D.O.s in specialties.

[Doghead]

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I have recently become aware that D.O.s have lesser chances of obtaining residencies in an alarming amount of specialties. I was wondering what specialties, if any, are commonly D.O. friendly?

This concern stems from the fact that my dream is to become a neuroradiologist, as this was the sub-specialty of the physician responsible for saving my big sister's life. Is this reality impossible for me to actualize via Osteopathy?

 

[Awesome Sauceome]

I was under the impression that very specialized things (particular through fellowships) are slightly more challenging to get in to as a DO. Specifically because of the long line of hoops you would have to jump through. 1) You have to do VERY well in school and on boards, which is already hard (DO or MD), 2) get into a competitive allopathic residency (Radiology and other competitive specialties are easier to get in to as an MD), 3) Get into a fellowship, which the allopathic route has significantly more of and you can pretty much only attain if you went to an allopathic residency (unless you are applying for one of the fewer osteo fellowships)..

So from what I have heard on here time and again, if you are willing to work for it and are a strong test taker, its attainable. But otherwise its not that its impossible, but it is just a very steep uphill battle where you have many "checkpoints" that could become insurmountable hurdles depending on your stamina and work ethic. From what I have heard, it is easier to take an extra year, bolster your application and get in to an MD school, than it is to go to a DO school and become one of those super rare specialties simply because comparably its a year of post-bac or MCAT studying vs years of staying on your A game and jumping through the 3 hoops stated above.

having said that, I personally know several DO's that are in what people would consider "rare" specialties. When I ask them about it, they "just say work hard, no one can stop you from doing anything." So thats what I am gonna do. I have taken 2 years off preparing to apply, so for me, whoever takes me gets me and I will figure out my future later. So "challenge and reward" are words that only you can define for yourself.

just my 2 cents

 

[pattr]

Neuroradiology definitely possible as a DO. It is a subspecialty of Radiology which is a competitive but very do-able specialty for DO as long as you score average or above average on USMLE and get good grades.

Cliquesh's answer to this question has been posted many many times and should really be stickied but here it is for now:

It's realistic, as a DO, to match at:

A top tier pyschiatry, family medicine, anesthesia, PM&R or pathology program.

A mid-tier internal medicine, neurology, pediatric, Ob/gyn or emergency medicine program

A mid to low tier general surgery or radiology program.

It's also realistic to match AOA orthopedics and general surgery, as well as emergency medicine, family medicine, pediatrics, internal medicine, psych and Ob/gyn.

It's unrealistic to match Acgme orthopedics, neurosurgery, urology, ENT, derm, radiation oncology and plastic surgery. Opthamology may or may not be unrealistic (not enough data to determine).

It's unrealistic to match aoa surgical subspecialities, except for aoa general surgery and orthopedics, because there are so few spots ( 14 neurosurgery, 24 ENT, 17 urology, and 15 opthamology). This is in contrast to the 135 general surgery spots and 100 orthopedic spots offered last year.

Similar there are few AOA anesthesia, radiology, and derm spots (about 30 for each speciality). However, acgme anesthesia is very DO friendly and acgme radiology is pretty DO friendly. AOA derm is weird because you don't apply as a 4th year, you apply as an intern, so I don't know how realistic aoa derm is.

 

[nardini46]

From my experience and what I've heard the above post is very true.

 

[Awesome Sauceome]

cliquesh knows his crap, to OP you best answer is looking up stuff from him rather than my long winded post haha

 

[Doghead]

Very insightful. Thank you for elaborating so clearly for me.

 

[Doghead]

Neuroradiology definitely possible as a DO. It is a subspecialty of Radiology which is a competitive but very do-able specialty for DO as long as you score average or above average on USMLE and get good grades.

Cliquesh's answer to this question has been posted many many times and should really be stickied but here it is for now:

Your advice is very uplifting. I have no quarrels about working harder and more often to achieve my goals. Even if I still fall short, I will only be a better doctor for having pushed myself, and will have done so knowing someone more capable will have filled the roll which means better care for the patients.

 

[cliquesh]

Hah, thanks.

Of the 209 neuroradiology spots offered last year, 9 went to DOs. There were roughly 40 pgy4 DOs that were eligible to apply to the fellowship. 11 DOs matched IR.

 

[Doghead]

That being said, are there D.O. schools better known for providing opportunity in specialty residencies? And where do you pull these fantastic statistics from?

 

[Awesome Sauceome]

I have heard a good deal about CCOM and PCOM. I have heard a problem with getting a harder specialty is you need to do rotations in that area and have good letters of recommendations from people there. The problem with some DO schools is that they are sort of in the middle of no where and many of their hospitals and training facilities simply do not have the specialties you would be looking for. I have heard that CCOM and PCOM help with those types of rotations simply because they are so close to many large hospitals that constantly have med students running through them.

 

[cabinbuilder]

That being said, are there D.O. schools better known for providing opportunity in specialty residencies? And where do you pull these fantastic statistics from?

Residency does not have anything to do with which DO school you go to. It's not networked that way. It's up to you as the individual to be competitive enough for the residency you are looking to be admitted into.

 

[cliquesh]

Acgme fellowship http://www.nrmp.org/match-data/fellowship-match-data/
Acgme residency http://www.nrmp.org/match-data/main-residency-match-data/
AOA residency number of spots per field https://www.natmatch.com/aoairp/stats/2013prgstats.html
General AOA match data by school for 2013 https://www.natmatch.com/aoairp/stats/2013sklstats.html
Average board scores and number of applicants for AOA programs http://data.aacom.org/media/DO_GME_match_2012.pdf
A list of all the current AOA residencies and fellowships http://opportunities.osteopathic.org/

 

[FrkyBgStok]

I love how everyone worries so much about how being a DO might hurt residency chances. Obviously, every person who starts med school will be in the top 25% of their class. The specialties that are hard for DOs to match in are generally the same ones that are hard for MDs to match in.

 

[Silent Cool]

That being said, are there D.O. schools better known for providing opportunity in specialty residencies? And where do you pull these fantastic statistics from?

No, they will all leave you equally disadvantaged relative to your MD counterparts 🙂

 

[cliquesh]

I love how everyone worries so much about how being a DO might hurt residency chances. Obviously, every person who starts med school will be in the top 25% of their class. The specialties that are hard for DOs to match in are generally the same ones that are hard for MDs to match in.

I think it's a big deal and I also think every DO applicant should be well aware of what they are getting themselves into before attending a DO school. I know many of my classmates were naive about the difficulties DOs face in match.

With that said, I'm happy with my education and I did fairly well in the match.

 

[Dogcat1290]

I think it's a big deal and I also think every DO applicant should be well aware of what they are getting themselves into before attending a DO school. I know many of my classmates were naive about the difficulties DOs face in match.

With that said, I'm happy with my education and I did fairly well in the match.

So is being a DO harder in a sense that the popular specialties have few spots and thousands of applicants competing for them and a MD is looked upon favorably or is it because out of the thousands of applicants MDs just have higher scores then DOs and they are more likely to get in? I went on a tour at PCOM a couple years ago and they handed out a sheet (which of course I threw out last week ) that had their match list and the top two matches were cardiology and neurosurgery. I mean would that be possible even with the other 3 medical schools competing within the same area or do you think they were padding up their list?

 

[cabinbuilder]

I love how everyone worries so much about how being a DO might hurt residency chances. Obviously, every person who starts med school will be in the top 25% of their class. The specialties that are hard for DOs to match in are generally the same ones that are hard for MDs to match in.

Yes, it gets quite tiresome. I also love how it's perpetuated "that every single DO student strives for the most competitive ACGME specialty residency" which is definitely NOT the case. There are plenty of DO students who do AOA residencies without applying to the MD side. Sigh......... carry on.

 

[cabinbuilder]

So is being a DO harder in a sense that the popular specialties have few spots and thousands of applicants competing for them and a MD is looked upon favorably or is it because out of the thousands of applicants MDs just have higher scores then DOs and they are more likely to get in? I went on a tour at PCOM a couple years ago and they handed out a sheet (which of course I threw out last week ) that had their match list and the top two matches were cardiology and neurosurgery. I mean would that be possible even with the other 3 medical schools competing within the same area or do you think they were padding up their list?

So how is it that someone matched into cardiology? To be a cardiologist you match into an Internal Medicine residency for 3 yrs and THEN apply to a 3 yr cardiology fellowship so the match list should not list a cardiology match. Then if you want to be and EP cardiologist that's another 3 yr fellowship after the first. Something is fishy there.

 

[cabinbuilder]

cliquesh knows his crap, to OP you best answer is looking up stuff from him rather than my long winded post haha

I beg to differ on many of his points.

 

[cliquesh]

So is being a DO harder in a sense that the popular specialties have few spots and thousands of applicants competing for them and a MD is looked upon favorably or is it because out of the thousands of applicants MDs just have higher scores then DOs and they are more likely to get in? I went on a tour at PCOM a couple years ago and they handed out a sheet (which of course I threw out last week ) that had their match list and the top two matches were cardiology and neurosurgery. I mean would that be possible even with the other 3 medical schools competing within the same area or do you think they were padding up their list?

I think it's a mixture of everything you mentioned. There are fewer AOA speciality spots, most Acgme programs prefer USMDs, and the average DO has lower board scores than the average USMD.

Pcom isn't padding their list. I guarantee you that the "impressive" matches you are describing were AOA matches and, therefore, they were positions that the local Philadelphia MD programs were not elligiable for.

Being a DO is only bad if you want to do one of the surgical subspecialities (besides orthopedics), derm or rad onc. Everything else is obtainable.

 

[Dogcat1290]

So how is it that someone matched into cardiology? To be a cardiologist you match into an Internal Medicine residency for 3 yrs and THEN apply to a 3 yr cardiology fellowship so the match list should not list a cardiology match. Then if you want to be and EP cardiologist that's another 3 yr fellowship after the first. Something is fishy there.

Like I said it was a couple years ago and the list might of been specialties that people eventually went into. I remember cardiology and neurology being top of the list because I remember thinking to myself how impressive it was 🙂

 

[Spikebd]

I beg to differ on many of his points.

Just curious, which ones?

 

[cabinbuilder]

Just curious, which ones?

You really expect me to come up with every aspect of all his conversations that I don't agree with? Many people don't agree with me either.

 

[Spikebd]

You really expect me to come up with every aspect of all his conversations that I don't agree with? Many people don't agree with me either.

You don't have to list anything I was just hoping to hear what you thought about his quote that was copied above. His quote seems reasonable to me as far as realistic expectations go. But I know very little of how the game (residency selection process) actually works. All I know is his comment seems to match that NRMP data the public can see.

 

[1badz]

D.O.'s can specialize? 😵 !

 

[HopefulReapp]

D.O.'s can specialize? 😵 !

Wait, what are OD's again?

 

[1badz]

Wait, what are OD's again?

Wizards!

 

[Mad Jack]

Residency does not have anything to do with which DO school you go to. It's not networked that way. It's up to you as the individual to be competitive enough for the residency you are looking to be admitted into.

There is some truth to this, but also to the counter argument. Look at the number of PCOM students that attend PCOM residencies. Partly, this is certainly due to location. But there is certainly a component of being able to rotate with said programs. If it was just a stats game, PCOM graduates wouldn't make up more than half of their orthopedic surgery residents consistently every year.

However, I do agree with the overall message of your post. While going to a specific school may increase your chances of matching at particular programs, it does not have a great effect on your ability to match in a specialty overall. You might not match PCOM orthopedic surgery as easily if you did not attend PCOM, but if your numbers are good enough, you'll probably match orthopedic surgery somewhere, for instance.

 

[cabinbuilder]

There is some truth to this, but also to the counter argument. Look at the number of PCOM students that attend PCOM residencies. Partly, this is certainly due to location. But there is certainly a component of being able to rotate with said programs. If it was just a stats game, PCOM graduates wouldn't make up more than half of their orthopedic surgery residents consistently every year.

However, I do agree with the overall message of your post. While going to a specific school may increase your chances of matching at particular programs, it does not have a great effect on your ability to match in a specialty overall. You might not match PCOM orthopedic surgery as easily if you did not attend PCOM, but if your numbers are good enough, you'll probably match orthopedic surgery somewhere, for instance.

How come your status says pre-med? Where are you in your training?

 

[Dr. Zombie]

How come your status says pre-med? Where are you in your training?

He JUST got accepted to med school this cycle.

 

[Mad Jack]

He JUST got accepted to med school this cycle.

Does that mean I am incorrect? I've been crunching match numbers of various schools in different specialties for for years. My comment was not opinion, it was statistical fact, as derived from comparing match lists with the NRMP results and AOA Opportunities website. Here's some numbers to back my claim.

http://opportunities.osteopathic.or...program_id=137587&hosp_id=137586&returnPage=1

http://pcomcollage.pcom.edu:86/Student_Life/Student_Affairs_Main/match_2012_phl.html

If you look at PCOMs match list, 5 of the 10 spots in PCOM Leigh Valley EM went to PCOM students. I do not know exactly how many people interviewed that year, but this year 187 students were interviewed for 12 spots. That breaks down to 15.6 students interviewed per slot, so they likely interviewed 156 students for 10 positions. Unless nearly 80 PCOM students (>11% of the entire class) interviewed for this residency, PCOM is over represented in the this residency.

http://opportunities.osteopathic.or...program_id=187705&hosp_id=119109&returnPage=1

PCOM took half of the PCOM Albert Einstein Urological Surgery residencies for this year. 60 students were interviewed for 4 positions. Unless 30 PCOM students (~4%) of the class interviewed for this highly competitive specialty, they are over represented.

The same teems is seen in orthopedic surgery and general surgery at PCOM Consortium. PCOM students are at an undeniable statistical advantage when applying to PCOM affiliated residencies.

 

[cliquesh]

I think Mad jack is correct. It is beneficial to attend a school with a robust residency OPTI.

 

[cliquesh]

Question: Do you need to do an ACGME residency to become an endocrinologist or cardiologist? I'm assuming this is true because these are fellowships and I'm not sure if you can do a fellowship out of an AOA residency.

No. There are AOA fellowships, too. There are 5 AOA endocrine fellowships and 27 AOA cardiology fellowships. http://opportunities.osteopathic.org/ has a list of all AOA residencies and fellowships.

 

[happypremed1]

I think Mad jack is correct. It is beneficial to attend a school with a robust residency OPTI.

If you are gunning for ACGME residencies, then OPTI should not matter right?

No. There are AOA fellowships, too. There are 5 AOA endocrine fellowships and 27 AOA cardiology fellowships. http://opportunities.osteopathic.org/ has a list of all AOA residencies and fellowships.

I assume the AOA fellowships are more difficult to get due to the limited number of positions. Can I graduate from DO school, do a ACGME residency, and still get into AOA fellowships?

 

[cliquesh]

If you are gunning for ACGME residencies, then OPTI should not matter right?



I assume the AOA fellowships are more difficult to get due to the limited number of positions. Can I graduate from DO school, do a ACGME residency, and still get into AOA fellowships?

Yea, it probably doesn't matter too much if you end up going Acgme, but keep in mind if you want to do a surgical subspeciality the AOA is your only realistic option. Additionally, 40% of DOs will end up going AOA, so even if you don't plan on it now, the aoa may be your only option.

I don't think AOA cardiology is too hard, but that's the only abundant AOA fellowship. Some aoa fellowships are strongly associated with a specific residency program, which greatly increases your chances of matching into a particular fellowship. PCOM's plastic surgery fellowship, for example, basically only takes PCOM's general surgery residents, so your odds of becoming a plastic surgeon from PCOM's general surgery program is something like 3 fellows/ 7 residents.

I do not believe you can go from Acgme to aoa, but I'm not 100% sure on that. In the past it was possible to go from an Aoa residency to an Acgme fellowship, but that's no longer possible.

 

[happypremed1]

Yea, it probably doesn't matter too much if you end up going Acgme, but keep in mind if you want to do a surgical subspeciality the AOA is your only realistic option. Additionally, 40% of DOs will end up going AOA, so even if you don't plan on it now, the aoa may be your only option.

I don't think AOA cardiology is too hard, but that's the only abundant AOA fellowship. Some aoa fellowships are strongly associated with a specific residency program, which greatly increases your chances of matching into a particular fellowship. PCOM's plastic surgery fellowship, for example, basically only takes PCOM's general surgery residents, so your odds of becoming a plastic surgeon from PCOM's general surgery program is something like 3 fellows/ 7 residents.

I do not believe you can go from Acgme to aoa, but I'm not 100% sure on that. In the past it was possible to go from an Aoa residency to an Acgme fellowship, but that's no longer possible.

Thanks. I'm interested in anesthesiology, and from what I've read online (SDN), I'm gunning for ACGME match. To be competitive as a DO applicant, what step 1 score should I get?

 

[cabinbuilder]

Does that mean I am incorrect? I've been crunching match numbers

Just means you are number cruncher with no real experience in how the match works. Bowing out of this thread.

 

[cliquesh]

Thanks. I'm interested in anesthesiology, and from what I've read online (SDN), I'm gunning for ACGME match. To be competitive as a DO applicant, what step 1 score should I get?

A 230 should be good enough to match somewhere decent.

 

[Mad Jack]

If you are gunning for ACGME residencies, then OPTI should not matter right?



I assume the AOA fellowships are more difficult to get due to the limited number of positions. Can I graduate from DO school, do a ACGME residency, and still get into AOA fellowships?

Outside of your OPTI where you go to school really doesn't mean a whole lot. Anesthesia had an average Step 1 of 230 for independent applicants (DOs, IMGs, reapplicants) with a standard deviation of 10 points, so 220-240 would leave you competitive. Anesthesiology is traditionally a fairly DO friendly field. Over 10% of allopathic anesthesia positions went to DOs last year (117 of 1,079 PGY-1 positions and 58 of 580 PGY-2 positions). Given reimbursement changes over the next three years, I wouldn't be surprised if it became even less competitive by the time you are trying to match.

 

[happypremed1]

A 230 should be good enough to match somewhere decent.

Ok, thanks! I will keep that in mind as I start medical school next year.

 

[egoodwi4]

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[SurgeDO]

Does that mean I am incorrect? I've been crunching match numbers of various schools in different specialties for for years. My comment was not opinion, it was statistical fact, as derived from comparing match lists with the NRMP results and AOA Opportunities website. Here's some numbers to back my claim.

http://opportunities.osteopathic.or...program_id=137587&hosp_id=137586&returnPage=1

http://pcomcollage.pcom.edu:86/Student_Life/Student_Affairs_Main/match_2012_phl.html

If you look at PCOMs match list, 5 of the 10 spots in PCOM Leigh Valley EM went to PCOM students. I do not know exactly how many people interviewed that year, but this year 187 students were interviewed for 12 spots. That breaks down to 15.6 students interviewed per slot, so they likely interviewed 156 students for 10 positions. Unless nearly 80 PCOM students (>11% of the entire class) interviewed for this residency, PCOM is over represented in the this residency.

http://opportunities.osteopathic.or...program_id=187705&hosp_id=119109&returnPage=1

PCOM took half of the PCOM Albert Einstein Urological Surgery residencies for this year. 60 students were interviewed for 4 positions. Unless 30 PCOM students (~4%) of the class interviewed for this highly competitive specialty, they are over represented.

The same teems is seen in orthopedic surgery and general surgery at PCOM Consortium. PCOM students are at an undeniable statistical advantage when applying to PCOM affiliated residencies.

i agree with you. for example, look at LECOM's ortho program. it seems you would be disadvantaged in matriculation if you did not graduate from LECOM.

this is better for the osteopathic medical world. it will weed out institutions that do not establish their own residencies.

 

[pietachok]

I have recently become aware that D.O.s have lesser chances of obtaining residencies in an alarming amount of specialties. I was wondering what specialties, if any, are commonly D.O. friendly?

This concern stems from the fact that my dream is to become a neuroradiologist, as this was the sub-specialty of the physician responsible for saving my big sister's life. Is this reality impossible for me to actualize via Osteopathy?

That a subspecialist saved your sister's life is usually not enough to sustain you through residency in that field if you don't love it, and rads is one of those fields where the practice is a major turn on or off to many people in clinical years, so I wouldn't bank too much on the idea that you'll actually end up pursuing this field (not out of qualification but mere interest and attraction to other specialties). That said, I assume she had a neurologic problem if she needed a neurorads consult -- while radiology is out of reach for many MD and DO students, neurology is not (I find this disturbing, but it's true). Only about 50% of spots in neuro fill with US MD graduates, and the rest go to DO and IMGs. Individual programs are not "DO friendly" but even some very well regarded ones like Cleveland Clinic have bunches of DOs training with them.

 

[csx]

. Some aoa fellowships are strongly associated with a specific residency program, which greatly increases your chances of matching into a particular fellowship. PCOM's plastic surgery fellowship, for example, basically only takes PCOM's general surgery residents, so your odds of becoming a plastic surgeon from PCOM's general surgery program is something like 3 fellows/ 7 residents.
.

Dumb question...but where can you find that information on programs that are bias for students of a certain institution?? Dig through the school website? is there someplace else?..

 

[cliquesh]

Dumb question...but where can you find that information on programs that are bias for students of a certain institution?? Dig through the school website? is there someplace else?..

Yea, it's something you're going to have to dig for on the Internet or talk to senior med students or residents about. Unfortunately, very few osteopathic residencies/fellowships have good webpages, so gathering that kind of information is difficult. I knew that little factoid about PCOM's surgery program because there use to be a decent pcom general surgery website with a list of recent alumni, but they took it down for whatever reason. In general, fellowship programs offer their spots to in-house applicants first and then to out-side applicants. That's why it's best to go to a program with lots of in-house fellowships.

 

[user3]

That a subspecialist saved your sister's life is usually not enough to sustain you through residency in that field if you don't love it, and rads is one of those fields where the practice is a major turn on or off to many people in clinical years, so I wouldn't bank too much on the idea that you'll actually end up pursuing this field (not out of qualification but mere interest and attraction to other specialties). That said, I assume she had a neurologic problem if she needed a neurorads consult -- while radiology is out of reach for many MD and DO students, neurology is not (I find this disturbing, but it's true). Only about 50% of spots in neuro fill with US MD graduates, and the rest go to DO and IMGs. Individual programs are not "DO friendly" but even some very well regarded ones like Cleveland Clinic have bunches of DOs training with them.

I was reading through the radiology forum recently and there was a DO with 222 USMLE (which is just under the average, I think) that had received 8 ACGME radiology interviews, which is enough to match. apparently the radiology job market has taken a downturn, and is now much less competitive than in the past.

cliquesh has also stated that some of his classmates with only COMLEX scores were able to match allo rads.

 

[cliquesh]

I was reading through the radiology forum recently and there was a DO with 222 USMLE (which is just under the average, I think) that had received 8 ACGME radiology interviews, which is enough to match. apparently the radiology job market has taken a downturn, and is now much less competitive than in the past.

cliquesh has also stated that some of his classmates with only COMLEX scores were able to match allo rads.

Yep, and they all had sub-600 scores too.

 

[pietachok]

I was reading through the radiology forum recently and there was a DO with 222 USMLE (which is just under the average, I think) that had received 8 ACGME radiology interviews, which is enough to match. apparently the radiology job market has taken a downturn, and is now much less competitive than in the past.

cliquesh has also stated that some of his classmates with only COMLEX scores were able to match allo rads.

Indeed. That's the case with several of the reputed "lifestyle" specialties. Still, the average step 1 for rads is 240, for neuro 225, and nationally 226, so there are "many" who are less competitive for rads but who would be quite competitive for neurology. Considering that as well as the high potential to discover in med school that you don't like your pre-med dream specialty, I just felt it apropos to point out that there's a pretty wide open door to neurology, because he was concerned with being able to practice in a field in which he had a personally motivating experience. Not knocking DOs or their ability to become radiologists.

Not sure what COMLEX scores have to do with anything I wrote.

 

[csx]

I was reading through the radiology forum recently and there was a DO with 222 USMLE (which is just under the average, I think) that had received 8 ACGME radiology interviews, which is enough to match. apparently the radiology job market has taken a downturn, and is now much less competitive than in the past.

cliquesh has also stated that some of his classmates with only COMLEX scores were able to match allo rads.

Yep, and they all had sub-600 scores too.

Is there a reason rad is taking a drop? or was this just by just a random abnormality that usually doesn't happen?

 

[cliquesh]

Is there a reason rad is taking a drop? or was this just by just a random abnormality that usually doesn't happen?

Radiology reimbursments are declining and the job market is becoming saturated with new radiologists. It's not uncommon for new radiologist to do a fellowship or 2 before finding a job. The salary is still good, however. A similar situation can be seen in pathology and, to a lesser extent, in anesthesia and cardiology.