Considering D.O. over M.D.

Go on-line to www.aacom.org

Order a copy of Osteopathic Medical College Information Book.

 

misfit-

One thing I must say right off the bat: Do not look to Osteopathic Medical School just because you can't get into an Allopathic School. Make sure you really do want to attend an Osteopathic school or you will be cheating yourself, the school, other applicants, and your future patients.

The Osteopathic education consists of the same courses taught at any Allopathic school, with a more holistic twist. Osteopathic students are also taught manual medicine, a skill not learned by MD's. The Osteopathic philosphy basically consists of looking at the patient as a PERSON, not a conglomerate of symptoms, and realizing that this person's health is determined by more than disease, but by the overall physical, mental, and spiritual well-being of that person.

Currently, there are approximately 40,000 D.O.'s practicing in the United States, in all 50 states. Most practice in primary care.

Costs for education are comparable to Allopathic schools. It also matters whether or not the school is a private or state school.

Osteopathic schools have a high tendency for accepting non-trad students as they are looking for students with life experience, a more mature attitude, and those who are determined about becoming a good physician.

Application deadlines depend on the school.

Your numbers are well withing the range for most Osteopathic schools.

My best Advice: learn more about Osteopathic medicine. Learn its philosophies and read about what it has done for people and how it has developed. Then apply.

Best of luck to you.



------------------
Joshua Paul Hazelton, CNA, EMT-B
[email protected]
University of the Sciences in Philadelphia (2002)
"D.O. Wannabe"

 

You know, I hear this all the time..."Osteopathic schools teach you to become a person that treats the WHOLE person and not just a person's symptoms." Or something like that. What does this actually mean? Other than manipulation, how do they teach students this in osteopathic schools? Do they integrate classes in such a way as to teach you how to consider the WHOLE person. Basicly, what does this mean..."Whole Person."
I am just curious. I have been accepted to a D.O. school (Kirksville) and plan on attending. However, I would like to know this. I mean, this sort of apporach seems almost obvious to me that you should always consider a person more than just a conglomerate of symptoms. So, why dont allopatic schools teach this also?

 

Where do you get this crap from? Am I supposed to believe that just because I don't have the letters "D.O." behind my name I am incapable of thinking about my patients as people but just as walking nephrotics and asthma attacks? Well, then I guess I'd better stop getting to know the patients I'm seeing because then I might think of them as something other than a bunch of symptoms. To cite this propaganda about how DO's are more holistic and MD's are a bunch of inhuman, unfeeling technicians borders on prejudicial and you should be ashamed to make such blanket statements about your (possible) future colleagues. A doctor is a doctor is a doctor. If you think that taking a class on holism (which many, if not all, allopathic medical schools have in their curriculum) is going to make you a holistic healer, I have news for you: It ain't. Your approach to patients depends on you and not what lectures you went to.

In this light, I would see no problems with going to a DO school if one didn't get acceptance to an MD school. It's the same thing, you learn the same stuff and you become a doctor in the end. NB: YOU BECOME A DOCTOR. That's all that matters. How you deal with patients is independent of what degree you have and what school you went to.

 

To correct JPH:

Costs for DO schools are all nearly $25,000 a year plus. While a number of allopathic private schools charge this amount - this is VASTLY more than what many state MD schools charge.

Also the private/state distinction DOES matter for application purposes. Schools like UHS, KCOM, NOVA etc take people from all over - but schools like Texas, NYCOM, and Michigan take almost all their students from in-state.

The other poster was correct to bash JPH, although s/he was a tad rough. The nature of a physician's treatment of a patient (such as how "holistic" their care is) is dependent on that particular physician's beliefs and method of treatment (personal decisions) rather than something that is taught in school. I am at a DO school and I could give TWO SH!TS about holism. All I care about is passing biochem.

NEWS FLASH: I am in DO school because I could not get into MD school. There, I said it. Am I happy to become a DO? You bet. All I want to do is be a doc. So I have to explain what a DO is to people sometimes. Big deal.

 

I guess some of the messages posted on this section really upset me. Alot of people who want to be "MD's" always assume that the reason people become "DO's is because they were unable to make it into a "MD" school. That is simply not the case. I have from the day I started college known that being a "DO" is where my life was going to end up. I would without a doubt have been accepted at an "MD" school if that was my choosen past of interest, but it was not. Osteopathic medicine is not for rejects of "MD" admission. It is for individuals who truely believe that treating the whole individual and not the symptom is something that should takes precidence. And yes there is a difference. I have been working with both "DO's" and "MD's" for about 5 years, and the way in which "DO's" work with their patients is clearly different. Now not all "DO's" are like that but the majority of them are. MOST "MD's I know would rather perscribe a drug and not deal with root of the problem. I will be attending KCOM this fall and I would hope that the majority of them believe in the Osteopathic philosophy.

 

I pose the question again since it has not yet been answered.


You know, I hear this all the time..."Osteopathic schools teach you to become a person that treats the WHOLE person and not just a person's symptoms." Or something like that. What does this actually mean? Other than manipulation, how do they teach students this in osteopathic schools? Do they integrate classes in such a way as to teach you how to consider the WHOLE person. Basicly, what does this mean..."Whole Person."
I am just curious. I have been accepted to a D.O. school (Kirksville) and plan on attending. However, I would like to know this. I mean, this sort of apporach seems almost obvious to me that you should always consider a person more than just a conglomerate of symptoms. So, why dont allopatic schools teach this also?

 

Actually cjkalmat, I think Ponyboy answered your question pretty well:

"A doctor is a doctor is a doctor. If you think that taking a class on holism (which many, if not all, allopathic medical schools have in their curriculum) is going to make you a holistic healer, I have news for you: It ain't. Your approach to patients depends on you and not what lectures you went to."

There isn't anything...

mj

 

MJ,

Lectures do not factor in on what type of doctor you become? Come on now, maybe you should revise your statement a bit huh? Most of the knowledge and skills used in clinical practice are gained through lectures and clinical experiences. You sound like you are saying that you arrive at medical school with all of the necessary skills and knowledge to interact with, diagnose, and treat patients, you just spend eight years getting the degree and post-grad work needed to do it legally. There are differences, they may not be HUGE differences, but they are there.

BTW-How is your application process going MJ?

[This message has been edited by RollTide (edited 12-03-2000).]

 

I think the question I was looking for to be answered is: what does it mean to treat the Whole Person?

 

Truth is, 99% of your clases are taught by PhD's who would teach the class the same way no matter what kind of medical school you go to. Holistic medicine is the idea that patients are more than the sum of their parts...a view which most physicians share and a term the AOA seems to have a monopoly on. IMHO, the term "holistic medicine" amounts to a lot of AOA hype which they spend thousands of dollars to advertise in order to exaggerate the difference between MD's and DO's...a difference that doesn't really exist in the real world for the most part. Naturally, most doctors recognize that patients are more than the sum of their parts...perhaps DO schools just emphasize this point more bluntly by liberal use of their catch phrase "holistic medicine". Now I have to get back to the path (which at UHS is taught by an MD...maybe we're not learning holistic pathology?!?)

[This message has been edited by UHS03 (edited 12-04-2000).]

 

Excellent question. Just to take a stab at it: Treating the whole person means approaching therapy for disease and prevention of illness in a framework that considers biological, social, environmental, psychological, and cultural influences on disease, illness, and health factors. There is nothing uniquely osteopathic about that. It is simply the practice of good medicine in my opinion. MD's and DO's who practice holistically subscribe to this belief.

Now, I'll take a stab at osteopathic medical care: Osteopathic medical care encompasses the full scope of the scientific practice of holistic medicine and surgery (see above) with particular attention paid to optimizing host factors in healing (immune, vascular, mechanical, and neuroendocrine interrelationships) by means including, but not limited to, manaul medicine interventions such as OMT. I know many MD's who practice more osteopathically than some DO's I know.

Those statements both represent ideal models in patient care. Does the context in which medical care is delivered in the U.S. today allow for either of those models of care to be CONSISTENTLY delivered? I don't think so. Unless you have great insurance or pay cash that is. That is why there are holistically-oriented MD's and reductionistically-oriented DO's and everything in between. That is why many DO's don't the time, confidence, or support to provide OMT as often as they would like.

Without a doubt, there are real differences in practice patterns between MD's and DO's that have everything to do with individual differences, culture of training, exposure to didactic and clinical information, etc. Nevertheless, these differences aren't written in stone. Moreover, third party payment, practice guidelines, and evidence-based medicine constrain the kind of care patients recieve regardless of where they go or what kind of doctor they see (and this generally a good thing). In order for hospitals to remain accredited and in order for doctors to keep their licenses, both must use approved treatment protocols.

Osteopathic medicine offers students the opportunity to learn medicine within a unique conceptual framework that is fully compatible with our contemporary understanding of the biomedical basis for pathophysiology of disease. The jury is still out on whether or not augmenting host factors (which ostensibly is the basis of osteopathic medicine; i.e. "It is the job of a physician to find health, anyone can find disease." A.T. Still) leads to measurably improved clinical outcomes. More research is needed. At the end of the day, competent DOs and MDs, regardless of their own personal beliefs or practice patterns, seek the best possible care for their patients.

Practically speaking, I encourage all premeds to apply to both kinds of schools because medical school admission is competitive and both routes lead to the same end: An unrestricted license to practice medicine. The kind of doctor you will eventually be, and the kind of medicine you will eventually practice, are shaped by forces stronger than where you went to medical school.

 

I would not consider myself an MD flunky and I am by no means an MD wannabe. I simply was not accepted at MD schools that were my first choice. So I am at a DO school, and very happy with my choice. As for why most everybody else in my class is here, I HAVE NO IDEA. Nobody (at least that I hang out with) gives 2 craps about stuff like that. Sure there are some people who are die-hard DO only, but I am not sure the number is very large.

I will say that there are a number of students in my class that would BLOW AWAY the curriculum at any top 10 U.S. medical school (I am not one of them). They are incredible driven and intelligent. So I assume they could have gone anywhere they damn well pleased.

 

MISFIT, if you do not get into an MD school, nothing wrong with considering DO. People get offended too easily.

In the real world (that is, outside the stressed minds of pre-meds and, to a much lesser extent, first year med students, which haven't shed the pre-med mentality after 5 months of med school, as we speak)nobody cares if it says MD or DO after your name. The attendings care that you are reliable, know what you are supposed to know and complete the tasks assigned to you.

I am doing my clinical rotations right now. It has worked out that I have had just as many DO attending as MD attendings. In some places I was the only med student at that time, in others there were other med students on the same service, MD and DO students. I have yet to experience any kind of discrimination because I am a DO student rather than an MD student. The MD students and residents are usually curious about Osteopathic manipulation (OMT), because a lot of them have never rotated with DO students. "Curious" is the word, not "critical". (Most nurses who have worked with DO students previously, will be already lining up to get some OMT done. It is a great way to make friends with the nurses, if you are comfortable with your OMT skills) Other than that, you cannot see any difference between DO and MD students. We usually try to help one another look less stupid in front of the attendings, we are all equally "smart" and equally "befuddled", depending on the situation and so on.

I have probably seen a few hundred patients in these past 3 months (I have been on very BUSY rotations!). Figure, this is my fourth rotation and I saw and average of 10 patients a day (inservice you see 3-14 or so, clinic you see easily 20, every day).I had the grand total of 3 people ask me what a DO was. It is easy to remember because they were so few. It took 30 seconds to explain: "DOs are physcians who are also trained in manipulative techniques". Geesh, they really didn't want the "philosophy blah blah". They were happy with the short version and we moved on as, after all, they were there to have their ills addressed , not to have a philosophy lesson.

Don't let this MD vs DO very BORING debate stop you from applying to DO schools.

 

Colleagues, I think both MDs and DO can be caring doctors and please lets not generalize that MDs are not humane and all DOs are humane. My brother is an MD and let me tell you he is a great physician,very humane. Some of his MD friends are great!! Excellent communication skills and very humane. I also know one of his MD friends who is just after money and could care less about anything else. I also know DOs who are great physician and truly care for their patients. Also, I met another DO who just did not care about all that holistic stuff. I myself will be attending a DO school this fall because I want to be the best physician I can be. Will my degree shape my personality and style of practice? Ofcourse not, a degree does not make you a certain type of a doctor. Our personalities are determined early in life, and our patients will judge us by our personalities and by the way we treat them, not whether we are MDs or DOs. The patient will care less. I mentioned this point at one of my DO interviews, and yes they accepted me. I am going to be a great physician and that is all I am thinking about. Remember keep your minds open and listen.

 

Wow! this was wonderful. I learned a lot through this discussion. Thank you everyone for responding. I dont mean to sound like I am trying to end the discussion here. Please continue to contribute if you have something to say. Anyway, I rambling now....

 

MisFit! You don't have to explain yourself to anyone. I understood what you said from the first post. People get too defensive.

 

I have to agree with the statement "a doctor is a doctor is a doctor." I am currently a DO student at CCOM (chicago) and feel that the term "holistic" is overused by the Osteopathic Profession. We are now in our winter quarter, and since the first day of orientation, our school has not stressed "holistic medicine" once. Nor has our school stressed primary care over any other specialty. Our anatomy professor is an MD! Does this mean we are getting ripped off? Of course not! Our clinical Medicine course is taught by DO's, but they have never ONCE said anything about the "holistic approach." It really doesn't matter. The only additional training which DO's receive in school (over the entire course of two years) is a 4 hour block each week consisting of manual manipulative medicine. The advantage of having this over our MD counterparts is that we are taught to feel and use our hands as "tools" in the diagnosis of somatic dysfunction. We are taught from day one to use our hands and may be able to diagnose musculoskeletal and/or orthopaedic dysfunction a bit faster than MD's just by palpation, but this in itself does not make a DO "holistic." The holistic approach is innate in the physician and caring comes from understanding and being empathetic with your patients. Any MD or DO can accomplish this.....just by being a caring person.
Every Osteopathic Physician I know does not use OMM (Osteopathic Manipulative Medicine) at all in their practice. Some DO students don't even believe in it! Some would rather be studying for that Anatomy or Pathology exam rather than being in OMM lecture and lab because they know they will never use it!
Yes, some students are here because they didn't get into any MD's schools, but others like myself are here because they only applied to DO schools....So, take your pick.
MD's and DO's are colleagues and equals.....

"A doctor is a doctor is a doctor..."

 

I preface my question with the following: I'm a big supporter of the osteopathic profession and perhaps its most vocal allopathic supporter on this board. So please don't label me an MD snob.

Reluctantly in response to BMSW04 of CCOM's post, I ask if there is no difference between the MDs and the DOs, and the "holistic approach" is something the AOA has beaten to death without much benefit, why does this country need two separate, but equal professions? In other parts of the world there is a very clear distinction between the MDs and the DOs. The MDs practice medicine and surgery. The DOs practice osteopathy and osteopathy only.

In the US we have a very unique situation, one that has been cited here and in other osteopathic forums many, many times. The belief that a DO is an MD+OMT is too simplistic, and so I ask you, a student who claims to only have applied to osteopathic schools, why do we have two professions?


Tim of New York City.

 

Turtle-I've talked with DO's in practice who wonder the same thing. When you ask this question, be prepared for various answers that just echo AOA unity campaign ads.

You are right in saying it is too simplistic to think of a DO as MD+OMT. As you know, we learn manipulative techniques, but there is also a deeper, more diagnostic aspect to it. What I mean is that we are taught in depth how various structures are interrelated (fascia, compensatory patterns, effects of gait abnormalities, etc.) These are not things that are necessarily only noticed by the DO, but they are things that are emphasized very heavily at our schools (at least in OPP). I find myself noticing awkward gait cycles all the time and then trying to figure out what else could be screwed up musculoskeletally as the body tries to compensate. As this person compensates, are there any points where they are especially prone to arthritis (hips maybe)? If this person were to need hip replacement surgery someday, has the problem really been corrected, or has her pain just been alleviated? Maybe some attention as to why her gait cycle is screwy would ensure a more complete and permanent rehab. This is something that anyone with a good knowledge of anatomic structure and function can do, but do they take the time to think about it that way? Is it emphasized for them to think about it that way? As I have never gone to an MD school, I cannot say that these things aren't emphasized, except I'm pretty confident you don't get OMT . I do not feel that using OMT is enough to have 2 separate degrees, but if these other things I have described are not emphasized as much at other schools, then maybe having sewparate degrees is important. I have never heard the term "holistic" defined in a way that doesn't sound like AOA rhetoric to me (and it naturally follows, in my cynical mind, that if it is AOA rhetoric, it implies some sort of insult to every doctor that isn't a DO.) I would like to think that situations like the scenario I described are what is meant by "holistic" care. It is not something that only DO's do, but it is something emphasized at DO schools. Whether or not that additional emphasis + OMT is sufficient to warrant a separate degree, who knows...maybe. I will say that at my school, the only time any of this is mentioned is in our OPP classes. Every other class is the same as at any other medical school. Now, once again, my holistic pathology class is calling!

 

Almost entirely because of political reasons and political reasons alone. If the mainstream MDs in the middle 1800's would have given A.T. Still a laboratory at Baker University in Kansas (what he originally wanted) to test and develop his theories, instead of laugh him out of town, osteopathy might have become nothing but a footnote in American medical history. Alternatively, mainstream medicine might have completely absorbed osteopathic tenets and today all MD's trained in the USA would learn manipulative techniques as a part of their general medical preparation. Interestingly, in Europe, orthopaedic surgeons are taught manual medicine in their residencies and think nothing strange about it.

It is important to remember that A.T. Still never intended to create a separate branch of medicine---he only intended to reform the current practices of his day. But, the hostility of the MD community resulted in balkanizing (and galvanizing) DO's into their own practice groups, hospitals, specialty societies, etc. The European model of osteopathy is *NOT* the "true model" as Europeans would have some believe because they do not practice the full scope of medicine and surgery as Still intended (himself, of course a MD and surgeon by training). The European DO's were heavily influenced by Littlejohn (a Scottish MD who studied with Still before returning the British Isles) and have developed their own "slant" on things.

I think of osteopathic medicine as one of those unique artifacts of early American frontierism. I think there is little harm by having equivalent degrees as long as the training is comparable. As it has been mentioned many, many times before on this board, the USA is also the only country with two degrees for dentists (DDS and DMD), two degrees for psychologists (Psy.D. and Ph.D.), two degrees for lawyers (L.L.B. and J.D.) a number of degrees for professional social workers (MSW, BSW, MSSW, MASW), a number of degrees for public health professionals (MPH, MSPH, MSACH), etc. While each degree is slanted a little differently in terms of their requirements, all manage to fulfill some core curricula (some claim to be more "applied" while others clain to be more "research" oriented). They all lead to a unrestricted license to practice in the same profession. In other developed, usually a bit more socialized countries, things tend to be more standardized. As one ponders why the USA is the only developed country with two medical degrees, one might also ponder why the USA is the only developed country that conducts its national elections with 50 different versions of ballots...



[This message has been edited by drusso (edited 12-07-2000).]