening a DO school are too far different from that of an MD school (while on the other side there are advertisements saying how DO's and MDs are the same).
-OMM: With time I think new faculty that lead the OMM side of things will start to become more verbal in pursuing and focusing in on OMM techniques that are not as far-fetched as cranial or Chapmans points.
-Mentors: I think this should be adjusted to be mentors who are at a minimum, faculty within a residency program so that advice is given from someone who is aware of how GME works, is actively assisting in the process of selecting applicants, and can provide insightful information regarding how DO students should tailor their application but be successful. This is difficult to do with many DO schools (KCU in Kansas City has a class size of 270+ with FIVE internal medicine faculty of which 2, maybe 3, actually practice still and none of which are affiliated at all with the residency program KCU sponsors that is located in Joplin, MO....a couple hundred miles south of Kansas City.)

At this point in time and at least in IM, DO's with similar strong scores and research will not get the same sort of interviews as those at USMDs. This is a multifaceted issue that still includes some prestige bias. I have had a PD literally write down where I did my third year IM rotations and Sub-I's and heard through the grapevine that this same PD has asked DO applicants "why should I take you over an MD student when you have done rotations at places I have never even heard of and don't know if you've had the same tasks or schedules as MD students as third years" which is honestly a well thought-out concern and a part of the preference for MD vs. DO students. is it fair? no. I am sure I will get a response saying how there are MD schools with similar or worse DO rotations which I am sure there are, but the majority are not the model provided at DO schools (preceptor based model).

Ivory towers are looking for much more in their residents than a guarantee to pass residency boards with high board scores. They want leaders and innovators which by and large, is more easily cultivated at an MD school as there are more faculty (of which a number are leaders in their respected fields), more resources (not only in research but funding in programs to support other areas beyond medicine), and usually a more flexible curriculum (1.5 year, 1 year pre clinical model) allowing for more time to students to tailor their interests even more.

 

[AlteredScale]

Wanna breakdown the stigma in residency apps for DO? Most you can do is 700+ COMLEX 270+ step 1, get multiple pubs in reputable journals, and from what I gather the door may still closed to some programs. However, I bet a PD will look at your app twice.

Your scores and pubs will unfortunately not matter if a PD chooses to add the filter "USMD" on their side of ERAS. Not saying it won't get looked at but it will probably get looked at later if they haven't run out of interviews already with MD's who have the same stats, research, letter strength as yours. Then maybe they'll extend an interview and as such will rank you. But where they will rank you is truly different across each program.

 

[NurWollen]

Wait for real or are you just being facetious?

I hear for an easy 50k AUA will give you that MD you so want after DO school.

Sent from my SM-G930V using SDN mobile

 

[Osminog]

The best way to fix the “DO stigma” is to convert all DO schools into MD schools (thereby merging the degrees), hold them to LCME standards, end the NBOME’s money-making scheme known as the COMLEX, and eliminate OMM quackery.

There is no longer any reason to have two separate degrees. In the twenty-first century, anything that makes the DO degree unique (OMM, osteopathic “philosophy,” baseless claims about being holistic, etc.) is also what causes people to discriminate against it.

 

[scoopdaboop]

This thread is almost entirely about the most competitive specialties and programs. In these fields and programs, yes, pedigree is a overwhelmingly a huge deal and if you really have to downplay that with an irrelevant rant to feel better about it, go ahead. Doesn't change anything.

yeah. we all know this, but it's just criticizing the process, and it's lack of logic.

 

[Goro]

The best way to fix the “DO stigma” is to convert all DO schools into MD schools (thereby merging the degrees), hold them to LCME standards, end the NBOME’s money-making scheme known as the COMLEX, and eliminate OMM quackery.

There is no longer any reason to have two separate degrees. In the twenty-first century, anything that makes the DO degree unique (OMM, osteopathic “philosophy,” baseless claims about being holistic, etc.) is also what causes people to discriminate against it.

How about some suggestions that are rooted in reality???

 

[BorntobeDO?]

Wait for real or are you just being facetious?

Sent from my SM-G930V using SDN mobile

The answer is both. It was what I heard, but I am being facetious.

 

[Whysoez]

This is like a thread for little girls to tell one another about their dream weddings

 

[Kardio]

Your scores and pubs will unfortunately not matter if a PD chooses to add the filter "USMD" on their side of ERAS.

What do you think about the DOs in ACGME leadership lobbying to have that filter removed? Maybe forcing them to at least look at DO apps would have some effect over time (even if they continue discriminating based on school).

 

[sab3156]

What do you think about the DOs in ACGME leadership lobbying to have that filter removed? Maybe forcing them to at least look at DO apps would have some effect over time (even if they continue discriminating based on school).

If they are not taking DOs so that their program image doesn't take a hit (which is extremely common), simply removing the filter means nothing. You need to realize how little this bias has to do with the perception that DOs are incompetent - as I stated before, go talk to several PDs in a competitive specialty and ask them about it. Do you think there is a drought with respect to great applications from low tier or lower mid tier MD schools in competitive specialties or at competitive programs? These applications still sometimes get tossed in the trash at prestigious programs, unless they had considerable connections to the program. I can give you many examples that I personally know of from PDs and Chiefs directly. Once we come to this realization (that this is not a bias against DO competence, but rather a bias against the DO tier) we will realize that nothing will change and it is just a pipe dream that the bias will ever be removed. They're not filtering you because they think you are going to be incompetent - they're filtering you because your degree is going to make them look less competitive. It is so simple that it is mind-numbing.

 

[Kardio]

I understand your thoughts - they are all reasonable. I'm also sure that you have more experience in dealing with this than I have. Threads talking about programs like Cleveland Clinic neurology demonstrate your point clearly.

Do you think there is a drought with respect to great applications from low tier or lower mid tier MD schools in competitive specialties or at competitive programs? These applications still sometimes get tossed in the trash at prestigious programs

No, I don't - but there is no option (as far as I know) for PDs to filter out based on the reputation of a USMD school. There's a difference (if only symbolic) between clicking the "DOs be gone" button, and having to manually toss those apps in the trash yourself.

In my OP, I also said "even if they continue discriminating based on school." Symbolic wins are meaningful, even if not immediately impactful.

 

[2021Doctor]

One of my students matched at Hopkins last year. Not family med either.
To the OP. I think the horse is out of the barn with respect to DO stigma and residency matching. Remember why DO students were thrown out of acgme match several years ago? 500 MD students didnt match after the scramble. Parents and alums went ballistic because DOs were matching and their students were not.(Personal communication with one of my Deans)
AOA did the politically expedient thing by allowing merger to occur as AOA did not have enough slots for all DO grads. This has been discussed ad nauseam on SDN. What to do? As I said, I think the horse is out of the barn. Either DO degree will become MD, or it will represent a degree for primary care.
As for better clinicals? Big training hospitals are closing. Drexel and Wheeling to name 2. Big teaching hospitals are not being built. In our area, smaller, overnight hospitals are being built where very acute cases are sent to the regional center. I dont see an opportunity for inpatient resident medical training. Since Acgme in essence owns us, we are at their mercy
I agree with dropping enrollment by 33%. I'm frankly getting tired of twisting myself into a pretzel to get the bottom third to pass boards. As far as better clinicals,DO schools need to build/buy hospitals and convert them to teaching. It's not like they are in need of money.

I think the rampant expansion of new DO schools is making the issue worse and causing friction. MD schools want to make sure that their students get placed in residency and are feeling pressure to do so. The MD schools see the DO expansion as competition for residency slots. COCA's response to the issue: Eight new schools opening in 2019-2020: NSU-Clearwater, PCM-South Georgia, LMU Knoxville, CHSU Clovis, SHSU Conroe, VCOM Louisiana, OSU Tahlequah, LECOM ELmira. COCA is pouring gasoline on the fire imo.

 

[sab3156]

I understand your thoughts - they are all reasonable. I'm also sure that you have more experience in dealing with this than I have. Threads talking about programs like Cleveland Clinic neurology demonstrate your point clearly.



No, I don't - but there is no option (as far as I know) for PDs to filter out based on the reputation of a USMD school. There's a difference (if only symbolic) between clicking the "DOs be gone" button, and having to manually toss those apps in the trash yourself.

In my OP, I also said "even if they continue discriminating based on school." Symbolic wins are meaningful, even if not immediately impactful.

Yeah, I definitely get your point, and it is an interesting suggestion. I just think that these issues of prestige are too ingrained into the academic culture. Programs will always try to bolster their reputation, and if that means not taking DOs and IMGs so that they can keep attracting more Harvard and Stanford graduates, they're not going to stop. Lots of people in competitive specialties pay attention to the pedigree of residents, and that won't change, either. It is the same thing in my previous field of finance - my firm would not interview any MBAs from any school below the top 10ish. The COO told me that it was about the prestige of the firm and to make it look excellent, not just to take the brightest. None of those firms have a filter based on school, they just do it themselves and if someone with a low tier MBA has a connection or gets lucky, he might get in (just like what happens with DOs). But it does not change the overwhelmingly prevalent culture of prestige.