Combined Match cage rattling

[Pikevillemedstudent]

I think it is actually much simpler than everyone is making it out to be. It all comes down to convenience for the applicant, and really nothing to do with closing DO programs. I mean who are we kidding, do you think that there is going to be some mad flux of DO's to MD land? Md residencies take basically the same percentage and numbers of DO's across all specialties each year, and that is not going to change because you make it easier to apply to the MD programs. MD programs still by and large will want to fill their spots with MD's (or top DO or FMG applicants), and average DO's and FMG's next. Its like saying that if you open up NFL training camp to anyone that wants to try out, that there will be an efflux of players from the CFL and the CFL will be done for. I mean lets not kid ourselves again and think that average or beloiw average DO students are now all of a sudden going to get their pick in the MD residencies because it becomes easier for them to apply. In the end, a few primary care DO residencies that suck will have to close or compete. Oh well, life goes on, and they should probably have lost their accreditation anyway. I mean go to scutwork.com and check out some of the FP and IM DO residencies and read what the residents have said about them. Some say things about how their hospital is lucky to have an average daily census of 6 patients!!!

But the specialty DO residencies will not see anything but an improvement in the competition among applicants for their programs. For instance, there are a several people in each class per year that want to do ortho, ENT, Derm, Ophtho, or Neurosurg, and probably right now 5-10% of them will be lucky enough to an MD spot. If you open up all the MD and DO residencies and make them all available to these applicants in one match, my guess is that you will end up simply shifting a few applicants around, but in the end you will end up with the same number going MD as before.

It says a lot about the confidence of the DO programs when they without any facts basically state on record that they feel a joint match would do them in. They must know that something is bad about their program I guess. If you look at the way the ACGME programs use the internet to attract applicants, you will see what I mean. Go to AAFP.com and see how awesome the residency search program works, and see how incredible the websites are for each program. Then go to ACOFP.org and see how crappy their website (though improving) is. Most programs have dead links, or worse than that, the link takes you to some hospital's page but has no real information on the residency. Times have changed, and people no longer rely so much on the interview to choose a program. Smart candidates have spent months researching programs on the internet, using these great websites to contact residents from those programs and unearth great info. If the AOA wants to compete, it needs to take an active role and do the same thing. Go to AOA's website and simply try to find a link to the specialty organizations and their residencies. For some specialties the best you will find is a list, and then you have to go back to the tricks of the early 90's and actually have to call and "request a packet". Who the hell wants to go through that crap?

If the AOA wants to compete, then it should start with things like this!!

I don't really think it is that simple. Everything you wrote is based on your opinion. Alot of what I wrote is based on opinion as well because neither of us knows what will happen.

No one said the average to low DO grad would get their pick of ACGME programs. But I did say more would rank ACGME programs and it only stands to reason that more would eventually match to ACGME programs. That's how the math works. The more you rank, the better your chances. Hence less DO grads in AOA programs. That's a real possiblity and I think that if you don't see it, you are blinded by your own joint match bias.

As for specialty residencies. I never said they would have any problems. You would still get 100 applicants for ortho even if it was in Siberia. I said the associated primary care and other non comp. residencies at the same hospitals would experience problems. This could lead to decrease GME funding at the larger DO hospitals.

Wait you like the internet site for ACGME programs better and that's why you are applying to their programs? If you don't want "to go through that crap" to see which program is best for you, more power to you. I just don't think that is a wise decision.

It seems everyone has made up their mind on the joint match already so I think I will probably just give up. Most have said "hey it's simple, it's just better for students". Nothing is ever that simple.

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[PACtoDOC]

I honestly don't think you get it at all PV. And my guess is that you are someone that is nowhere near ready to apply for residency. But lets use an example to help you through this. I have known for 3 solid years that I would be going into family medicine. I also chose to come to a DO school because I felt it would make me a better FP than MD school would. I certainly would have preferred to have avoided the headache of having the DO initials, but I felt the training was (and still believe) better than any MD training in my part of the world for what I wanted to do. Had I wanted to do surgery or specialty medicine, I would have never accepted a DO spot.

I started looking into family medicine residencies my first year. I started with the ACOFP and requested a list of their residencies, because there was no website listing. I found it very hard to learn anything truly useful about these programs though because they are bad about returning emails, slow if ever to send out info, and just this year began to appeal to us with websites (and most are primitive). I also started looking at AAFP residencies because their website was simply stunning. In seconds I could learn about the backgrounds of the residents I might be working with as my upper levels, find out their pay, their benefits, their rankings on scutwork (which by the way has few if any DO feedbacks), and could write their program directors directly. I have gained so much info by communicating directly with the residents, the faculty, and I have never experienced anything but complete red-carpet treatment by the people I have contacted. One program flew me up to see them and paid for my weekend there with my wife in 3rd year. And several others have paid for my dinners, hotels, or at least spent a great deal of time with me. All this before interview season. The DO side of the house for some reason does not seem to feel it is necessary to recruit or communicate with students. I just think they have become either burnt out or complacent over the last decade, and thus its like getting blood from a turnip to get useful info from them.

Not wanting though to give up on them, I paid out of my own pocket to fly to Phoenix this year for the ACOFP conference, and I went to the residency fair there. It was truly pathetic. There were probably less than 30% of all programs there, and the ones that were there made a rather poor effort at recruiting. For one thing, I noticed that the pay at most of the programs was rather bad, something like 5-10K less per year than the average ACGME FP program. Now I did meet some very nice program directors who were genuinely interested in recruiting, but having already experienced the AAFP residency fair, there was no comparrison. See, ACGME programs seriously had to start recruiting 10 years ago when FP became less competitive, and they still have to because there are so many of them. ACOFP programs as of yet have really done a poor job reaching out to their own students. I get a large envelope in the mail probably 3 times a week from an FP program because I am an NHSC scholar. The AAFP obviously paid for the list of names on this scholarship, but I have yet to receive any recruiting material from a DO FP residency other than my home program. And what I don't like about my home program is that they do not teach or care about OMT at all. In fact, for the 3rd year FP residents, they recruited medical students and OMM residents to teach a crash refresher course to them so that they could pass their manip portio of boards. So if you think you are going to a DO program in order to continue your manip, you better check it out thoroughly to find out, but don't bother using the internet because you will not find much. Short of spending thousands of dollars to go visit every FP DO residency in the country, you won't find another way to find out much about most DO FP programs. I think this is changing though with ACOFP's desire to bring things to the internet, and this could be a really positive change.

Lastly, I think the "chicken little, the sky is falling" mentality of a joint match is simply hilarious. We DO's have a really big ego if we believe that we can simply walk into the ACGME match and take it over. As I said in my previous point, and as Pikeville did not quite grasp, the "math" involved is really pretty simple and one sided. There are presently something like 2500 DO's that match in the ACGME each year, a number that has been steady and slightly climbing for years. The climbing is because there is good eveidence to show that more DO's are being graduated, with more DO programs closing than opening. The problem of DO programs closing is not because of a joint match obviously, because this is still only a proposition. So how do you explain this lack of DO graduate training even in the current time period? But what I am really trying to emphasize is this. Even in FP, probably the most unmatched specialty in medicine, most programs eventually fill within a few days of match day with scrambling MD's. Only a few truly empty seats remain around. So because of this, how do you think it is going to bring more DO's to the ACGME programs if they are already taking the maximum number they can accomodate now? Think of it this way. 50% of AOA program seats are unmatched in areas of primary care now. If all of a sudden next year we have a joint match, and all these people who would have ended up in DO programs decide to apply to both MD and DO programs, guess what happens? The same number of DO's end up in ACGME programs as before!!!!!!!!!!!!!!!!

Did you not understand my NFL analogy Pikeville? Here, I will try a different analogy then. Imagine that Kentucky medical schools decided to drop admission's standards to allow admission without taking the MCAT, and without the required organic and physics courses. Do you really believe that overnight the people in Kentucky would be placed at risk because now Kentucky physicians would be less qualified? OF COURSE NOT, because the natural supply of medical school applicants would still be overly plentiful, and the ones who really wanted to be competitive would meet these qualifications regardless of Kentucky lowering their standards. So what I am getting at is this. If the average ACGME program routinely fills its 10 spots with 7 MD's, 2 DO's, and 1 FMG, do you really believe that if they get more DO applicants that they will take less MD's? These MD students have to have a place to go as well you know, and if overnight all 5000 DO grads a year started coming to ACGME programs and abandoning DO programs, that would mean that ZERO FMG's would be coming to the US, and that some 2000 MD grads would be left without a residency in their own system. That is simply not going to happen.

True, a joint match could create more competition all around for ACGME and DO programs, but that is only a good thing. Right now the majority of the ones competing for me from my vantage point are ACGME or dual programs, and the reason the dual programs compete is because they are the smart ones. They are usually former ACGME-only programs that have merged with the DO world to ensure a steady stream of DO's coming into their program, and this basically guarantees that they will always fill those 2-3 non-MD slots in the match.

I really don't think anyone should comment though on the difficulties that are experienced without a joint match unless you are in a position to have gone through this chaos. I have been lucky enough to have found a great dually accredited program where I feel at home, and I can only hope I end up there. But these PMR guys and others who are doing a traditional year in waiting for PGY2 specialty positions, this crap is really a tough thing. I can just confidently strate that the DO programs are losing out on the absolute best graduates year after year, because these sharp people want to at minimum follow their dream of going to a place like Hopkins or Mayo. But to even shoot for their top spot, they will have to completely forgo a chance of landing a slot at a respectable AOA program where they might have been equally happy to end up when their dream did not materialize. My bet is that of the top DO grads that apply to these incredible programs, only a small percentage end up there. And when they don't end up there, they settle for a mediocre MD program simply because they were not able to rank even their home AOA program or other AOA programs. I have seen it over and over again where someone in the top 10% with great board scores shoots for a place like UCSF and end up at Wright State or some Meharry affiliated program. Now I am not saying that these programs are bad programs, but my guess is that these students might have been just as happy ending up in the same specialty at Pontiac DO hospital or at Tulsa regional. Because when you get out of the realm of the incredible programs with money and pathology flying out of their butts, most run of the mill MD and DO programs are one in the same in the quality of training.

 

[Pikevillemedstudent]

I honestly don't think you get it at all PV. And my guess is that you are someone that is nowhere near ready to apply for residency. But lets use an example to help you through this. I have known for 3 solid years that I would be going into family medicine. I also chose to come to a DO school because I felt it would make me a better FP than MD school would. I certainly would have preferred to have avoided the headache of having the DO initials, but I felt the training was (and still believe) better than any MD training in my part of the world for what I wanted to do. Had I wanted to do surgery or specialty medicine, I would have never accepted a DO spot.

I started looking into family medicine residencies my first year. I started with the ACOFP and requested a list of their residencies, because there was no website listing. I found it very hard to learn anything truly useful about these programs though because they are bad about returning emails, slow if ever to send out info, and just this year began to appeal to us with websites (and most are primitive). I also started looking at AAFP residencies because their website was simply stunning. In seconds I could learn about the backgrounds of the residents I might be working with as my upper levels, find out their pay, their benefits, their rankings on scutwork (which by the way has few if any DO feedbacks), and could write their program directors directly. I have gained so much info by communicating directly with the residents, the faculty, and I have never experienced anything but complete red-carpet treatment by the people I have contacted. One program flew me up to see them and paid for my weekend there with my wife in 3rd year. And several others have paid for my dinners, hotels, or at least spent a great deal of time with me. All this before interview season. The DO side of the house for some reason does not seem to feel it is necessary to recruit or communicate with students. I just think they have become either burnt out or complacent over the last decade, and thus its like getting blood from a turnip to get useful info from them.

Not wanting though to give up on them, I paid out of my own pocket to fly to Phoenix this year for the ACOFP conference, and I went to the residency fair there. It was truly pathetic. There were probably less than 30% of all programs there, and the ones that were there made a rather poor effort at recruiting. For one thing, I noticed that the pay at most of the programs was rather bad, something like 5-10K less per year than the average ACGME FP program. Now I did meet some very nice program directors who were genuinely interested in recruiting, but having already experienced the AAFP residency fair, there was no comparrison. See, ACGME programs seriously had to start recruiting 10 years ago when FP became less competitive, and they still have to because there are so many of them. ACOFP programs as of yet have really done a poor job reaching out to their own students. I get a large envelope in the mail probably 3 times a week from an FP program because I am an NHSC scholar. The AAFP obviously paid for the list of names on this scholarship, but I have yet to receive any recruiting material from a DO FP residency other than my home program. And what I don't like about my home program is that they do not teach or care about OMT at all. In fact, for the 3rd year FP residents, they recruited medical students and OMM residents to teach a crash refresher course to them so that they could pass their manip portio of boards. So if you think you are going to a DO program in order to continue your manip, you better check it out thoroughly to find out, but don't bother using the internet because you will not find much. Short of spending thousands of dollars to go visit every FP DO residency in the country, you won't find another way to find out much about most DO FP programs. I think this is changing though with ACOFP's desire to bring things to the internet, and this could be a really positive change.

Lastly, I think the "chicken little, the sky is falling" mentality of a joint match is simply hilarious. We DO's have a really big ego if we believe that we can simply walk into the ACGME match and take it over. As I said in my previous point, and as Pikeville did not quite grasp, the "math" involved is really pretty simple and one sided. There are presently something like 2500 DO's that match in the ACGME each year, a number that has been steady and slightly climbing for years. The climbing is because there is good eveidence to show that more DO's are being graduated, with more DO programs closing than opening. The problem of DO programs closing is not because of a joint match obviously, because this is still only a proposition. So how do you explain this lack of DO graduate training even in the current time period? But what I am really trying to emphasize is this. Even in FP, probably the most unmatched specialty in medicine, most programs eventually fill within a few days of match day with scrambling MD's. Only a few truly empty seats remain around. So because of this, how do you think it is going to bring more DO's to the ACGME programs if they are already taking the maximum number they can accomodate now? Think of it this way. 50% of AOA program seats are unmatched in areas of primary care now. If all of a sudden next year we have a joint match, and all these people who would have ended up in DO programs decide to apply to both MD and DO programs, guess what happens? The same number of DO's end up in ACGME programs as before!!!!!!!!!!!!!!!!

Did you not understand my NFL analogy Pikeville? Here, I will try a different analogy then. Imagine that Kentucky medical schools decided to drop admission's standards to allow admission without taking the MCAT, and without the required organic and physics courses. Do you really believe that overnight the people in Kentucky would be placed at risk because now Kentucky physicians would be less qualified? OF COURSE NOT, because the natural supply of medical school applicants would still be overly plentiful, and the ones who really wanted to be competitive would meet these qualifications regardless of Kentucky lowering their standards. So what I am getting at is this. If the average ACGME program routinely fills its 10 spots with 7 MD's, 2 DO's, and 1 FMG, do you really believe that if they get more DO applicants that they will take less MD's? These MD students have to have a place to go as well you know, and if overnight all 5000 DO grads a year started coming to ACGME programs and abandoning DO programs, that would mean that ZERO FMG's would be coming to the US, and that some 2000 MD grads would be left without a residency in their own system. That is simply not going to happen.

True, a joint match could create more competition all around for ACGME and DO programs, but that is only a good thing. Right now the majority of the ones competing for me from my vantage point are ACGME or dual programs, and the reason the dual programs compete is because they are the smart ones. They are usually former ACGME-only programs that have merged with the DO world to ensure a steady stream of DO's coming into their program, and this basically guarantees that they will always fill those 2-3 non-MD slots in the match.

I really don't think anyone should comment though on the difficulties that are experienced without a joint match unless you are in a position to have gone through this chaos. I have been lucky enough to have found a great dually accredited program where I feel at home, and I can only hope I end up there. But these PMR guys and others who are doing a traditional year in waiting for PGY2 specialty positions, this crap is really a tough thing. I can just confidently strate that the DO programs are losing out on the absolute best graduates year after year, because these sharp people want to at minimum follow their dream of going to a place like Hopkins or Mayo. But to even shoot for their top spot, they will have to completely forgo a chance of landing a slot at a respectable AOA program where they might have been equally happy to end up when their dream did not materialize. My bet is that of the top DO grads that apply to these incredible programs, only a small percentage end up there. And when they don't end up there, they settle for a mediocre MD program simply because they were not able to rank even their home AOA program or other AOA programs. I have seen it over and over again where someone in the top 10% with great board scores shoots for a place like UCSF and end up at Wright State or some Meharry affiliated program. Now I am not saying that these programs are bad programs, but my guess is that these students might have been just as happy ending up in the same specialty at Pontiac DO hospital or at Tulsa regional. Because when you get out of the realm of the incredible programs with money and pathology flying out of their butts, most run of the mill MD and DO programs are one in the same in the quality of training.

"you are someone that is nowhere near ready to apply for residency" AND "I really don't think anyone should comment though on the difficulties that are experienced without a joint match unless you are in a position to have gone through this chaos."

It is comments like this that truly show you didn't read a word of what I have said. Go back and read ALL my posts and you will realize what I am talking about.

 

[Pikevillemedstudent]

I understand your analogies, I just don't agree with them.

FACT: A set number of DO's apply to ACGME programs every year.

FACT: A joint match would increase the number of DO applicants applying to ACGME programs per year (especially to primary care since DO's are more likely to enter those fields).

FACT: The laws of probability are obvious that more DO's would match to ACGME programs.

HERE'S AN ANALOGY FOR YOU: Imagine if every DO applied only to ACGME programs. Do you really think the same number(1500) of DO's would match as the previous year? There is no way that's true. Also, the programs filled after the match especially FP are filled mainly by FMG's. Many programs prefer DO's over FMG's esp. primary care so even those unmatched DO's would end up in an ACGME program through the scramble.

Also, your numbers are off
http://www.scutwork.com/other/match2004/2004advdata.pdf

Look at page 3.
There were a little more than 1500 DO's in the match last year(not 2500). There are actually only 2500-3000 DO grads per year. As for non-US FMG's, almost 3,000 matched last year. I think many DO's would be considered ahead of alot of those applicants. I am not even including the many US FMG's (1100 matched last year).

I don't think that there is a cap, as you suggest, to the number of positions DO's could obtain in ACGME programs. I guess I have more faith in my classmates. But I don't think we would take it over either. You have to realize that there are more spots in ACGME programs than US MD and DO grads combined. Many ACGME programs are left taking applicants in the scramble they feel are less than desireable but take them anyway for the funding.

I have done my homework on this.

Also, in case you didn't take my advice in the previous post. I graduated this year and matched. Someone has pie on their face?

 

[PACtoDOC]

I understand your analogies, I just don't agree with them.

FACT: A set number of DO's apply to ACGME programs every year.

FACT: A joint match would increase the number of DO applicants applying to ACGME programs per year (especially to primary care since DO's are more likely to enter those fields).

FACT: The laws of probability are obvious that more DO's would match to ACGME programs.

HERE'S AN ANALOGY FOR YOU: Imagine if every DO applied only to ACGME programs. Do you really think the same number(1500) of DO's would match as the previous year? There is no way that's true. Also, the programs filled after the match especially FP are filled mainly by FMG's. Many programs prefer DO's over FMG's esp. primary care so even those unmatched DO's would end up in an ACGME program through the scramble.

Also, your numbers are off
http://www.scutwork.com/other/match2004/2004advdata.pdf

Look at page 3.
There were a little more than 1500 DO's in the match last year(not 2500). There are actually only 2500-3000 DO grads per year. As for non-US FMG's, almost 3,000 matched last year. I think many DO's would be considered ahead of alot of those applicants. I am not even including the many US FMG's (1100 matched last year).

I don't think that there is a cap, as you suggest, to the number of positions DO's could obtain in ACGME programs. I guess I have more faith in my classmates. But I don't think we would take it over either. You have to realize that there are more spots in ACGME programs than US MD and DO grads combined. Many ACGME programs are left taking applicants in the scramble they feel are less than desireable but take them anyway for the funding.

I have done my homework on this.

Also, in case you didn't take my advice in the previous post. I graduated this year and matched. Someone has pie on their face?

If you REALLY graduated this year, then your school obviously does not require any form of advanced math prior to matriculation. You are talking like some college sophomore and your ideas sound completely like speculation. All our opinions are just that, opinions. I suggest you run for AOA leadership in the coming years because you sound just like them. I never pretended to know actual numbers in terms of grads, but my numbers show that I was basically saying that 50% go ACGME and 50% stay DO. And all I was saying is that these 50% of DO's that stay DO are not going to all head for the hills )ACGME land) simply because they now can apply. You are flat out wrong about ACGME programs not having quotas though. They know from a statistical standpoint how many non-US MD's they will have to take (have to take, not want to take), and they bank on this. Like it or not, many an ACGME program will take a mediocre MD over a reasonably well qualified DO, just for name sake. Not so much in primary care, but undoubtedly in specialties. The bottom line is that you have no argument to substantiate your theory as to why DO's would all of a sudden choose MD over DO. What about what I said in terms of more DO's ranking AOA programs when previously they never would have? Its all theory, but if you want to talk about pie in your face, perhaps we should discuss your board scores!!

Now relax, take a deep breath, I am just poking fun at you. We are on the same team remember. I respect your views, but enjoy debating this issue. So what specialty did you end up in if you don't mind me asking?

 

[Pikevillemedstudent]

If you REALLY graduated this year, then your school obviously does not require any form of advanced math prior to matriculation. You are talking like some college sophomore and your ideas sound completely like speculation. All our opinions are just that, opinions. I suggest you run for AOA leadership in the coming years because you sound just like them. I never pretended to know actual numbers in terms of grads, but my numbers show that I was basically saying that 50% go ACGME and 50% stay DO. And all I was saying is that these 50% of DO's that stay DO are not going to all head for the hills )ACGME land) simply because they now can apply. You are flat out wrong about ACGME programs not having quotas though. They know from a statistical standpoint how many non-US MD's they will have to take (have to take, not want to take), and they bank on this. Like it or not, many an ACGME program will take a mediocre MD over a reasonably well qualified DO, just for name sake. Not so much in primary care, but undoubtedly in specialties. The bottom line is that you have no argument to substantiate your theory as to why DO's would all of a sudden choose MD over DO. What about what I said in terms of more DO's ranking AOA programs when previously they never would have? Its all theory, but if you want to talk about pie in your face, perhaps we should discuss your board scores!!

Now relax, take a deep breath, I am just poking fun at you. We are on the same team remember. I respect your views, but enjoy debating this issue. So what specialty did you end up in if you don't mind me asking?

Otolaryngology--yeah let's compare board scores now!! j/k

Did you just copy what I wrote earlier about opinions? Wait you probably didn't read what I wrote.

Of course everything anyone writes on this subject is just opinion/specualtion. However, for no one to concede that a combined match could potentially be harmful just shows your bias. This has been my point from the begining. But it seems everyone wants think the world of the joint match is rosy with butterflies and unicorns. Only a responsible person would look at both sides. I seem to be the only one doing that. I concede the benefits of a combined match and have previous stated such(which you haven't read yet). However, as with anything, there are side effects/complications that come with any change. The question is do the risks outweigh the benefits and can osteo GME survive those risks? That's what I would like to figure out. Neither of us know but we both have our ideas which are completely opposite.

If you would have went back and read my posts, you would see why I (a recent grad) have more at stake in the passage of a combined match than you or macman(both being recent grads as well). This time I am not going to tell you the reason. You need to read it yourself.

I understand you are just poking fun. It makes these long posts easier to read.

 

[PACtoDOC]

Otolaryngology--yeah let's compare board scores now!! j/k

Did you just copy what I wrote earlier about opinions? Wait you probably didn't read what I wrote.

Of course everything anyone writes on this subject is just opinion/specualtion. However, for no one to concede that a combined match could potentially be harmful just shows your bias. This has been my point from the begining. But it seems everyone wants think the world of the joint match is rosy with butterflies and unicorns. Only a responsible person would look at both sides. I seem to be the only one doing that. I concede the benefits of a combined match and have previous stated such(which you haven't read yet). However, as with anything, there are side effects/complications that come with any change. The question is do the risks outweigh the benefits and can osteo GME survive those risks? That's what I would like to figure out. Neither of us know but we both have our ideas which are completely opposite.

If you would have went back and read my posts, you would see why I (a recent grad) have more at stake in the passage of a combined match than you or macman(both being recent grads as well). This time I am not going to tell you the reason. You need to read it yourself.

I understand you are just poking fun. It makes these long posts easier to read.

ENT, cool. I just finsished my ENT rotation and loved it. But I did not love all those septoplasties and myringo's. But I can see the appeal of making your practice an outpatient surgery only type of practice.

I'll put up 2 chocolate pies though on a bet on board scores if you promise not to flinch before they hit you in the face

FYI, I do agree that there is a potential risk to DO GME, but I just don't care. I am not willing to prop up a system that is failing simply because it refuses to compete. Dual accreditation will solve all this anyway, and its entirely possible that in 10 years even your ENT programs will all be dually accredited. Then the joint match is mute. FP is becoming primarily dual, and that is a great way to mirror the real world we will practice in.

 

[rustedcj7]

No one said the average to low DO grad would get their pick of ACGME programs. But I did say more would rank ACGME programs and it only stands to reason that more would eventually match to ACGME programs. That's how the math works. The more you rank, the better your chances. Hence less DO grads in AOA programs. That's a real possiblity and I think that if you don't see it, you are blinded by your own joint match bias.

This is probably true.

 

[Pikevillemedstudent]

ENT, cool. I just finsished my ENT rotation and loved it. But I did not love all those septoplasties and myringo's. But I can see the appeal of making your practice an outpatient surgery only type of practice.

I'll put up 2 chocolate pies though on a bet on board scores if you promise not to flinch before they hit you in the face

FYI, I do agree that there is a potential risk to DO GME, but I just don't care. I am not willing to prop up a system that is failing simply because it refuses to compete. Dual accreditation will solve all this anyway, and its entirely possible that in 10 years even your ENT programs will all be dually accredited. Then the joint match is mute. FP is becoming primarily dual, and that is a great way to mirror the real world we will practice in.

Well I do care. My ultimate goal is to teach at PCSOM and hopefully begin more osteo residencies at Pikeville Medical Center including ENT. It is nearly impossible to start an ACGME ENT residency. They like to keep the supply down to increase demand. I don't really want to pass anything that could potentially harm this. But then again there is the dilemma with my spouse (which you still don't know about cause you didn't read it ) that makes me want the combined match (which is a truly selfish reason).

BTW your board scores may be higher than mine but my dad can beat up your dad. And don't give me none of that your dad is dead stuff either.

 

[Disse]

Oh hell, I guess if I’m finally posting after being a ghost for so many years I may as well post here as well…

Disclaimer: Most of this has already been said in a many different ways already but I'm simply throwing in my 2 cents as well.

Speaking as someone who once was a die-hard wannabe D.O., became a somewhat beaten down D.O. medical student and who now is a resident physician D.O. in an ACGME accredited program I completely agree with a combined match. Why? Because if it had existed when I was going through the match I probably would have ranked and attended a D.O. internship. As it happens there was no way in hell I was going to participate in a) the military match b) the AOA match for internship as well as c) the ACGME couples match for residency. Navigating and hoping for a deferment in the military match was hard enough.. You think I was going to blow my chances at my top residency choices simply in order to take an AOA internship (which I would have preferred at the time to take since I was matching into anesthesia)? NO WAY! Luckily my wife was extremely understanding and came with me into the ACGME world as well.

Long long ago (well not that long ago but 1998) the then current AOA president talked to my class. I, unfortunately, can’t remember his name (and a quick search of the AOA site doesn’t seem to include a list of past-presidents so I can’t find it there either) gave a speech at our school. I don’t remember much but I do remember him specifically stating “Go to where you’ll get the best training during your residency and then come back.”

Apparently, he had pursued training in urology (I think) back when D.O.’s were fairly unwelcome. He succeeded and took his new knowledge back to the osteopathic world and he encouraged anyone who wanted to go the allopathic route if they desired/thought it would give them better education but also encouraged everyone to come back to the osteopathic fold. He didn’t view this as a threat but as a way to get new techniques/training into the osteopathic world (I wish I could remember his name).

A combined match would benefit the osteopathic profession…provided the “powers that be” in the osteopathic world welcomed those who had pursued their training elsewhere back into the fold so to speak. Although this is my opinion (just as everything espoused on this forum is an opinion there just appears to be more on one side) if the AOA actively encouraged its students to pursue the best training they could and was also wise enough to allow those who pursued ACGME training to return it would be a much stronger organization than it is currently.

This, however, goes against the grain of the vast majority of those dinosaurs in power in the AOA who a) Can’t seem to imagine anyone would actually rank AOA approved programs highly in a combined match (this should insult those higher caliber DO programs of which there are more than a few) and b) Can’t seem to imagine that if they actually listened to student concerns and treat those concerns with respect and consideration they might actually have a stronger organization than they currently do. They instead continue with saber rattling and fear tactics and that oh-so D.O. tradition of neglecting their student members. When will it come to pass that the AOA will realize that its true lifeblood is its current and future students? That to actively listen to and encourage osteopathic students and to actively pursue those avenues necessary for those students to succeed is in ITS best interest as well?

Instead they hide their head in the sand and refuse to allow any sort of change that might threaten their hold on power. They talk long and hard of upholding the osteopathic tradition and defending osteopathic principles that few of their own residency programs even promote. They state they are actively recruiting more training programs into their OPTI programs but, when you talk to many ACGME programs that have had or had thought about having dual residency accreditation you realize that the AOA marches out a whole different set of hoops for those programs to dance through.

Bah. This whole topic makes me sick. Change in any form has the potential to be harmful—that is what change implies. However, without change things become stagnant—which is definitely NOT healthy to any sort of individual or organization. Furthermore, this argument regarding the combined match (at least from those in power at the AOA—idealists here are probably different) has absolutely nothing to do with “protecting students” or “protecting osteopathy” . It is simply about MONEY and POWER as the AOA fear that a combined match MIGHT cause them to have a huge influx of students and thus have less influence, power and monetary funds. At least when I read of the idiots in power at the AOA and their continued contempt of osteopathic students I am continually dissuaded from even attempting to attain AOA accreditation and “returning to the fold.”


Sorry for the rant…especially at the end…I just couldn’t hold it back any longer.

 

[macman]

whoa-I go out for a few drinks and this thread explodes....cool

PMS- DO or MD ENT???


PAC to DOC -thanks for taking over-I was getting tired talking to that guy....

this is a great rant thread-we ought to call it Dr. Phil's thread

 

[Pikevillemedstudent]

whoa-I go out for a few drinks and this thread explodes....cool

PMS- DO or MD ENT???


PAC to DOC -thanks for taking over-I was getting tired talking to that guy....

this is a great rant thread-we ought to call it Dr. Phil's thread

Well I am done with this thread guys. I have made my arguement. Everyone can believe what they what but the truth is the AOA will never let it happen so we are all just wasting our time anyway.

You can count the number of DO's entering MD ENT programs per year on one hand and sometimes you don't even need any fingers. I was a DO match of course so the future of osteo GME is MUCH more important to me than you or PAC and it should be important to any DO student interested in ENT, derm, ortho, neurosurg. etc. My stake in this is alot greater than yours due to training in osteo GME, spouse applying to future GME positions, and desire to be involved in academic osteo GME positions later on.


Dr. Phil thread? No way! It should be the Dennis Miller thread!!


Check ya' later

 

[PACtoDOC]

Well I am done with this thread guys. I have made my arguement. Everyone can believe what they what but the truth is the AOA will never let it happen so we are all just wasting our time anyway.

Well you can count the number of DO's entering MD ENT programs per year on one hand and sometimes you don't even need any fingers. I was a DO match of course so the future of osteo GME is MUCH more important to me than you or PAC and it should be important to any DO student interested in ENT, derm, ortho, neurosurg. etc. My stake in this is alot greater than yours due to training in osteo GME, spouse applying to future GME positions, and desire to be involved in academic osteo GME positions later on.


Dr. Phil thread? No way! It should be the Dennis Miller thread!!


Check ya' later

One theme I have heard from PMS a couple of times is something worth addressing. I hear a lot of people talk about how they want to go to a DO GME program because they want to be on faculty one day in a DO institution. I think this is a common myth perpetuated by the AOA that you cannot do exactly that if you go to an MD program. In my own school there are tons of ACGME board certified DO's who have come back to be faculty, and even residency faculty. One did FP at Baylor, one did Neuro at Brown, many did military ACGME programs and carry only those board certs, one did OBGYN at Baylor, and yet the all still are highly respected and were recruited to come back to their home school in the end. Now how do you explain that? I sure can't.

 

[Pikevillemedstudent]

One theme I have heard from PMS a couple of times is something worth addressing. I hear a lot of people talk about how they want to go to a DO GME program because they want to be on faculty one day in a DO institution. I think this is a common myth perpetuated by the AOA that you cannot do exactly that if you go to an MD program. In my own school there are tons of ACGME board certified DO's who have come back to be faculty, and even residency faculty. One did FP at Baylor, one did Neuro at Brown, many did military ACGME programs and carry only those board certs, one did OBGYN at Baylor, and yet the all still are highly respected and were recruited to come back to their home school in the end. Now how do you explain that? I sure can't.

Just when I thought I was done with this thread....

I understand what you are saying. You are exactly right. No one has to complete an AOA internship/residency to teach in an osteo school or residency. That is a myth and I am not sure where it comes from. That was not what I meant or said. I never said I had to do an AOA residency to teach. I said I wanted to start an AOA residency since starting an ACGME residency in ENT is nearly impossible. To be a program director at an AOA residency also does not require you to complete an AOA internship/residency. Look at the DO-online website, I have seen some PD's that are MD's (I don't remember which program it was). Sorry if I somehow lead some to believe that but re-reading my posts, I really don't see how anyone would have interpreted my post to mean that.

Also, from my understanding all military programs are dually accredited. I have not heard of an ACGME military program. Do they exist? Maybe they completed their residency before they were dual.

 

[PACtoDOC]

Just when I thought I was done with this thread....

I understand what you are saying. You are exactly right. No one has to complete an AOA internship/residency to teach in an osteo school or residency. That is a myth and I am not sure where it comes from. That was not what I meant or said. I never said I had to do an AOA residency to teach. I said I wanted to start an AOA residency since starting an ACGME residency in ENT is nearly impossible. To be a program director at an AOA residency also does not require you to complete an AOA internship/residency. Look at the DO-online website, I have seen some PD's that are MD's (I don't remember which program it was). Sorry if I somehow lead some to believe that but re-reading my posts, I really don't see how anyone would have interpreted my post to mean that.

Also, from my understanding all military programs are dually accredited. I have not heard of an ACGME military program. Do they exist? Maybe they completed their residency before they were dual.

Military programs are by default ACGME accredited. Every MD residency in the country is ACGME accredited, including the military ones. They may not all go through the NRMP match (ie..SF, military, urology, etc..), but they are ACGME accredited. I have no idea if military programs are also AOA accredited. My guess is that there is some waiver that allows military guys to take the AOA board exam in that particular specialty, but my guess is only a small tiny percentage bother to pay out of their pocket to take both the ACGME board exam plus an AOA board exam. The military will likely only pay for one, and most people would probably prefer the ACGME board cert. But what do I know!!?

 

[Disse]

Military programs are by default ACGME accredited. Every MD residency in the country is ACGME accredited, including the military ones. They may not all go through the NRMP match (ie..SF, military, urology, etc..), but they are ACGME accredited. I have no idea if military programs are also AOA accredited. My guess is that there is some waiver that allows military guys to take the AOA board exam in that particular specialty, but my guess is only a small tiny percentage bother to pay out of their pocket to take both the ACGME board exam plus an AOA board exam. The military will likely only pay for one, and most people would probably prefer the ACGME board cert. But what do I know!!?

Military residencies are ACGME accredited and the AOA might approve them if your internship compares (specialities, time in each etc) with an AOA rotating internship, you fill out an application and send in a copy of your orders. This is significantly easier than trying to get an ACGME approved non-military internship through the AOA's resolution 42. Of course, it truly comes down to the reason of why bother? Hell, my current ACGME training facility has shown more loyalty and commitment to me in the years I've been there than the AOA ever did throughout medical school (or after for that matter). Similarly, I have much more of a commitment to my residency program (i.e. I'll do what I can to ensure the future success of its graduates) than I will ever have to the AOA (note: I do not include other D.O.'s in this--just the AOA )

 

[TCOM-2006]

a few comments based on my experience with the issue (and forgive any misspellings - typing this after a few glasses of wine)...

1> I think that it's clear that it's in the best interests of the individual DO student to have a combined match system - i.e. to be able to consider all GME programs (both AOA and ACGME) according to their own individual criteria (specialty choice, location, percieved quality, etc). there's no debating this.

2> regarding the larger question of "what's in the best interests of DO GME and the osteopathic profession?" - this is a bit more complicated...

2.1> first, it should be stated that the only debatable sub-point to this question here is what impact the combined match would have on the *percentage of DO grads entering AOA programs*. as i state in earlier posts, a combined match would have no (zero) impact on our "identity" as a profession because the match process (allopathic = Military/San Francisco/Urology/NRMP, osteopathic = AOA, administered by NMS) is totally seperate from the following processes:

--medical school accreditation process (allopathic = LCME, osteopathic = AOA-COCA)
--GME accreditation process (allopathic = ACGME, osteo = AOA-COPT)
--GME application process (both = ERAS, which is owned by AAMC)
--licensure process (state medical or osteopathic boards)
--board certification process (individual american board of ___ or american osteopathic board of ___)

**google the abbreviations if you don't know them. from my perspective - our osteopathic identity is formed from our education (and the accred bodies which set educational standards are not changed at all by a combined match) and protected by state legislation granting licensure (again - which is not impacted by a combined match).

**in other words - examples cited by our AOA president about california in 30-40 years ago have zero relevance to this discussion, because a> that was 30-40 years ago and a lot has changed since then, and b> that was an issue of licensure, which is totally seperate and not impacted by the proposal for a combined match. now, that said - i respect our AOA president for some of his other efforts on other issues (this is not the most important issue in healthcare, and we should keep this in proper perspective).

2.2> although it's somewhat of a side issue, i thinks it's debatable how much "osteopathic training" (i.e. actual teaching and implementation of osteopathic principles and practice) we really get in an AOA residency, especially in some specialties (e.g. surgery?). so - even if more DO graduates enter AOA programs - does this make us truly more "osteopathic", or is just osteopathic in name only? there might be clear economic benefit (e.g. osteopathic hospitals getting GME funding) but the educational component is questionable.

2.3> the only debatable point idirectly related to this whole discussion (and post if you disagree with this) is the question" WILL A COMBINED MATCH LEAD TO AN INCREASE OR DECREASE IN THE PERCENTAGE OF DO GRADS THAT ENTER AOA PROGRAMS? i agree with PMS (forgive the abbreviation) that no-one can answer this question with 100% certainty. this IS an important question because it does have an impact on funding and maintaining the status quo. let me address the complexities of this question in a future post...

 

[TCOM-2006]

there are some other issues note mentioned in the following text - i'm just copying and pasting to save myself time, but i can come back and answer questions - and i'll also add some additional points in future posts...

1> THE SYSTEM AND PROPOSAL FOR REFORM

The current system is set up so that any DO student who matches into an AOA program through the AOA match (match date in Feb.) will be automatically withdrawn from consideration by any ACGME programs that they have ranked through NRMP (match date in Mar.). The proposal would be to have one match system for DO students that would allow them to rank both AOA and ACGME programs on one rank order list (ROL), with one match date (most likely this would involve the AOA contracting with NRMP, in a manner similar to the AOA contracting with AAMC to use the ERAS).

2> TWO IMPORTANT QUESTION TO CONSIDER

#1: What is in the best interests of the individual osteopathic medical student, intern, and resident?

#2: What is in the best interests of the osteopathic graduate medical education (GME) system and our osteopathic profession in general?

3> KEY RATIONALE

The current system provides the incentive for many DO students to not participate in the AOA match at all, even if they are interested in some AOA programs, because there happen to be more ACGME programs which fit their individual criteria (which is common, given the relative paucity of AOA programs in many geographic locations and in some specialties).

4> KEY STATISTICS:

for the 2005 match, of the total # of DO grads: 5.8% matched to a military (ACGME) program through the military match in december, 46.3% particiapted in the AOA match, and 48.0% did *not* participate (most participate in NRMP).

under the current system, there has been a 22% decrease (from 77% to 55%) of the percentage of DO grads entering AOA internships since 1997. Since many DOs complete an AOA internship and then enter an ACGME residency (PGY-2 on), the percentage of DOs entering AOA residencies would be well less than those that enter internships.

there has been a 92% increase in the number of DO grads entering ACGME programs at the PGY-1 level from 1997 to 2002.

5> ISSUE OF IDENTITY?

A combined match in no way compromises our ability to maintain our independance as a seperate and unique branch of the medical profession. The match process is totally seperate from the the following processes (i.e. - each of these processes is governed by a seperate entity):

--GME application (that's ERAS, which is owned by AAMC).
--osteopathic medical school accreditation (that's AOA-COCA)
--osteopathic GME accreditation (that's AOA-COPT)
--physician licensure (that's individual state medical and osteopathic medical boards)
--board certification (that's individual osteopathic specialty boards)

The match systems (both AOA and NRMP) are essentially just there to compare the rank order lists of participants and programs in order to distribute participants to these programs in a fair and uniform way. under a combined match - the AOA (through COCA and COPT) would still retain full authority to educational standards as accreditation requirements to ensure that we still are trained as osteopathic physicians. this is no different than the AOA choosing to use ERAS (which is owned by AAMC - the organization that represents MD schools) for DO students' application to AOA programs.

6> TO ANSWER THOSE 2 QUESTIONS...

#1 - It is clearly in the best interests of the individual osteopathic medical student or intern/resident match participant to be able to rank both AOA and ACGME in one list according to their own criteria.

#2 - If a combined match would lead to a decrease in the percentage of DOs who enter AOA programs - then this would lead to decrease fill rates, decreased funding, and put osteopathic GME in a difficult situation - and therefore would not be in the best interests of the profession. However, if the opposite were true, this would strengthen osteopathic GME and benefit the profession. Although we can't be *totally* sure of how a combined match system will affect the percentage of DOs entering AOA programs until implementation, there are several important factors to consider:

--The current seperate match system has either contributed toward or failed to prevent a significant decrease in the percentage of DOs entering AOA programs.

--A combined match would instantly double AOA programs' potential match participant pool (i.e. those 48% who would have otherwise ignored AOA programs altogether under the current system would have everything to gain and nothing to lose by ranking AOA programs in their list). The individual AOA programs would have the opportunity to actively recruit this new group of students (and dispell the mis-conception that some students may have about the quality of some AOA programs), possibly getting these students to rank the programs toward the top of (or at least on) their rank order list. If an AOA program makes it onto a student's ROL (one who, under the current seperate match system would have not participated in the AOA match at all), even it it's not #1, it increases the possibility that the student will match with the AOA program.

--The combined match could be set up as a contract between AOA and NRMP, which is subject to reauthroization in 2-3 years, therefore the real impact of implementation can be studied, and the AOA can choose not to renew the contract and return to a seperate match system if this proves to decrease the number of DO graduates who enter AOA programs.

 

[Pikevillemedstudent]

Wow, great post TCOM 2006. Finally someone see's both sides of the issue.

4> KEY STATISTICS:

for the 2005 match, of the total # of DO grads: 5.8% matched to a military (ACGME) program through the military match in december, 46.3% particiapted in the AOA match, and 48.0% did *not* participate (most participate in NRMP).

under the current system, there has been a 22% decrease (from 77% to 55%) of the percentage of DO grads entering AOA internships since 1997. Since many DOs complete an AOA internship and then enter an ACGME residency (PGY-2 on), the percentage of DOs entering AOA residencies would be well less than those that enter internships.

there has been a 92% increase in the number of DO grads entering ACGME programs at the PGY-1 level from 1997 to 2002.

Good stats, but I think everyone must realize that the number of osteo grads have also increased significantly in this time frame as well. So that may be part of the reason for the amazing 92% increase. However, your points still hold true.

5> ISSUE OF IDENTITY?

A combined match in no way compromises our ability to maintain our independance as a seperate and unique branch of the medical profession. The match process is totally seperate from the the following processes (i.e. - each of these processes is governed by a seperate entity):

--GME application (that's ERAS, which is owned by AAMC).
--osteopathic medical school accreditation (that's AOA-COCA)
--osteopathic GME accreditation (that's AOA-COPT)
--physician licensure (that's individual state medical and osteopathic medical boards)
--board certification (that's individual osteopathic specialty boards)

The match systems (both AOA and NRMP) are essentially just there to compare the rank order lists of participants and programs in order to distribute participants to these programs in a fair and uniform way. under a combined match - the AOA (through COCA and COPT) would still retain full authority to educational standards as accreditation requirements to ensure that we still are trained as osteopathic physicians. this is no different than the AOA choosing to use ERAS (which is owned by AAMC - the organization that represents MD schools) for DO students' application to AOA programs.

I think the reasons presented earlier for preserving identity was really more about preserving osteo GME. Thanks for the clarification.

6> TO ANSWER THOSE 2 QUESTIONS...

#1 - It is clearly in the best interests of the individual osteopathic medical student or intern/resident match participant to be able to rank both AOA and ACGME in one list according to their own criteria.

#2 - If a combined match would lead to a decrease in the percentage of DOs who enter AOA programs - then this would lead to decrease fill rates, decreased funding, and put osteopathic GME in a difficult situation - and therefore would not be in the best interests of the profession. However, if the opposite were true, this would strengthen osteopathic GME and benefit the profession. Although we can't be *totally* sure of how a combined match system will affect the percentage of DOs entering AOA programs until implementation, there are several important factors to consider:

--The current seperate match system has either contributed toward or failed to prevent a significant decrease in the percentage of DOs entering AOA programs.

--A combined match would instantly double AOA programs' potential match participant pool (i.e. those 48% who would have otherwise ignored AOA programs altogether under the current system would have everything to gain and nothing to lose by ranking AOA programs in their list). The individual AOA programs would have the opportunity to actively recruit this new group of students (and dispell the mis-conception that some students may have about the quality of some AOA programs), possibly getting these students to rank the programs toward the top of (or at least on) their rank order list. If an AOA program makes it onto a student's ROL (one who, under the current seperate match system would have not participated in the AOA match at all), even it it's not #1, it increases the possibility that the student will match with the AOA program.

--The combined match could be set up as a contract between AOA and NRMP, which is subject to reauthroization in 2-3 years, therefore the real impact of implementation can be studied, and the AOA can choose not to renew the contract and return to a seperate match system if this proves to decrease the number of DO graduates who enter AOA programs

Great summary of the issues. The best part I think is the last paragraph where essentially a way out is provided to osteo GME. I would support a joint match proposal with the 2-3 year time frame you mentioned.

For some reason I actually think a proposal with a time limit MAY have a chance with the AOA. However, it would be important to clarify WHO would study the impact of the joint match after the 2-3 year time frame.

 

[honkeytonkman]

I checked out that link.....the problem with looking at PM&R fill/unfilled is that its such a small field that if you have just a few programs that do not fill (bottom feeder programs, and/or programs that are in a non-desirable location) it quickly pulls down the percentage. E.G. take a look at this years match stats, there were zero unfilled spots for the western US in PM&R, how many other specialites can claim that??? I was on the trail, saw the competition, talked to PDs, etc. It is very competitive for the GOOD programs.


I think most "good" programs in any residency (IM,anes, peds, etc.) are competitive, that's why they're good program. As far as the western US, a lot of people want to go to California for residency. There are many average to below average programs of any residency in California, but location makes it a difficult match. Don't thin PMS was trying to stir things up. You might be too sensitive and would like further confrimation that you accomplished a "competitive" residency by posting on these forums.

 

[macman]

I checked out that link.....the problem with looking at PM&R fill/unfilled is that its such a small field that if you have just a few programs that do not fill (bottom feeder programs, and/or programs that are in a non-desirable location) it quickly pulls down the percentage. E.G. take a look at this years match stats, there were zero unfilled spots for the western US in PM&R, how many other specialites can claim that??? I was on the trail, saw the competition, talked to PDs, etc. It is very competitive for the GOOD programs.


I think most "good" programs in any residency (IM,anes, peds, etc.) are competitive, that's why they're good program. As far as the western US, a lot of people want to go to California for residency. There are many average to below average programs of any residency in California, but location makes it a difficult match. Don't thin PMS was trying to stir things up. You might be too sensitive and would like further confrimation that you accomplished a "competitive" residency by posting on these forums.

Well, think what you will.....I do not think I need confirmation from anyone to feel good about my match.

Are you going into psych?

Anyway, anyone who has applied to PM&R knows how crazy competitive it has become. The MD students and current residents who I met on the trail with were saying that it was becoming the 'new derm'. Their words, not mine. PDs were bragging about the drastic change in applicant quality and quantity. All I'm saying is, do not comment on something you do not know about. This discussion is not that pertinent to this thread and really only came up because PMS was either doubting my motives for dropping out of the AOA match, or just wanted to make an assumption.

I did not apply to D.O. ENT and I will therefore not comment on how the applicant pool was, the quality of the programs, or how competitive it is/isn't. I'm sure it is a great honor to get a spot, just as it was to get a PM&R spot this year at any program other than the 3 or 4 that totally stink.

Hopefully this concludes the pissing contest, unless PMS would like to compare CV's while we stand on our big heads.

 

[Pikevillemedstudent]

Military residencies are ACGME accredited and the AOA might approve them if your internship compares (specialities, time in each etc) with an AOA rotating internship, you fill out an application and send in a copy of your orders. This is significantly easier than trying to get an ACGME approved non-military internship through the AOA's resolution 42. Of course, it truly comes down to the reason of why bother? Hell, my current ACGME training facility has shown more loyalty and commitment to me in the years I've been there than the AOA ever did throughout medical school (or after for that matter). Similarly, I have much more of a commitment to my residency program (i.e. I'll do what I can to ensure the future success of its graduates) than I will ever have to the AOA (note: I do not include other D.O.'s in this--just the AOA )

Missed this post earlier.

Thanks for the info. I am surprised. Some military recruiters actually say they are dually accredited. I guess we shouldn't trust those guys.

 

[Pikevillemedstudent]

Well, think what you will.....I do not think I need confirmation from anyone to feel good about my match.

Are you going into psych?

Anyway, anyone who has applied to PM&R knows how crazy competitive it has become. The MD students and current residents who I met on the trail with were saying that it was becoming the 'new derm'. Their words, not mine. PDs were bragging about the drastic change in applicant quality and quantity. All I'm saying is, do not comment on something you do not know about. This discussion is not that pertinent to this thread and really only came up because PMS was either doubting my motives for dropping out of the AOA match, or just wanted to make an assumption.

I did not apply to D.O. ENT and I will therefore not comment on how the applicant pool was, the quality of the programs, or how competitive it is/isn't. I'm sure it is a great honor to get a spot, just as it was to get a PM&R spot this year at any program other than the 3 or 4 that totally stink.

Hopefully this concludes the pissing contest, unless PMS would like to compare CV's while we stand on our big heads.

Don't drag me back into this. I was never in a pissing contest with anyone.

 

[Docgeorge]

Here's a link with ppts in favor and against the Joint match. http://www.studentdo.com/

 

[TCOM-2006]

Here's a link with ppts in favor and against the Joint match. http://www.studentdo.com/

thanks for the link to the powerpoints used in SOMA's discussion of the combined match at their meeting.

i think it's good that SOMA is trying to take a look at the issue from both sides - but i'm personally dissapointed with their inaction on the issue at their last meeting. it's best not to vote on something if you are not sure - but i don't think there was a realization of the critical timing of their vote - and it seems like much homework could have been done before the meeting. -- but, we're in the position that we're in now - so it's best to just re-group and move on.

you will notice that the 'pro-seperate match' powerpoints inappropriately confuse this issue as one of 'uniqueness' or 'identity' and miss the point about allowing DO students the opportunity to choose from all programs at once according to their own criteria.

the whole issue about increasing enrollement at MD schools, while true, is not really connected with the combined match issue because

1> it does not mention that currently 27% of all ACGME slots are filled by IMGS. fair or not, programs tend to prefer US grads - so they will likely feel the squeeze perhaps more than any other group.

2> this assumes that the combined match will lead to a decrease in percentage of grads that enter AOA programs - which will most likely not occur

3> this assumes that DO candidates are not competative with MD candidates for residency positions. while there is definitely still some ACGME programs that don't take DOs - this is now the exception rather than the rule for most specialties.

the other issue regarding dual-accred programs is a valid point - and DO students would likely loose that advantage under a combined match. but keep in mind that most of the dual accred programs have become so in an effort to fill their slots (ie - they are relatively non-competative). ACGME programs that are having no problem filling their slots (with MDs and DOs via NRMP, SF, Urol) are not rushing to pay the extra money and jump through more hoops to become AOA accred. so, this is more of a minor trade off for the advantages that a combined match offers.

regarding the 'survey' - i can't really comment on this since i have not been given the opportunity to review the data and methods myself - but my understanding is that the response rate was relatively low. i hope to have a chance to review this issue more.

i do have some other things to add re: geography and this issue that i will try to post soon

 

[Docgeorge]

Thanks TCOM-2006 for breaking down the anti joint match peoples argument. It boggles me to think that Dr. Thomas only 1.6% number comes from a survey that only had a 16% response rate. I whish I had seen that ppt before he came to DMU.

 

[Pikevillemedstudent]

2> this assumes that the combined match will lead to a decrease in percentage of grads that enter AOA programs - which will most likely not occur

We definitely disagree on this point. I agree with your previous assessment that it could double the AOA program applicant pool, but I am just not sure that many would rank AOA programs high enough to match. However, as previously stated no one really knows.

3> this assumes that DO candidates are not competative with MD candidates for residency positions. while there is definitely still some ACGME programs that don't take DOs - this is now the exception rather than the rule for most specialties.

I am not so sure about this one. While all primary care fields are open to DO's on a fairly equal basis, many other fields have a clear US MD bias over DO's. This is true in any surgical specialty and is the rule not the exception. This includes gen surg, ortho, neuro surg, ENT, ophtho, and especially plastics. Of course this also includes Derm as well. DO grads have fairly equal chance of matching in any other field. An increase of US MD grads will obviously make residency placement into an ACGME residency more difficult for DO's (assuming there is no change in ACGME residency positions) simply due to an increase of quality applicants for the same number of positions, however, this perceived increase in US MD's will certainly not occur for quite some time if ever. Just because the AAMC recommends something certainly does not mean it will be done.

Bottomline: The joint match is definitely good for students, but there is still a risk to osteo GME. A short term agreement to enter a joint match would help eliminate this risk in the long term if our worst fears for osteo GME come true.

I am interested to see your comments on geography. It is obvious that osteo GME is geographically handicapped. A combined match has the potential to allow the applicant who wants to stay in the osteo GME geographic areas to now apply to both AOA and ACGME programs. Which direction will this shift Osteo grads? I am not sure but I have my own ideas.