Competitive Specialties as a Class of 2024 D.O.

[deleted898021]

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This is just not true. People match into the ultra competitive fields from these new/low tier MD schools out in the middle of nowhere all the time. The difference is that they don't have to face an aggressive bias that handicaps them before they even start. There's no "low tier/new MD" filter on ERAS. There is a DO one.

The poster was saying it does happen according to the match lists he saw on his interviews at those MD schools but it’s more like an outlier simmilar to DO schools, not like mid tier MD or top MD, and that makes sense since we prbly see a simmilar # of those matches in the ultra competitive specialties such as derm or ortho, IR from DO schools as well. And I get the filter aspect but the DO’s do have their own “programs” which made the transition where they won’t be filtered out and many of those programs are still primarily filling with DO’s and even if they aren’t they are still considering and interviewing DO’s(i.e. Broward’s derm program)

 

[AnatomyGrey12]

a DO student would have that and can audition at those places.

MD's can audition at these places and would likely be given full consideration if they did so.

No, the low tier MD student is not disadvantaged compared to any DO student.

and that makes sense since we prbly see a simmilar # of those matches in the ultra competitive specialties such as derm or ortho, IR from DO schools as well.

No we don't. Pick any random low tier MD school and glance at the match list.

You're starting to grasp at straws, creating random scenarios trying to fit your belief.

 

[slowthai]

The poster was saying it does happen according to the match lists he saw on his interviews at those MD schools but it’s more like an outlier simmilar to DO schools, not like mid tier MD or top MD, and that makes sense since we prbly see a simmilar # of those matches in the ultra competitive specialties such as derm or ortho, IR from DO schools as well.

I know that's what he said, but it's still not correct. The point is that they're not comparable, like at all, lol. Sure, not having a home program will handicap you in the match, but it's not anywhere close to that of having DO behind your name. It can also be overcome by doing more aways/a research year.

Also, we're really talking about MD matches here. Yes, DOs still match into almost all of those fields, but 99% of those are former AOA, excluding IR. That's the one hyper-competitive field that's less prestige focused.

 

[CaffineDoc24]

Reading this thread kinda makes me a little sad. Although I knew being a DO would probably mean I won’t get my dream job of being a dermatologist (lived with acne for years) I thought other semi-competitive specialties would still be very attainable. Last years match list looks great(at least to me), but I guess the P/F step thing is gonna ruin that?

 

[Chibucks15]

I’m starting this year at one if the top DO schools. Reading this thread kinda makes me a little sad. Although I knew being a DO would probably mean I won’t get my dream job of being a dermatologist (lived with acne for years) I thought other semi-competitive specialties would still be very attainable. Last years match list looks great(at least to me), but I guess the P/F step thing is gonna ruin that?

Don’t take everything you see on here as gospel. There are DO dermatologists. Just bust your ass and make as good of an app as you can. Nobody knows how P/F is gonna play out. People were yelling about the sky falling with the merger for residencies and DOs had arguably the best match ever. Keep your head down and work hard

 

[Lexdiamondz]

What about top/mid tier programs or desirable locations for less competitive or at least DO-friendly specialties?

Such as neuro, psych, EM, PM&R, gas, or even Rads.

Is matching into strong ACGME programs in these specialties reasonably achievable for a DO? Or is it as much of a long shot as getting into a plastics/IR/Derm/ENT type speciality ANYWHERE?

Depends on the field you're talking about.

With the exception of PM&R, all of the fields you mentioned are moderately competitive. Speaking from EM - many of the "top" EM programs are reasonably DO friendly, although it is still significantly harder to match as a DO than as an MD. Same for anesthesia - there are DOs at hopkins, MGH and Penn in anesthesia however they are relatively far - between. PM&R is almost dominated by DOs, whereas ivory tower neuro and Rads may be closed off to you.

 

[AnatomyGrey12]

I’m starting this year at one if the top DO schools. Reading this thread kinda makes me a little sad. Although I knew being a DO would probably mean I won’t get my dream job of being a dermatologist (lived with acne for years) I thought other semi-competitive specialties would still be very attainable. Last years match list looks great(at least to me), but I guess the P/F step thing is gonna ruin that?

It will still be possible. How attainable depends completely on what "semi-competitive" specialities you are talking about, as there is a range of "don't fail anything" to "you should have a 240+/Research."

It's good to bear in mind that most of us are making our comments with the premise that you, or anyone we are talking about will be average, because chances are that's what you will be. We've had two MD derm matches in the last 3 years, both applicants were elite. If you turn out to be an elite medical student then you will still have those doors potentially available. The issue is pretty much everyone that posts on this site thinks they are going to be that person when the simple truth is that they won't be anywhere close, so it's best to be realistic. It's also to remind people that you can be an elite applicant as a DO and still not match those specialties, whereas the match rate for MDs, even in those fields, are very high for the elite applicants.

 

[CaffineDoc24]

It will still be possible. How attainable depends completely on what "semi-competitive" specialities you are talking about, as there is a range of "don't fail anything" to "you should have a 240+/Research."

It's good to bear in mind that most of us are making our comments with the premise that you, or anyone we are talking about will be average, because chances are that's what you will be. We've had two MD derm matches in the last 3 years, both applicants were elite. If you turn out to be an elite medical student then you will still have those doors potentially available. The issue is pretty much everyone that posts on this site thinks they are going to be that person when the simple truth is that they won't be anywhere close, so it's best to be realistic. It's also to remind people that you can be an elite applicant as a DO and still not match those specialties, whereas the match rate for MDs, even in those fields, are very high for the elite applicants.

Fields I’m into other than derm would probably include (at least for now) rads (would be my second choice) anesthesia and maybe EM. Are these considered “DO friendly”? Also from SoCal, I guess this all applies to getting a residency back home as well?

 

[lernaeann]

Fields I’m into other than derm would probably include (at least for now) rads (would be my second choice) anesthesia and maybe EM. Are these considered “DO friendly”? Also from SoCal, I guess this all applies to getting a residency back home as well?

I am a current M4 from Northern California applying to radiology this cycle. It is extremely competitive in California. There are very few DOs that match here. There is a former AOA program in Hemet but I cannot comment on how good the program actually is. The other west coast programs are not DO friendly either, although OHSU did take one this year. Arizona is definitely possible as a DO and is probably the closest.

 

[AnatomyGrey12]

Fields I’m into other than derm would probably include (at least for now) rads (would be my second choice) anesthesia and maybe EM. Are these considered “DO friendly”?

Yes those are DO friendly to those who apply broadly and have good apps for those specialties.

Also from SoCal, I guess this all applies to getting a residency back home as well?

This will make things very difficult outside of primary care. California is a competitive market, and has hoards of high quality MD applicants to all specialties every year.

 

[Butters Stotch]

I am a current M4 from Northern California applying to radiology this cycle. It is extremely competitive in California. There are very few DOs that match here. There is a former AOA program in Hemet but I cannot comment on how good the program actually is. The other west coast programs are not DO friendly either, although OHSU did take one this year. Arizona is definitely possible as a DO and is probably the closest.

Yes those are DO friendly to those who apply broadly and have good apps for those specialties.


This will make things very difficult outside of primary care. California is a competitive market, and has hoards of high quality MD applicants to all specialties every year.

Define a “good application” for radiology; of course if I’m geographically flexible I would imagine it’s attainable with a 220-230+?

 

[Kardio]

Define a “good application” for radiology; of course if I’m geographically flexible I would imagine it’s attainable with a 220-230+?

Use this:

Match Data

Core to the NRMP’s mission is the development and distribution of data reports and publications that inform national conversations about the transition to residency and advance understanding of the…

www.nrmp.org

 

[DNC127]

Just stopping by to say keep working hard kids. Now that I am on the other side this thread isn’t anxiety provoking anymore, but I remember every year this thread would hit hard and make me super sad. keep grinding and you will end up where you are supposed to be.

 

[AnatomyGrey12]

Define a “good application” for radiology; of course if I’m geographically flexible I would imagine it’s attainable with a 220-230+?

Yes. Check out the 2020 charting outcomes in my signature.

 

[CocoMelon0531]

Just want to throw my 2 cents in here. You will get excellent training at all mid tier university programs. I define top tier and mid tier as the following:

1) Top 20-25 university programs for top tier
2) #26-70 university programs for mid tier

This means getting into all fellowships. Just be average, work hard, and be cool to work with.

For all surgical specialties, you better be gunning for them bc you can't be outside the OR. If you're gunning for them due to the money, you're doing it wrong, bc I'm telling you right now that you will be close to those salaries if you're working the same # of surgical hours.

This is coming from a resident who's making attending money through my side businesses that I have built prior and during med school.

With Biden as the new president, the sweet spot in term of the best return for your money vs time scarified by working is somewhere bet $370-420K. Anything above will require extensive more time away from your hobbies and family while you're only bringing home about 50% of those $$$.

 

[Solodyn]

I believe I can be at the top 10% of my med school class (has internal rankings) and I'm hungry to work & do whatever it takes to keep my options open.

I love the optimism of OP's assessment of how well he/she is going to do academically even before starting medical school. Even at a DO school, scoring the top is not a walk in a park. There are always a few freakish super-geniuses in every DO school where you wonder why they are not at Harvard Med. If you end up in the middle of the pack in grades and board scores (which is not out of the realm of possibility, as everyone will be working hard), then the entire value of waiting another year to get an MD is completed wasted. You make the same amount of $$ as MD or DO within the same specialty. Waiting another year to get an MD no longer makes sense.

Start your DO school, Get the best grades possible, ace the boards, and rotate and figure out what specialty you will do by working with various specialists and reading the Medical Students Survival Guide by Steven Polk (keep in mind the advice may be dated, but still good). Once you know what you want to do then you can figure out what you need to do to get there.

You can't plan your path until you know where you are going. Plan your journey based on the destination, not options.

 

[CaffineDoc24]

Just want to throw my 2 cents in here. You will get excellent training at all mid tier university programs. I define top tier and mid tier as the following:

1) Top 20-25 university programs for top tier
2) #26-70 university programs for mid tier

This means getting into all fellowships. Just be average, work hard, and be cool to work with.

For all surgical specialties, you better be gunning for them bc you can't be outside the OR. If you're gunning for them due to the money, you're doing it wrong, bc I'm telling you right now that you will be close to those salaries if you're working the same # of surgical hours.

This is coming from a resident who's making attending money through my side businesses that I have built prior and during med school.

With Biden as the new president, the sweet spot in term of the best return for your money vs time scarified by working is somewhere bet $370-420K. Anything above will require extensive more time away from your hobbies and family while you're only bringing home about 50% of those $$$.

Which specific specialties do you think reach that time speant/income ratio?

 

[Fat_Albert]

Why the hell do people make these threads knowing you’re going to get the same answer as the other threads you creeped on that asked the same question

 

[slowthai]

Which specific specialties do you think reach that time speant/income ratio?

Derm, DR, EM. They all make around the same range, on average. Derm obviously has a great lifestyle. DR's is average. EM would be on par with derm, except for the fact that circadian disruption is a thing and it accelerates the aging process. Personally, I'd only recommend it if you want to FIRE your way to freedom. You could take on extra shifts for the first 10 years or so, make some serious bank, and then ride into the sunset as a part timer or something else entirely. Either that or do a fellowship.

 

[BorntobeDO?]

Just stopping by to say keep working hard kids. Now that I am on the other side this thread isn’t anxiety provoking anymore, but I remember every year this thread would hit hard and make me super sad. keep grinding and you will end up where you are supposed to be.

I take umbrage at the last statement, some people end up with nothing, and certainly if you survived the crapfest that is DO hazing, I mean schooling, you surely deserve something for making it through that torture besides 300k + of loans.

On a side note, since this thread is about matching, some unsolicited advice. The people who matched Derm from my school were absolute rockstars, one I knew well who was over 250 on step, had research, was fantastic to work with, and still matched former AOA. If she was MD she would have been Ivys. It isn’t a meritocracy guys, don’t ever forget it. Go look at the outcomes for non primary care, there are still people not matching with lists longer than 10 in their primary specialty, and they aren’t all weird or failing boards. I am of the opinion that 20 is the goal for interviews now, and it definitely can be done, as many of my classmates did.

Trust your gut on the residency’s and rank places higher on how they treat you, not the benefits, real or perceived. I am glad to report that my residency experience has been a complete 180 from med school so far and I wouldn’t be here if I didn’t trust my gut. That’s enough from me tho, I have contributed enough here in the past, lol.

 

[MrTaco92]

Tell that to the 118 DO’s and DO grads that matched into ortho last year, at least do some homework and research before you give such blanket statements, the overall DO match rate across all usmle and comlex for ortho was a 65.1% soo it’s doable especially at the former aoa programs you will have to work hard and get great scores etc..

I've done plenty of homework and research and went through the match process. I know the reality of matching hyper competitive specialties as a DO because I know how many people in my class did not match into the hyper competitive or even average competitive specialties they tried for and ended up matching into their backups. You never fully understand this reality until you personally get a sense of how many people matched into their backups vs truly desired specialties. Even then, there are plenty of people who will just barely match into their desired specialties (far down their rank lists) even if they're deemed competitive by numbers. 65% chance at matching is really not a situation you'd want to see yourself in one day

 

[slowthai]

Trust your gut on the residency’s and rank places higher on how they treat you, not the benefits, real or perceived. I am glad to report that my residency experience has been a complete 180 from med school so far and I wouldn’t be here if I didn’t trust my gut. That’s enough from me tho, I have contributed enough here in the past, lol.

Interesting. What we're usually told is to rank based on where we truly want to go and not try to game the match because programs love to lie about where you really stand. Too many people have gotten burned by listening to programs that like to make you feel special. They tell you that you're ranked to match, and then you end up not matching there when that was your number 1.

 

[hallowmann]

What about top/mid tier programs or desirable locations for less competitive or at least DO-friendly specialties?

Such as neuro, psych, EM, PM&R, gas, or even Rads.

Is matching into strong ACGME programs in these specialties reasonably achievable for a DO? Or is it as much of a long shot as getting into a plastics/IR/Derm/ENT type speciality ANYWHERE?

Work hard and apply broadly. Those specialties are all attainable at good quality programs (i.e. supportive environments and good training). As others have said, "top tier" means different things and can certainly mean malignant. As long as you are not geographically limited to one competitive city or state (in the case of CA), you'll be fine.

The top tier programs are competitive in every specialty, with PM&R being the only one where DOs reliably match. This really doesn't matter though honestly. You can do almost anything with regards to long-term career coming from a low to mid-range university program.

Average student at average DO school isn't going to match into the scenario you described usually. You just asked if a mid rank DO who got a 228 on step 1 and no research is going to match a strong program in what I'm assuming you mean to be a non-rural location. That's generally not true now and it will be less so in the future.

Plenty of average DOs match in mid-sized cities at university programs in Neuro, Psych, and EM. I agree with your other post, but this is a bit too fatalistic. Average DOs should be going for these specialties because they do match them all the time. They just need to cater their apps and build connections by doing aways/getting LORs, getting SLOEs, showing community involvement, etc.

Interesting. What we're usually told is to rank based on where we truly want to go and not try to game the match because programs love to lie about where you really stand. Too many people have gotten burned by listening to programs that like to make you feel special. They tell you that you're ranked to match, and then you end up not matching there when that was your number 1.

That's the case regardless. You should never rank based on your "likelihood" of matching at a specific program, not just because people lie, but because that doesn't benefit you at all. What @BorntobeDO? is talking about is ranking based on your gut/fit at the program, which is absolutely what you should do. If you like the people you meet on the interview and have a good feeling for the culture of the program, that's how you should rank, not for prestige, or perceptions of "competitiveness". Those are meaningless when you're working 80 hrs a week with the same couple of people. You need to like the people you are with and feel supported in residency.

 

[slowthai]

That's the case regardless. You should never rank based on your "likelihood" of matching at a specific program, not just because people lie, but because that doesn't benefit you at all. What @BorntobeDO? is talking about is ranking based on your gut/fit at the program, which is absolutely what you should do. If you like the people you meet on the interview and have a good feeling for the culture of the program, that's how you should rank, not for prestige, or perceptions of "competitiveness". Those are meaningless when you're working 80 hrs a week with the same couple of people. You need to like the people you are with and feel supported in residency.

Definitely, the algorithm was designed specifically to utilize the applicants' and programs' preferences and nothing else. I guess I misunderstood what BorntobeDO? meant precisely. Thanks for clarifying. I totally agree.

 

[AnatomyGrey12]

I understand it's sorta specialty-specific, but what would being an elite DO applicant generally look like?

Maybe something like this?

-240+ Step 1 (or 250+ Step 2 now?)
-Top 10% class rank
-At least 2-3 publications
-Successful audition rotations (how many?)
-Letter from someone well-regarded in the field


Looking for some benchmarks to aim for.

No. That’s just a “really good” applicant.

-Step 1 250+ Step 2 260s
-Level 1 750+ Level 2 800+
-15+ peer reviewed publications that are in well known medical journals
-3 first author publications in the top journal in their desired field
-Being the kind of person who constantly works hard but also that everyone wants to be around. Who has attendings calling their buddies in residency programs telling them this student is one of the best they’ve ever seen and they need to take them.

That is what a truly elite applicant looks like.

 

[DNC127]

No. That’s just a “really good” applicant.

-Step 1 250+ Step 2 260s
-Level 1 750+ Level 2 800+
-15+ peer reviewed publications that are in well known medical journals
-3 first author publications in the top journal in their desired field
-Being the kind of person who constantly works hard but also that everyone wants to be around. Who has attendings calling their buddies in residency programs telling them this student is one of the best they’ve ever seen and they need to take them.

That is what a truly elite applicant looks like.

CC is truly one of a kind.

 

[CocoMelon0531]

Which specific specialties do you think reach that time speant/income ratio?

You can literally make ~300-350K in literally all specialties outside of gen Peds, and cush primary care working 45-50h a week.

There is a diminishing return to income when you're relying mostly on W-2s as an employee due to our nation tax laws.

So, if you want to make banks, you need to develop other skills. But, being a doc and making around ~300-350K isn't a bad backup plan if you manage to make it through and lack other skills.

Some things to think about in order to get the best bank for your bucks and make banks:
1) Long term capital gain in this country is about 20%
2) Selling your primary home is tax free for a couple up to 500K in profit
3) Real estate profit can be delayed after selling properties if you take the money to buy other properties and keep delaying the tax
4) As a business owner, you can reinvest your profit in other money making machines to generate more passive income in order to lower your annual tax

Again, etc... etc... Your gunning time is better spent understanding the business aspects of life rather than an extra 20-40h per week ANKIng dumb things that won't yield much long term benefits, if money and lifestyle are your priorities.

 

[CaffineDoc24]

No. That’s just a “really good” applicant.

-Step 1 250+ Step 2 260s
-Level 1 750+ Level 2 800+
-15+ peer reviewed publications that are in well known medical journals
-3 first author publications in the top journal in their desired field
-Being the kind of person who constantly works hard but also that everyone wants to be around. Who has attendings calling their buddies in residency programs telling them this student is one of the best they’ve ever seen and they need to take them.

That is what a truly elite applicant looks like.

How much does the school matter? I’ve seen match lists for some of the “better” DO schools and they seem to have some ok matches. For example, I believe my buddy told me CCOM had 8 Ortho matches last year (not sure where though). I’m by no means an expert so just tryna learn.

 

[AnatomyGrey12]

How much does the school matter? I’ve seen match lists for some of the “better” DO schools and they seem to have some ok matches. For example, I believe my buddy told me CCOM had 8 Ortho matches last year (not sure where though). I’m by no means an expert so just tryna learn.

School name itself doesn't really matter. There are definitely schools though that have more resources than others, which can make it easier to build a stellar app. But some of the best residency applicants I've seen come from places like LMU, so it's not impossible.

 

[Angus Avagadro]

I take umbrage at the last statement, some people end up with nothing, and certainly if you survived the crapfest that is DO hazing, I mean schooling, you surely deserve something for making it through that torture besides 300k + of loans.

On a side note, since this thread is about matching, some unsolicited advice. The people who matched Derm from my school were absolute rockstars, one I knew well who was over 250 on step, had research, was fantastic to work with, and still matched former AOA. If she was MD she would have been Ivys. It isn’t a meritocracy guys, don’t ever forget it. Go look at the outcomes for non primary care, there are still people not matching with lists longer than 10 in their primary specialty, and they aren’t all weird or failing boards. I am of the opinion that 20 is the goal for interviews now, and it definitely can be done, as many of my classmates did.

Trust your gut on the residency’s and rank places higher on how they treat you, not the benefits, real or perceived. I am glad to report that my residency experience has been a complete 180 from med school so far and I wouldn’t be here if I didn’t trust my gut. That’s enough from me tho, I have contributed enough here in the past, lol.

I generally agree with what you say. I'd like to add that matching is up to the individual. Many who don't match didn't play the match game well. Some with good boards dont apply broadly enough. Some think their high step score will guarantee them a spot and don't have back up programs on their list. I had an excellent student with high 240's not get a single interview until late December. I believe it is very important to understand the market, honestly assess how strong a candidate you are, and apply to mostly programs that take DOs, and candidates with similiar credentials as you. Have a couple reach programs and at least one backup where you would go if not matching anywhere else. Specialties change every year with respect to how "Hot" they are with applications. Some university affiliate programs are quite good, but you have to do your research and find them.

 

[BSM_OTO]

I'm the OP, thanks for the advice. I didn't go into medicine to become a specific high-paid high-prestigious specialist otherwise I would've not done DO. Already paid DO tuition and starting school literally now so MD isn't an option and I could care less honestly, just wanted to start school this is a long process especially with residency.

Some of you are asking why I listed those specialties; my point wasn't that I had to do those or even really wanted to, it was that I have very little idea of what I wanted to do and if I found that the specialty or part of medicine I enjoy/love and desire is competitive, is it possible for me to do it?

This not being as much of a meritocracy as I thought it was is good to know. Also, I know it sounded naive with my ambitious 10% top of the class and high board scores without even starting medical school lol, but if I never set those goals they'd never happen. Anyone can say these things though so over the next few years I'll just have to prove myself, to myself.

Out of curiosity, for pain management is it better to go through anesthesia or PMnR? This is with hopes to open a private clinic in interventional pain eventually as I see a lot of them near me and I would love to own a business in medicine, knowing that IM private clinics are pretty dead nowadays unless you're in a bumbleF* state lol. I'm in NY. It's a generic question but any thoughts regarding which mildly competitive specialties (even IM specialties) have some future in private practice? Can be group owned and hospital affiliated

 

[Neopolymath]

I'm the OP, thanks for the advice. I didn't go into medicine to become a specific high-paid high-prestigious specialist otherwise I would've not done DO. Already paid DO tuition and starting school literally now so MD isn't an option and I could care less honestly, just wanted to start school this is a long process especially with residency.

Some of you are asking why I listed those specialties; my point wasn't that I had to do those or even really wanted to, it was that I have very little idea of what I wanted to do and if I found that the specialty or part of medicine I enjoy/love and desire is competitive, is it possible for me to do it?

This not being as much of a meritocracy as I thought it was is good to know. Also, I know it sounded naive with my ambitious 10% top of the class and high board scores without even starting medical school lol, but if I never set those goals they'd never happen. Anyone can say these things though so over the next few years I'll just have to prove myself, to myself.

Out of curiosity, for pain management is it better to go through anesthesia or PMnR? This is with hopes to open a private clinic in interventional pain eventually as I see a lot of them near me and I would love to own a business in medicine, knowing that IM private clinics are pretty dead nowadays unless you're in a bumbleF* state lol. I'm in NY. It's a generic question but any thoughts regarding which mildly competitive specialties (even IM specialties) have some future in private practice? Can be group owned and hospital affiliated

The best route to pain is via anesthesia residency as they control most of the fellowships but plenty of people achieve it via PMR. Good luck.

 

[BoneWizard]

I'm surprised by how low PM&Rs match rate is. I thought it was one of the more DO friendly specialties.

Out of curiosity, for pain management is it better to go through anesthesia or PMnR?

Anesthesia.

 

[slowthai]

I'm also wondering which specialties are most conducive to private practice besides Psych.

Anything that can charge mostly cash for their services. So besides what was mentioned earlier, derm and plastic surgery.

 

[AnatomyGrey12]

Are there any niches of IM or FM (or anything more DO-able) that can do this? Like a headache clinic or sleep medicine maybe?

Yes. Sleep, allergy, rheum, etc.

 

[Angus Avagadro]

I'm the OP, thanks for the advice. I didn't go into medicine to become a specific high-paid high-prestigious specialist otherwise I would've not done DO. Already paid DO tuition and starting school literally now so MD isn't an option and I could care less honestly, just wanted to start school this is a long process especially with residency.

Some of you are asking why I listed those specialties; my point wasn't that I had to do those or even really wanted to, it was that I have very little idea of what I wanted to do and if I found that the specialty or part of medicine I enjoy/love and desire is competitive, is it possible for me to do it?

This not being as much of a meritocracy as I thought it was is good to know. Also, I know it sounded naive with my ambitious 10% top of the class and high board scores without even starting medical school lol, but if I never set those goals they'd never happen. Anyone can say these things though so over the next few years I'll just have to prove myself, to myself.

Out of curiosity, for pain management is it better to go through anesthesia or PMnR? This is with hopes to open a private clinic in interventional pain eventually as I see a lot of them near me and I would love to own a business in medicine, knowing that IM private clinics are pretty dead nowadays unless you're in a bumbleF* state lol. I'm in NY. It's a generic question but any thoughts regarding which mildly competitive specialties (even IM specialties) have some future in private practice? Can be group owned and hospital affiliated

Interventional pain management would best be accessed via anesthesia. Anesthesia is a much more procedure oriented specialty than PM&R. I have found variability amongst operators, mostly from PM&R. As for the top 10% goals, it is good to have goals. My wife was an elite student, Summa cum laude, Phi Beta Kappa, top 10% in med school. She would go to class to socialize. It would be quite common for her to come home as a student and rave about how some people were "Scary Smart". Dont think those types arent in DO schools. I had more than a few in my class. Many go to DO shools because of an interest in primary care or for family reasons, cost, geography, etc. Nevertheless, just wanted to add some perspective. Good luck and best wishes!

 

[Dwan]

Honestly even going to a low tier (90th or below) MD school will rule out a lot of the super competitive specialities like IR/Vascular/ENT/Plastics. You would still need to be a stellar applicant. At all of the low tier medical schools I attended interviews for, I looked at their match lists and it was heavily primary care oriented and only a few outliers in competitive specialities. If you are seriously gunning for something competitive you probably need to get into a mid tier MD school. Which might be difficult considering you only had DO acceptances this time around.
But on the bright side you don’t need to do IR or be a plastic surgeon to be a good doctor.

To evaluate the impact of prestige, It is better to look at competitive matches rather than competitive specialties. The majority of HMS students go into IM, and the majority of med students scoring 250+ go into IM. Obviously these students could get competitive specialties if they wanted, but they didn't want to pursue those fields. Fields like IM give you a better perspective of how much "boost" you can get because there are always a ton of matches every year, and those matching competitive places weren't "forced" into IM.

I'm from a low-tier MD ranked below 70 and the difference in opportunity is drastic between low tier MD and DO. For IM, I interviewed at top places that refuse to take DOs, as well as many mid tiers, a select few which occasionally take DOs. However, those DOs were scoring 20-30+ higher than me on step 1/2 in order to receive a much lower quantity of mid-tier interviews if lucky - typically less competitive locations, and a large chunk of my mid-tier invites still had 0 DOs in their current roster. Sadly, it's far more common for someone from my single low-tier med to get into MGH/BWH/JHH/UCSF than for one of any of the many stellar DOs nationally to get an interview at UC Davis or Utah IM (zero to my knowledge). There is data available yearly on the IM spreadsheets that show how drastic the differences in invites are. Low-tier MDs still constantly complain about lack of prestige, and the difference is that the HMS students I knew with 200-220 Step 1 were able to match top 10 IM/Rads/ENT, with plenty of options (wasn't just a feat of luck). This is common from HMS, but very unlikely from low-tier MD, although I have seen it happen with great research/connections.

 

[deleted898021]

To evaluate the impact of prestige, It is better to look at competitive matches rather than competitive specialties. The majority of HMS students go into IM, and the majority of med students scoring 250+ go into IM. Obviously these students could get competitive specialties if they wanted, but they didn't want to pursue those fields. Fields like IM give you a better perspective of how much "boost" you can get because there are always a ton of matches every year, and those matching competitive places weren't "forced" into IM.

I'm from a low-tier MD ranked below 70 and the difference in opportunity is drastic between low tier MD and DO. For IM, I interviewed at top places that refuse to take DOs, as well as many mid tiers, a select few which occasionally take DOs. However, those DOs were scoring 20-30+ higher than me on step 1/2 in order to receive a much lower quantity of mid-tier interviews if lucky - typically less competitive locations, and a large chunk of my mid-tier invites still had 0 DOs in their current roster. Sadly, it's far more common for someone from my single low-tier med to get into MGH/BWH/JHH/UCSF than for one of any of the many stellar DOs nationally to get an interview at UC Davis or Utah IM (zero to my knowledge). There is data available yearly on the IM spreadsheets that show how drastic the differences in invites are. Low-tier MDs still constantly complain about lack of prestige, and the difference is that the HMS students I knew with 200-220 Step 1 were able to match top 10 IM/Rads/ENT, with plenty of options (wasn't just a feat of luck). This is common from HMS, but very unlikely from low-tier MD, although I have seen it happen with great research/connections.

Gosh this thread is getting depressing, in all honesty tho most DO students don’t care about prestige of the program as long as it gives you the training you need and isn’t a malignant program. I will say that I have seen more jaw dropping DO IM matches more recently like Emory IM, UTSW IM, BCM, Yale IM to name a few. I know that some qualified(not all) DO’s are atleast getting interviews from mid tier/upper mid tier places and that is significant in itself imho.. ivory tower places obvious look down upon the DO degree(in IM atleast) and such but that fact that DO’s made such in roads recently is significant no doubt. Personally I don’t know anyone in my class that cares about the prestige of a program and cares much much more about where they fit in. Also I am pretty sure that Utah IM has taken DO’s in the past so I don’t think they are anti do per say.

 

[scoopdaboop]

Like I said, MD's have won the war. This step being pass fail was undoubtedly fueled by top 20 MD schools who saw DO's matching into good programs, fearing that the process has been likely getting more and more merit based on step 1, and stepping in to stop that. I mean, you are a medical applicant that has a 3.9 and 515, going to a top 20, and workin your butt off to be a doctor, then the 3.3 506 guy has a good chance of getting a competitive specialty? Nah, they said BUMP DAT.

 

[deleted898021]

Like I said, MD's have won the war. This step being pass fail was undoubtedly fueled by top 20 MD schools who saw DO's matching into good programs, fearing that the process has been likely getting more and more merit based on step 1, and stepping in to stop that. I mean, you are a medical applicant that has a 3.9 and 515, going to a top 20, and workin your butt off to be a doctor, then the 3.3 506 guy has a good chance of getting a competitive specialty? Nah, they said BUMP DAT.

We will see, I just see the focus shifting to step 2 and then we are back to the same, but yea it hurts DO’s a bit and the IMG’s A LOT more since step 2 is taken much later and many don’t even take it before they apply, obviously the top 20 MD applicants won’t take it before they apply.

 

[AnatomyGrey12]

Also I am pretty sure that Utah IM has taken DO’s in the past so I don’t think they are anti do per say.

University of Utah is notoriously anti-DO. Even in the programs that have taken them it's an uphill battle.

 

[Darrow O'Lykos]

obviously the top 20 MD applicants won’t take it before they apply.

If PDs ultimately do shift focus to Step 2 scores, I have to imagine schools will adjust and students will begin taking step 2 prior to ERAS submission. Once that happens, I have to imagine even those at top 20 schools will have to adjust and apply with those scores as well. If PDs see applicants that have high Step 2 scores in their submission, they're probably inviting them to interview over the applicant from a top 20 school that doesn't have chops proven with the absence of a Step 2 score. Right?

It may not be immediate, but the response will happen. Plenty of schools have already shifted to a 12, 15, or 18 month pre-clinical curriculum. I imagine more and more schools will do this now that Step 1 is P/F.

I'm by no means an expert, and I get that making Step 1 P/F benefited those at top schools more so, but the game will adjust in response to this change. You can't expect the status quo to remain the same and those at top 20 schools to skate by.

 

[deleted898021]

University of Utah is notoriously anti-DO. Even in the programs that have taken them it's an uphill battle.

Hmmm would have never known, Utah isn’t exactly what I would have considered an elite coastal city

 

[DNC127]

Hmmm would have never known, Utah isn’t exactly what I would have considered an elite coastal city

Mormons are elite academically (usually) and 700+ leave Utah per year for Med school and they all wanna come back. Makes it tough.

 

[MLNS]

Hmmm would have never known, Utah isn’t exactly what I would have considered an elite coastal city

Probably because Utah is a freaking state, not a city.

 

[AnatomyGrey12]

If PDs see applicants that have high Step 2 scores in their submission, they're probably inviting them to interview over the applicant from a top 20 school that doesn't have chops proven with the absence of a Step 2 score. Right?

Probably not. Do not underestimate the prestige whoring that happens at the top of the ivory tower.

 

[Dwan]

If PDs see applicants that have high Step 2 scores in their submission, they're probably inviting them to interview over the applicant from a top 20 school that doesn't have chops proven with the absence of a Step 2 score. Right?

We already have evidence that most top 20 applicants with proven bad scores still match very well. It isn't common for them to do poorly, but those I knew with below avg scores still got into elite residencies. You also see the bias with M3 clinical grading - some the top med schools have eliminated it completely to favor true P/F, others will hand out H's like candy compared to normal MD/DO schools, and it has not impacted their match lists. Top med schools have also gotten rid of AOA without hurting their applicants. From a non-top 20, the less factors you have to prove you are better than applicants from the top 20's, the worse it will be.

 

[Darrow O'Lykos]

From a non-top 20, the less factors you have to prove you are better than applicants from the top 20's, the worse it will be.

Precisely why those from non-top 20s with Step 2 scores at the time of their ERAS application have a significant opportunity to stick out against those without Step 2 scores. I’m fully aware of the whoring for top 20s, but if those of us not attending top 20s are committed to proving ourselves and PDs have a stack of solid applicants with out-of-the-park Step 2 scores, don’t think they’re going to drop those applicants in the trash for a top20 school applicant with a Step 1 “Pass” and no Step 2 score.

The paradigm will shift. The game will adapt and we along with it. The sky is not falling for Class of 2024 and beyond.

Schools that shift their curriculum to better allow their students adequate time to prep for Step 2 and COMLEX will likely see better match lists. That isn’t their driving force, but they know with poor match lists that their desired students will look elsewhere. Students are their own strongest advocates and have been the most vocal/active force behind schools changing their curriculums. We are seeing this at plenty of mid-tier schools on the rise that are looking to advance medical education to put themselves within shouting distance near the top.

 

[AnatomyGrey12]

Precisely why those from non-top 20s with Step 2 scores at the time of their ERAS application have a significant opportunity to stick out against those without Step 2 scores. I’m fully aware of the whoring for top 20s, but if those of us not attending top 20s are committed to proving ourselves and PDs have a stack of solid applicants with out-of-the-park Step 2 scores, don’t think they’re going to drop those applicants in the trash for a top20 school applicant with a Step 1 “Pass” and no Step 2 score.

You are underestimating the prestige whoring. They could leave Step 1/2 scored for everyone and have P/F scores for students at the top 20 med schools and their match lists wouldn't change at all.

 

[Dwan]

Precisely why those from non-top 20s with Step 2 scores at the time of their ERAS application have a significant opportunity to stick out against those without Step 2 scores. I’m fully aware of the whoring for top 20s, but if those of us not attending top 20s are committed to proving ourselves and PDs have a stack of solid applicants with out-of-the-park Step 2 scores, don’t think they’re going to drop those applicants in the trash for a top20 school applicant with a Step 1 “Pass” and no Step 2 score.

The paradigm will shift. The game will adapt and we along with it. The sky is not falling for Class of 2024 and beyond.

Schools that shift their curriculum to better allow their students adequate time to prep for Step 2 and COMLEX will likely see better match lists. That isn’t their driving force, but they know with poor match lists that their desired students will look elsewhere. Students are their own strongest advocates and have been the most vocal/active force behind schools changing their curriculums. We are seeing this at plenty of mid-tier schools on the rise that are looking to advance medical education to put themselves within shouting distance near the top.

Like I said, even those with poor scores currently are doing very well. If anything, hiding their score would make PDs potentially assume they would've been high, like most the rest of the students at T20 schools (and chose to skip it to dedicate their time to other pursuits like research).