Can't DOs just attend a AOA residency if they want to specialize?

[mary3x]

I may be a naive pre-med, but I have read a lot about how it is difficult to specialize if you go to a DO School because ACGME residences will automatically rank you below MD counterparts, even if you have higher board scores.

BUT for DOs that would like to specialize, can't they just go to an AOA speciality residency?

Just wondering...

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[Goro]

Yes, but it will still depend upon how competitive the student is.

Also forgot to mention that there are more DO grads that there are AOA residencyies.

 

[DeezNutzonUrChin]

Yes, but it will still depend upon how competitive the student is.

Also forgot to mention that there are more DO grads that there are AOA residencyies.

Its also on board scores and I think that merge might change this right?
For example the MD's who dont match anywhere and the handful of DO's who match into something competitive like radiology etc prove that it's not just title.

 

[Marrowist]

Aren't we about to experience "The Merge?", I think I understand but someone elaborate please. Thank you.

 

[John Buster]

Yes, but it will still depend upon how competitive the student is.

Also forgot to mention that there are more DO grads that there are AOA residencyies.

What effect will the merge have on this?

 

[Goro]

Haven't a clue. My analogy is that it will be a diffusionary process. How fast things can cross the membrane will be dependent upon pore size....the pores being the attitudes of PDs.

What effect will the merge have on this?

 

[Goro]

It starts in 2020 and ACGME will be responsible for all residency programs. There will be only a single match.

Aren't we about to experience "The Merge?", I think I understand but someone elaborate please. Thank you.

 

[nlax30]

I may be a naive pre-med, but I have read a lot about how it is difficult to specialize if you go to a DO School because ACGME residences will automatically rank you below MD counterparts, even if you have higher board scores.

BUT for DOs that would like to specialize, can't they just go to an AOA speciality residency?

Just wondering...

I think there's a lot of generalizations made here and honestly there's so many variables that go into this process that it would be impossible to give a straightforward answer.

In GENERAL I wouldn't say that ACGME residencies automatically rank you below an MD counterpart. Does it happen? Sure. There are still programs I'm sure that just will not accept a DO for whatever reason but again that's a very general statement.

But yeah, currently a DO would have the option of going into an AOA residency OR an allopathic/MD residency. Of course that's about to the change with this whole "merger" business. (Not really sure about the 'merger' aspect of it as the transition part is really about AOA programs now becoming accredited by the ACGME...) How this will change things ultimately I don't think we know. Based on my experience sitting on committees at my home DO program there has been a lot of confusion in general about the merger and the focus has been on just transitioning over to ACGME rules/regs and getting accredited.

 

[nlax30]

I think a take home point is it's probably useless to worry too much about that sort of stuff now. There are too many variables involved and the focus should be on doing well in undergrad to get into X or Y med school (whether that be MD or DO), then do well in med school while narrowing down you list of potential specialities to make yourself as good a candidate as possible.

There's always going to the extreme cases of someone absolutely dead set on going to an IVY league school followed by a prestigious Neurosurgery program that is the ONLY fit speciality wise for them and if that's the case then yea, it would certainly be wise to go for the prestigous allopathic school and residency program.

 

[IslandStyle808]

I may be a naive pre-med, but I have read a lot about how it is difficult to specialize if you go to a DO School because ACGME residences will automatically rank you below MD counterparts, even if you have higher board scores.

BUT for DOs that would like to specialize, can't they just go to an AOA speciality residency?

Just wondering...

Well, it is not so much that they automatically rank DOs under MDs. They make it harder in several ways. The first thing is that program directors use a DO filter to filter out any DO application. This means if a DO had a 270 USMLE score (insanely high score) then they wouldn't see it what so ever. So this can take out a large chunk of potential programs that all MDs are invited to (this is dependent on how competitive the specialty is). The second thing is that DOs have to meet higher standards when receiving an interview. So a DO student would have to have a higher USMLE score than a US MD to receive the an interview invite. This is what weeds out DOs mostly.

However, this doesn't mean all program see DOs this way. There are some that will take the best person no matter what the school US MD, US DO, IMG (such as certain Mayo or Clevland Clinic residencies). I believe in PM&R a DO is judged on equal ground to an MD, this is one of the exceptions to the rule.

As to the question of can't DOs go to AOA residencies in order to match into competitive specialties, the answer is that they can but there are too few AOA programs. As it stands, there are far more DOs than AOA programs. So this right here is the issue of why DOs have a hard time matching.

Aren't we about to experience "The Merge?", I think I understand but someone elaborate please. Thank you.

What effect will the merge have on this?

The merger will put all AOA residencies under the management of the ACGME. A lot of this stemmed from the fact that DOs from AOA residencies were under prepared for ACGME fellowships. With the increase of the amount of DOs, the ACGME wanted to put the reigns on the physicians coming out of these programs. This is why the merger is occurring.

As for the impact of the merger, a lot is unknown as to how PDs will treat DOs in the future. However, this change was a necessary one to ensure DO quality rises. When DO come out of these programs in 2020, the quality level of their training will be much higher over all. This means a better shot at fellowship and less doubt from future employees about the quality of training.

 

[MADD!!!]

Yes, but it will still depend upon how competitive the student is.

Also forgot to mention that there are more DO grads that there are AOA residencyies.

A lot more, unfortunately

I think if the AOA had enough spots for all DO students, they would have had better leverage for the upcoming merger.

 

[Goro]

Tell that to the AOA, please.

A lot more, unfortunately

I think if the AOA had enough spots for all DO students, they would have had better leverage for the upcoming merger.

 

[Mad Jack]

I may be a naive pre-med, but I have read a lot about how it is difficult to specialize if you go to a DO School because ACGME residences will automatically rank you below MD counterparts, even if you have higher board scores.

BUT for DOs that would like to specialize, can't they just go to an AOA speciality residency?

Just wondering...

There are no more AOA residencies as of 2020, when all programs are required to be ACGME accredited or close.

 

[Mad Jack]

Well, it is not so much that they automatically rank DOs under MDs. They make it harder in several ways. The first thing is that program directors use a DO filter to filter out any DO application. This means if a DO had a 270 USMLE score (insanely high score) then they wouldn't see it what so ever. So this can take out a large chunk of potential programs that all MDs are invited to (this is dependent on how competitive the specialty is). The second thing is that DOs have to meet higher standards when receiving an interview. So a DO student would have to have a higher USMLE score than a US MD to receive the an interview invite. This is what weeds out DOs mostly.

However, this doesn't mean all program see DOs this way. There are some that will take the best person no matter what the school US MD, US DO, IMG (such as certain Mayo or Clevland Clinic residencies). I believe in PM&R a DO is judged on equal ground to an MD, this is one of the exceptions to the rule.

As to the question of can't DOs go to AOA residencies in order to match into competitive specialties, the answer is that they can but there are too few AOA programs. As it stands, there are far more DOs than AOA programs. So this right here is the issue of why DOs have a hard time matching.






The merger will put all AOA residencies under the management of the ACGME. A lot of this stemmed from the fact that DOs from AOA residencies were under prepared for ACGME fellowships. With the increase of the amount of DOs, the ACGME wanted to put the reigns on the physicians coming out of these programs. This is why the merger is occurring.

As for the impact of the merger, a lot is unknown as to how PDs will treat DOs in the future. However, this change was a necessary one to ensure DO quality rises. When DO come out of these programs in 2020, the quality level of their training will be much higher over all. This means a better shot at fellowship and less doubt from future employees about the quality of training.

Actually, the real impetus behind the merger was the federal government and CMS got sick of dealing with two residency systems, so they pushed the ACGME to consolidate. That's some behind-the-scenes stuff though.

 

[AlbinoHawk DO]

I may be a naive pre-med, but I have read a lot about how it is difficult to specialize if you go to a DO School because ACGME residences will automatically rank you below MD counterparts, even if you have higher board scores.

BUT for DOs that would like to specialize, can't they just go to an AOA speciality residency?

Just wondering...

It is not as simple as you think. While there are DO residencies, these are very limited and some of questionable quality. For example, in derm there are those that you just spend all day shadowing a guy at his private office. There is a lot of brown nosing too. Some people get in just because the residency director likes them.

 

[DeezNutzonUrChin]

It is not as simple as you think. While there are DO residencies, these are very limited and some of questionable quality. For example, in derm there are those that you just spend all day shadowing a guy at his private office. There is a lot of brown nosing too. Some people get in just because the residency director likes them.

That and Ive heard it is actually not as bad as it sounds. Arent some ABCDEFGHIJK (allopathic residencies) able to weigh DO and MD the same. My cousin got an Allo neurosurgery residency with decent board scores and research etc with a DO degree. This was at George Washington Hospital where I think they take 3 residents a year, she was chosen over students from top MD schools. I dont think DO screws you at all for many places.

 

[AlbinoHawk DO]

That and Ive heard it is actually not as bad as it sounds. Arent some ABCDEFGHIJK (allopathic residencies) able to weigh DO and MD the same. My cousin got an Allo neurosurgery residency with decent board scores and research etc with a DO degree. This was at George Washington Hospital where I think they take 3 residents a year, she was chosen over students from top MD schools. I dont think DO screws you at all for many places.

It is as bad as it sounds. It all depends on the PD, but by the most part, DO does screw you from the better places or more competitive specialties.

 

[MADD!!!]

It is as bad as it sounds. It all depends on the PD, but by the most part, DO does screw you from the better places or more competitive specialties.

Sorry but I have to disagree. I think your board scores and individual efforts will present a more significant effect on your chances for speciality.

Yea, if student A and student B got the same board scores, neither did research, and the PD has ONLY this information to go off of, then probably the student with the MD has a better chance. But other variables, like your board scores, research, audition rotations, your personal characteristics, are all important factors. Someone can sit here saying I didn't get in because of X, Y, and Z, or someone else could say "I'm going to make this happen, regardless of X, Y, and Z"

 

[AlbinoHawk DO]

Sorry but I have to disagree. I think your board scores and individual efforts will present a more significant effect on your chances for speciality.

Yea, if student A and student B got the same board scores, neither did research, and the PD has ONLY this information to go off of, then probably the student with the MD has a better chance. But other variables, like your board scores, research, audition rotations, your personal characteristics, are all important factors. Someone can sit here saying I didn't get in because of X, Y, and Z, or someone else could say "I'm going to make this happen, regardless of X, Y, and Z"

Okay, Pre-med. Thanks for letting us know.

 

[IslandStyle808]

That and Ive heard it is actually not as bad as it sounds. Arent some ABCDEFGHIJK (allopathic residencies) able to weigh DO and MD the same. My cousin got an Allo neurosurgery residency with decent board scores and research etc with a DO degree. This was at George Washington Hospital where I think they take 3 residents a year, she was chosen over students from top MD schools. I dont think DO screws you at all for many places.

Sorry but I have to disagree. I think your board scores and individual efforts will present a more significant effect on your chances for speciality.

Yea, if student A and student B got the same board scores, neither did research, and the PD has ONLY this information to go off of, then probably the student with the MD has a better chance. But other variables, like your board scores, research, audition rotations, your personal characteristics, are all important factors. Someone can sit here saying I didn't get in because of X, Y, and Z, or someone else could say "I'm going to make this happen, regardless of X, Y, and Z"

There is definitely data that supports the fact that DOs aren't treated the same as US MD. Here is the 2014 program director's survey report:

http://www.nrmp.org/wp-content/uploads/2014/09/PD-Survey-Report-2014.pdf

Many programs just won't interview/rank DOs in the more competitive fields. For example, in neurosurgery only 21% of programs interview/rank DOs while 96% of programs interview/rank US MD students. And here is the kicker, you have a better shot matching into neurosurgery from a caribbean school (40% of programs interview/rank IMGs). However, the opposite is true for almost all other fields (where more programs interview/rank DO than IMGs).

I think it is also time that I introduce to you the concept of the non-LCME filter that PDs use. PDs have filters for various variables when looking at candidates this includes board scores, region, and yes even DO status. Let say you had a USMLE score of 270 as a DO. If a PD were to put a DO filter when looking at applicants, it is as if your application never existed to begin with! So they would have never seen you get a 270 at all, since your application was filtered (like GPA or MCAT filters that DO schools use). This is what eradicates DOs from the US MD pile and the strongest contributing factor to DOs not matching into ultra competitive specialties and top tier programs.

I'm not even getting into the MD = DO + 10 on the USMLE aspect either...

Yes, there are many other reasons why DOs are not selected (ex. no specialty specific research, lack clinical rotations with residencies, no excellent LORs from big shot physicians). However, don't think for a second that their isn't a DO bias even when you have the full package.

 

[MADD!!!]

First off, @AlbinoHawk DO, I'm sorry if my post came off the wrong way. The information I've shared is from the information I've gathered from those above me, and not from personal experiences. I fully understand I could be wrong and acknowledge that you probably do have more insight into this than I do.

To @IslandStyle808, I also agree with you that a bias does exist, and having the DO title is an additional barrier for some programs. But like the process I've seen this far, it reduces your chances, but doesn't eliminate it. For example, I'm a pre-med and I have little to no research experience. There are some medical schools that would basically screen me out because of this reason, but some might not care. Yea, even with a very high MCAT and very high GPA I still wouldn't be competitive for an Ivy league, but I'd still get in somewhere right? With that argument, if someone has a 270 USMLE score and is a DO, I'm sure there are schools like you said that would screen them out on that basis, but I'm also assuming that some others wouldn't and the applicant would get in somewhere most likely?

Correct me if I'm wrong, but this is the perception I currently have.

 

[hallowmann]

There is definitely data that supports the fact that DOs aren't treated the same as US MD. Here is the 2014 program director's survey report:

http://www.nrmp.org/wp-content/uploads/2014/09/PD-Survey-Report-2014.pdf

Many programs just won't interview/rank DOs in the more competitive fields. For example, in neurosurgery only 21% of programs interview/rank DOs while 96% of programs interview/rank US MD students. And here is the kicker, you have a better shot matching into neurosurgery from a caribbean school (40% of programs interview/rank IMGs). However, the opposite is true for almost all other fields (where more programs interview/rank DO than IMGs).

I think it is also time that I introduce to you the concept of the non-LCME filter that PDs use. PDs have filters for various variables when looking at candidates this includes board scores, region, and yes even DO status. Let say you had a USMLE score of 270 as a DO. If a PD were to put a DO filter when looking at applicants, it is as if your application never existed to begin with! So they would have never seen you get a 270 at all, since your application was filtered (like GPA or MCAT filters that DO schools use). This is what eradicates DOs from the US MD pile and the strongest contributing factor to DOs not matching into ultra competitive specialties and top tier programs.

I'm not even getting into the MD = DO + 10 on the USMLE aspect either...

Yes, there are many other reasons why DOs are not selected (ex. no specialty specific research, lack clinical rotations with residencies, no excellent LORs from big shot physicians). However, don't think for a second that their isn't a DO bias even when you have the full package.

Thanks. Was planning on making a big reply like yours, but you did it for me.

First off, @AlbinoHawk DO, I'm sorry if my post came off the wrong way. The information I've shared is from the information I've gathered from those above me, and not from personal experiences. I fully understand I could be wrong and acknowledge that you probably do have more insight into this than I do.

To @IslandStyle808, I also agree with you that a bias does exist, and having the DO title is an additional barrier for some programs. But like the process I've seen this far, it reduces your chances, but doesn't eliminate it. For example, I'm a pre-med and I have little to no research experience. There are some medical schools that would basically screen me out because of this reason, but some might not care. Yea, even with a very high MCAT and very high GPA I still wouldn't be competitive for an Ivy league, but I'd still get in somewhere right? With that argument, if someone has a 270 USMLE score and is a DO, I'm sure there are schools like you said that would screen them out on that basis, but I'm also assuming that some others wouldn't and the applicant would get in somewhere most likely?

Correct me if I'm wrong, but this is the perception I currently have.

This is generally true, but depends on the field. Regardless of how great an applicant is, there are still fields that are so difficult to match into, its very possible to have amazing stats as a DO and not find one to match into. Now that DO with a 270 will still be fine, but its very possible that they may not match into ACGME ENT, Derm, or NS, they'll match into their backup specialty (Anesthesia, Path, or Neuro for example). The only exception to this is if you have some sort of connection with the program that others don't have.

This is also completely ignoring the fact that getting a 270 (or even 260+) on the USMLE is so much harder than the 240s that US MDs can get and still match that it makes it virtually meaningless for the vast majority of DOs.

 

[IslandStyle808]

First off, @AlbinoHawk DO, I'm sorry if my post came off the wrong way. The information I've shared is from the information I've gathered from those above me, and not from personal experiences. I fully understand I could be wrong and acknowledge that you probably do have more insight into this than I do.

To @IslandStyle808, I also agree with you that a bias does exist, and having the DO title is an additional barrier for some programs. But like the process I've seen this far, it reduces your chances, but doesn't eliminate it. For example, I'm a pre-med and I have little to no research experience. There are some medical schools that would basically screen me out because of this reason, but some might not care. Yea, even with a very high MCAT and very high GPA I still wouldn't be competitive for an Ivy league, but I'd still get in somewhere right? With that argument, if someone has a 270 USMLE score and is a DO, I'm sure there are schools like you said that would screen them out on that basis, but I'm also assuming that some others wouldn't and the applicant would get in somewhere most likely?

Correct me if I'm wrong, but this is the perception I currently have.

My views on matching are actually more similar to yours. I definitely know of a few cases on SDN where DOs with below 240 on the USMLE have matched into highly competitive specialties. On the charting outcomes report of 2014, there was one DO that matched into Radiation Oncology with a USMLE of 230. So yes there is more wiggle room for DOs than most of us once thought. You can match into these fields, but it is risky. And quality of the program can matter even in fields like IM, where one goes to residency can affect ones chances at a competitive fellowship (GI, cards, heme/onc).

The take home point is that when you have $300k of debt looming over you, your ability to take risks diminishes. You are not sweating it nearly as much applying for medical school because you, like most people, come into it already having paid for their undergraduate degree. You may think a 70% chance of matching seems like good odds, but with that debt looming over you it looks like bad odds.

 

[DeezNutzonUrChin]

My views on matching are actually more similar to yours. I definitely know of a few cases on SDN where DOs with below 240 on the USMLE have matched into highly competitive specialties. On the charting outcomes report of 2014, there was one DO that matched into Radiation Oncology with a USMLE of 230. So yes there is more wiggle room for DOs than most of us once thought. You can match into these fields, but it is risky. And quality of the program can matter even in fields like IM, where one goes to residency can affect ones chances at a competitive fellowship (GI, cards, heme/onc).

The take home point is that when you have $300k of debt looming over you, your ability to take risks diminishes. You are not sweating it nearly as much applying for medical school because you, like most people, come into it already having paid for their undergraduate degree. You may think a 70% chance of matching seems like good odds, but with that debt looming over you it looks like bad odds.

What is the potential for a DO to go into industry ?
I know about a dozen physicians who went into medical insurance, medical device companies, a few went abroad. They ended up making a lot of money. However I only know MD's who did this. So if paying off debt when no residency is available is a problem, then this is a solution.
Have you seen any DO's follow a similar pathway?

 

[IslandStyle808]

What is the potential for a DO to go into industry ?
I know about a dozen physicians who went into medical insurance, medical device companies, a few went abroad. They ended up making a lot of money. However I only know MD's who did this. So if paying off debt when no residency is available is a problem, then this is a solution.
Have you seen any DO's follow a similar pathway?

I cannot really give an answer to this one. The purpose of the DO/MD degree is to match into residency and then practice medicine. So anything that deviates from this is risky, since it is not the intended purpose of the degree. If you want to pursue this path, I highly suggest doing a residency and then getting board certified. This way if the industry business doesn't pan out then you can go back to practicing medicine. An DO/MD degree is not worth much without a residency.

 

[DeezNutzonUrChin]

I cannot really give an answer to this one. The purpose of the DO/MD degree is to match into residency and then practice medicine. So anything that deviates from this is risky, since it is not the intended purpose of the degree. If you want to pursue this path, I highly suggest doing a residency and then getting board certified. This way if the industry business doesn't pan out then you can go back to practicing medicine. An DO/MD degree is not worth much without a residency.

eh understood, just curious if they would hire a DO after residency in industry.

 

[mary3x]

How about non-competitve residencies like Internal Medicine or Pediatrics? Can DOs with good board scores compete with comparable MD students for these spots?

I was just looking at UMass Med internal medicine...they had a decent amount of DOs and IMGs..

 

[Mad Jack]

How about non-competitve residencies like Internal Medicine or Pediatrics? Can DOs with good board scores compete with comparable MD students for these spots?

I was just looking at UMass Med internal medicine...they had a decent amount of DOs and IMGs..

That's because UMass is a low tier academic program. DOs can attend such places just fine, but they'd better have comparable board scores to their MD counterparts.

 

[IslandStyle808]

eh understood, just curious if they would hire a DO after residency in industry.

I have no idea if having the DO degree is an issue, I would assume not though.

 

[gyngyn]

eh understood, just curious if they would hire a DO after residency in industry.

I have known several DO's who run clinical trials for Pharma.

 

[IslandStyle808]

How about non-competitve residencies like Internal Medicine or Pediatrics? Can DOs with good board scores compete with comparable MD students for these spots?

I was just looking at UMass Med internal medicine...they had a decent amount of DOs and IMGs..

Unfortunately the same concept applies here also. It is not just the fact the entire field is competitive (ex. derm, plastics, neurosurg), but also the fact that even highly regarded programs in less competitive fields (IM, peds, psych) can be highly competitive. For instance, Internal Medicine at Mass General (Harvard's program) has no Caribbean or DO students. This is because they are at the top of internal medicine, and they have so many applicants that they will do anything to weed them out (this an even includes weeding out DOs).

When you start going toward the lower and mid tier academic programs, these programs will start looking at DOs and even IMGs. This is because they want smart and highly motivated people in their program rather than a US MD that just skated by. This is how the matching game works.