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

[BorntobeDO?]

I used to believe this until i heard a PD on SDN say he wont hire any more DOs as one he hired had never had an inpatient medical rotation. I was incredulous as this was far from my experience. I started investigating, talking to colleagues and current residents at our school and found this to not be unusual for some schools. There is also no way to play the elective rotation game to get this. How many 3rd and4th yrs students dont even realize this is a deficiency?This is not acceptable. Most residents are required to have inpatient responsibilities and should be somewhat comfortable with the emr and patient management.This needs to be corrected.

So I make clear at my interviews that I have done many months of inpatient IM and I have pushed for my school to list whether the rotation is inpatient or outpatient. They refuse to differentiate, and I always suspect that experiences like mine are covering for other places where its all outpatient.

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[BorntobeDO?]

Clinical experiences suck at a lot of the newer MD schools.
Third-year medical students at Orlando-based University of Central Florida can no longer complete clerkships at the region's two largest health systems, according to the Orlando Sentinel.

Altamonte Springs, Fla.-based AdventHealth and Orlando Health closed their doors to UCF when it chose HCA Healthcare as its partner for a new teaching hospital, which is slated to open next year. AdventHealth and Orlando Health are longtime partners of the university, and their support helped UCF earn approval to open a medical school more than 10 years ago, according to the report.

The split is a major loss for UCF — the two health systems hosted 40 percent of its clerkships, and student feedback on HCA sites has not been overwhelmingly positive, according to the report. For example, one student's end-of-year evaluation said, "HCA facilities are not good places to train. We are treated very poorly at HCA sites and there is very little going on," according to the report. The HCA sites in the area are community hospitals, which tend to have lower patient volumes and less complex cases.

Orlando Health and AdventHealth are continuing to partner with UCF in other ways, including offering training for nursing students.

Florida medical school loses 40% of student training sites after partnering with HCA

Third-year medical students at Orlando-based University of Central Florida can no longer complete clerkships at the region's two largest health systems, according to the Orlando Sentinel.

www.beckershospitalreview.com

This post is getting lost in the ruckus, but having lived in Orlando in the past and watching what UCF is doing, they are becoming like a DO school. The only good sites they had are the two large hospital systems they just lost. Its fairly annoying reading that article and seeing that they could have started more GME with powerhouses like OrlandoHealth or adventhealth (both have huge hospitals 900 and 1300 beds respectively in Orlando) but passed it up to work with HCA so they could own half of a 64 (lol) bed hospital. HCA has two small hosptials on some towns on the outskirts of Orlando Metro (read far away from downtown) and has no presence in the area with a couple hundred beds at most compared to 1000s at the other two. What greed and short sightedness.

 

[AlteredScale]

This post is getting lost in the ruckus, but having lived in Orlando in the past and watching what UCF is doing, they are becoming like a DO school. The only good sites they had are the two large hospital systems they just lost. Its fairly annoying reading that article and seeing that they could have started more GME with powerhouses like OrlandoHealth or adventhealth (both have huge hospitals 900 and 1300 beds respectively in Orlando) but passed it up to work with HCA so they could own half of a 64 (lol) bed hospital. HCA has two small hosptials on some towns on the outskirts of Orlando Metro (read far away from downtown) and has no presence in the area with a couple hundred beds at most compared to 1000s at the other two. What greed and short sightedness.

Will lake nona medical center (what is considered their teaching hospital to be built soon) only be a 64-bed hospital?

 

[Chibucks15]

Your point?

I agree the new schools are terrible, but there’s the fine line where if we don’t expand SOME schools then there will end up being more NPs and all that. I don’t wanna devolve this thread into that topic but we all know that’s not what anybody needs. The ‘lesser’ students go PC, filling a gap where it’s needed at least with better trained person than online empathy classes.

eventually some of the walls will break down a little bit for DOs, but it’ll always be an uphill battle at the top. Just like it is for some of the new MD schools

 

[Neopolymath]

I have made phone calls for my students and was faculty at a top 10 program. You should not make broad comments like that without any means to back them up.

Great. We found one kind person. Your students are lucky to have you.

 

[AnatomyGrey12]

I agree the new schools are terrible, but there’s the fine line where if we don’t expand SOME schools then there will end up being more NPs and all that. I don’t wanna devolve this thread into that topic but we all know that’s not what anybody needs. The ‘lesser’ students go PC, filling a gap where it’s needed at least with better trained person than online empathy classes.

eventually some of the walls will break down a little bit for DOs, but it’ll always be an uphill battle at the top. Just like it is for some of the new MD schools

1. Not really the point of the thread
2. We absolutely do not need to expand ANY schools. Doing so because "there will be more NP's if we don't" is a dumb reason for doing it.

 

[slowthai]

1. Not really the point of the thread
2. We absolutely do not need to expand ANY schools. Doing so because "there will be more NP's if we don't" is a dumb reason for doing it.

Furthermore, there will be more unmatched students secondary to this expansion because residencies aren't expanding at the same rate. And I think NPs will run themselves out of business eventually. It's a matter of time.

 

[slowthai]

Really. What basis do you have for that statement?
Here is some news:
November 26, 2019
At least 15 physicians have been fired from Edward-Elmhurst Health as the suburban Chicago-based health system moves to cut costs, sources told MedPage Today.
The doctors, who worked across its seven "Immediate Care" or urgent care sites, will be replaced by advanced practice nurses, according to an email sent by hospital leadership that was shared with MedPage Today. The physicians were informed late last week that they would be terminated as of April 1, 2020.

15 Doctors Fired From Chicago-Area Health System

Physicians 'broadsided' by their termination

www.medpagetoday.com

MD Kids Pediatrics will take over 13 of the locations, but a spokesperson confirmed it operates under a business model that relies more heavily on nurse practitioners and that some pediatricians will be let go. Current staff members declined to interview, but estimated more than two dozen pediatricians were losing their jobs.

CBS Texas - Breaking Local News, First Alert Weather & I-Team Investigations

Latest breaking news from CBS11 KTVT-TV | KTXA-TV.

dfw.cbslocal.com

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https://paeaonline.org/wp-content/uploads/2019/10/program-report-34-20191002.pdf

Two reasons: the number of midlevels graduating is exploding, so they will oversaturate their own market, like pharmacy and law. Secondly, after they get in trouble enough times (lawsuits) because they're operating outside of their license, I believe liability and/or laws will decrease their foothold, relative to physicians. I'm talking about independent midlevels here, of course.

 

[BorntobeDO?]

Will lake nona medical center (what is considered their teaching hospital to be built soon) only be a 64-bed hospital?

Correct, it is 64 now and it has a certificate of need to expand upto 100 beds total, but its not going to be a legit teaching hospital like the other two networks already had.

 

[BorntobeDO?]

Two reasons: the number of midlevels graduating is exploding, so they will oversaturate their own market, like pharmacy and law. Secondly, after they get in trouble enough times (lawsuits) because they're operating outside of their license, I believe liability and/or laws will decrease their foothold, relative to physicians. I'm talking about independent midlevels here, of course.

A pipedream on the lawsuit. If they are independent they will be judged by thier own, weak, cohert. A NP is compared to a similar NP as thier standard. You have to be pretty bad to fall below NP standard.

And I agree they have already oversaturated thier own market. The problem is that market is not independent of ours. There is quite a bit of overlap. How much this will effect us remains to be seen, but we do not operate in a vacuum. Its why I don't like the long term outlook of fields that midlevels are heavy in like primary care and ER. Right now both of those specialties are booming tho. Something will have to be done about the midlevels evenutally tho.

 

[MightBeACylon439]

Do we have evidence for this?

I mean the amount of likes I have for this comment is a kind of evidence I guess. If you did a google search for the type discussion this thread has worked out a million times you'll find similar comments. I personally experienced this. Many DO's in their intern years have expressed this to me.

As far as researched and compiled evidence? Probably not.

But let's play a fun game- describe a research project we could do to put together that could help us gather and present this evidence.

 

[Tozanzibarbymotorcar]

I mean the amount of likes I have for this comment is a kind of evidence I guess. If you did a google search for the type discussion this thread has worked out a million times you'll find similar comments. I personally experienced this. Many DO's in their intern years have expressed this to me.

As far as researched and compiled evidence? Probably not.

But let's play a fun game- describe a research project we could do to put together that could help us gather and present this evidence.

We could easily ask program directors. I have actually heard the opposite when it comes to intern year.

 

[hallowmann]

I mean the amount of likes I have for this comment is a kind of evidence I guess. If you did a google search for the type discussion this thread has worked out a million times you'll find similar comments. I personally experienced this. Many DO's in their intern years have expressed this to me.

As far as researched and compiled evidence? Probably not.

But let's play a fun game- describe a research project we could do to put together that could help us gather and present this evidence.

My anecdotal experience hasn't born this out. Intern year is a steep learning curve for everyone. People know that you all start at different levels, but it's more individual dependent who can adjust to it. From that perspective, I have not seen much of a difference. There are some DOs that struggle and it takes them 6 mos or more, and there are some MDs that do the same. It says more about them than their previous clinical experience.

I've seen plenty of MDs (and some DOs) that struggle to separate themselves from med students 6 or even 9 mos in, those are the people that are a pain to work with, that everyone hears about and that are often in remediation. The DOs I've worked with that have bad med school rotations have a slightly steeper hill in the beginning, but the good docs meet the challenge. You'll see it when you get there.

To all the med students, your goal, just as important as straight medical knowledge, is your ability to adapt quickly to roles and varying responsibilities.

 

[AlteredScale]

I mean the amount of likes I have for this comment is a kind of evidence I guess. If you did a google search for the type discussion this thread has worked out a million times you'll find similar comments. I personally experienced this. Many DO's in their intern years have expressed this to me.

As far as researched and compiled evidence? Probably not.

But let's play a fun game- describe a research project we could do to put together that could help us gather and present this evidence.

Well we can start with subjective data gathering using surveys. Then from there, we could choose programs that have similar early, scheduled OSCE's and then use that subjective data along with school type (DO vs MD) as well as other potential influencing factors such as scores and number of inpatient core IM rotations to determine a potential association between such experiences and perceived vs. actual difficulty.

(To whoever ends up publishing this, you better put me on the author list.)

 

[MightBeACylon439]

Well we can start with subjective data gathering using surveys. Then from there, we could choose programs that have similar early, scheduled OSCE's and then use that subjective data along with school type (DO vs MD) as well as other potential influencing factors such as scores and number of inpatient core IM rotations to determine a potential association between such experiences and perceived vs. actual difficulty.

(To whoever ends up publishing this, you better put me on the author list.)

Altered you’re like me but smarter, nicer, and harder working.

 

[AnatomyGrey12]

Well we can start with subjective data gathering using surveys. Then from there, we could choose programs that have similar early, scheduled OSCE's and then use that subjective data along with school type (DO vs MD) as well as other potential influencing factors such as scores and number of inpatient core IM rotations to determine a potential association between such experiences and perceived vs. actual difficulty.

(To whoever ends up publishing this, you better put me on the author list.)

Altered Scale et al

 

[AlteredScale]

Altered you’re like me but smarter, nicer, and harder working.

impossible. I am but a medical student. Appreciate the kind words though <3

 

[DrStephenStrange]

Well we can start with subjective data gathering using surveys. Then from there, we could choose programs that have similar early, scheduled OSCE's and then use that subjective data along with school type (DO vs MD) as well as other potential influencing factors such as scores and number of inpatient core IM rotations to determine a potential association between such experiences and perceived vs. actual difficulty.

(To whoever ends up publishing this, you better put me on the author list.)

Altered Scale et al

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