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Honestly I think anyone who can't shut the hell up is in the wrong field.
sorry. but life sucks is the central principle of medicine.
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Debating withdrawing acceptance to pursue MD
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sorry. but life sucks is the central principle of medicine.
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pain is more competitive than not.
but the fellowship game is a lot of are you will to travel than step scores.
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6
68PGunner
250-300K gig for 40-50 hrs/wk job is enough bribery for me to stfu.
However, I do feel his frustration when Big Brotha DO doesn’t give a f... about his aspirations and goals, and only care if he graduates to become a PCP.
For his sake, I do hope that he’s just using this forum to vent off those steam.
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No prob.
Sure pain is competitive. However, applying for fellowship and residency are different beasts. Step scores, especially Step I, become much less important in the grand scheme of things in regards to fellowship applications. LORs from big names, the ol' "who you know" and who's willing to make phone calls on your behalf, exposure to an in house pain program, reputation of residency institution and research achievements during residency on the other hand sky rocket in their importance.
While it may be true that Step I is a very important piece of your application to get into your desired residency program/specialty, it holds far, FAR less weight when it comes to fellowship. After you get into residency, that score is almost as meaningless as your MCAT once you are already in med school.
The name brand of the institution (not SDN/Doximity program reputation) you train at is also important as I mentioned. Especially for people who are looking to cross into anesthesia pain programs from PM&R. The pain PDs I've had the chance to talk to didn't seem to be attuned to the "rankings" of PM&R programs themselves. But they do know names like WashU, Johns Hopkins, Georgetown, Stanford etc (not considered among the "super six" programs when you talk to PM&R folks on SDN--I'd guess Doximity popularity contest is the driving force here). If you land a categorical spot at one of the above it's even better because then your medicine intern year is also lumped into that institution. Not to mention PM&R residents with in house pain programs have a great advantage as they will likely rotate with the anesthesia pain service on their pain rotations during PM&R residency. Obviously it doesn't hurt to go to a place like Mayo, RIC (Northwestern), Spaulding (Harvard) as they have big names and also are considered elite PM&R programs by the SDN mafia.
On the other hand if you wanted to go into a PM&R based sports med fellowship I'd wager the actual reputation of the PM&R program itself probably matters a lot more to the PDs, as they will likely be aware and more heavily influenced by it when looking at candidates. But like I said, there are many factors that will play a role that are identical to the aforementioned for PM&R sports med as well.
Keep on gunning my friend. Hope this helped.
LOL, Big Brotha DO is my school's Dean, who tells us that we only need the COMLEX to match into any specialty.
Honestly I think people are super sensitive on this website. When people read something they don't like, it turns into an insult-factory. All the terrible advice passed around on the DO forum and all the ad hominem attacks are tolerated, but the second someone talks about anti-DO bias or about realistic expectations, all hell breaks loose and people are labeled as "self-hating" DOs. I get that people want to live in their bubble, but there is no need for them to start resorting to personal attacks just because they cannot deal with reality.
Though I get what you're saying, I'm not personally frustrated at all about how the DO system is treating me, because I literally avoided all that by working very hard prior to medical school to connected and set a path to match into the specialty I want. I am looking forward to staying away from anything osteopathic related after I graduate. I hope the same for you.
... But yeah sometimes I use this site to vent off steam. However, the information in posts is genuine and honest, which you can be proud of, sir.
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Hard to stay away when you got dat DO embroidered on your coat son!
Oh wait, you gonna do that Dr. Sab3156 thang.
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Lets keep things professional and on topic.
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68PGunner
As long as it’s your preferred name. Got to build up that rapport point with your pt.
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68PGunner
Where can I get a legit rank of brand name PMR programs? I am only aware of the Doximity ranking.
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The best legit ranking system is residency interview season.
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68PGunner
What does that mean exactly? Do I get that info from residents and PDs during interviews?
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That means you need to see the programs for yourself. Don't put a ton of stock in subjective rankings or other people's opinions. Each program is unique. They all have their strengths and weaknesses. Hard work and being part of the program that suits you best and that you will thrive in will likely do more for you in the long run than suffering at a program that Doximity or SDN says is "elite".
I FEEL the same way! I am proud to be an Osteopathic Physician, proud to have a DO behind my name and am full of gratitude for the gracious hard work my leadership has done to allow me to succeed (yes they are stupid sometimes I realize that). I personally chose a DO orthopedic residency spot because I felt my education would be better suited for me than the MD ortho residencies I rotated out (please see my previous extensive posts on this).
I've matched into a great sports ACGME fellowship (I have co residents who have matched at top tier programs in Joints, shoulder/elbow and trauma), published multitude of articles that have been presented at national conferences and score well into the 95 percentile every OITE (our program scores within the top 10% every year) - THIS BECAUSE I HAD AN OPPORTUNITY at a DO medical school, which helped me find a DO orthopedic residency coupled with my own hard work and tenacity - and now I have a multitude of job opportunities, including academic opportunities at large universities.
So for all those who posted about personally never going to a DO school, its too hard to match ortho, go the MD route, you don't have the same opportunities, etc etc--screw that defeatist mentality and how bout yall meet me in New Orleans first week of March (thats the AAOS conf week for those who don't know) and we'll compare stats and opportunities.
OP = take the acceptance and run with it! The opportunities are there if you are dedicated and driven. Yes you'll probably work harder and need more skills but holding off an additional year in my opinion is a huge risk/unknown and incurs more financial burden than you think (an additional year of the median orthopedic salary will easily outweigh the additional incured tuition expenses). So OP, feel free to message me and we can talk.
I wouldn't be where I'm at today if it wasn't for those "inferior" DO schools and "inferior" DO orthopedic residencies.
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Let me preface what I'm about to say by explaining my background. A DO school also gave me the opportunity to become a physician and I matched into a fantastic dual-accredited residency. For the amount of work I had to put in though I think I would have had more choices if I had gone MD. I think it's safe to say an applicant always has more options if they go the MD route.
The students coming out of your school are definitely strong. Here's the thing... your school has strong clinical rotations due to the proximity of big hospitals (Maricopa, Banner, Mayo, Children's, HonorHealth etc..). I'm out of state and Banner charged me a $125 fee (offset by the $150 meal card they gave me) and taught me an exceptional amount. Maricopa also charged me a nominal fee. My school charges $40k+ to send me worthless spam mail all day. Your school also charges a pretty hefty tuition to send kids to these sites.
Lets not kid ourselves, it's the big MD university programs giving us a good education during our clinical years. If I took you to some of the 100 bed sites where students just shadow and don't write a single note you would be shocked. I've run into 4th year students who can barely take a proper H&P, write a progress note, or even coherently present a patient. When they go out into the big university hospitals and just absorb information like a sponge. Most of these students are exceptionally bright but are bottlednecked in their education by being stuck there. I have relatives and family friends who take students from AZCOM, ATSU, and UA. From what they tell me, 85% of the time they can tell the difference. It bothers me greatly that an institution can charge so much money and get away with pulling this kind of crap. Is that something to be proud of?
What about the 240+ Step 1 superstar DO students I've met that outshine their MD counterparts? During the match their options will be limited. The reasoning behind that discrepancy is the basis of my argument.
For any borderline student who is between MD and DO I'm going to stick to my guns and tell them to go MD.
@Ibn Alnafis MD , can you chime in?
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100% agree.
Academically speaking, I can't think of a situation where attending an MD school isn't superior to attending a DO school. While you are providing a free labor to your private practice preceptor and helping him see more patients $$$, your counterpart MD student is receiving a quality clinical training and structured didactics from physicians who dedicated their career to academia.
OP, if you think you can get into an MD school, go for it.
\
When you say options are limited, are you specifically addressing residency sites or specialties. I have always had the impression that sites that are open to both DO and MD applicants won't bias towards a 240+ step 1 DO applicant. However, I also understand that not every residency site is open towards DO applicants and will show huge bias. So I conclude that if I have a competitive application, then I wont necessarily be limited (to some extent) to specialties but perhaps limited to those ultra competitive sites in very appealing areas. I'm okay with this. I don't mind doing my residency in some backwoods hospital.
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1. My understanding is that fellowship and job placement isn’t competitive once out of ortho residency, that’s why it’s such a bottle neck to get into residency. Your job offer / fellowship achievement isn’t necessary as impressive as it sound in light of this information.
2. What ortho joe is talking about here “an opportunity” maybe a few years back, a personable candidate with good clinical skill but poor test scores can BACKDOOR into DO ortho by brown nosing/impressing people in audition rotations to be in the old boy’s club that’s DO ortho.
I am not saying ortho joe is one of those candidate (dont know him), but this was one of the case where going DO was superior since you would be competing against other DOs for similar chance of going ortho (less spots but less candidates, less emphasis for research and scores)
My understanding is that this opportunity is becoming lost in the merger.
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The above quote is made by another DO ortho resident in orthojoe’s fellowship thread
“Couple of things to remember:
1) Ortho fellowships is not where the bottleneck is, the bottleneck is to get into ortho. Often times there are more spots than applicants for fellowships. Therefore, if you're reasonable, you will likely match...unless it's hand or Joints. Plenty of unmatched DOs in those two fields last two years.
2) The bias is really when DOs try to get in as faculty members after fellowship training. Most places are happy to train you, but you'll hardly find a DO that trained through the AOA route for residency at large academic center as faculty, regardless of their fellowship pedigree. I can count the DOs trained through AOA route on one hand that are currently faculty at Large academic ACGME programs.
Bottom line, if you are lucky enough to match ortho, you will most likely get the fellowship in your desired field as a DO, there will def be some bias at top programs. However, if you're set on having an academic practice at a large ACGME center, you'd have a hard time. Of course this is my observation and some anecdotes, therefore n is pretty small, but I find it to be pretty accurate.”
“Couple of things to remember:
1) Ortho fellowships is not where the bottleneck is, the bottleneck is to get into ortho. Often times there are more spots than applicants for fellowships. Therefore, if you're reasonable, you will likely match...unless it's hand or Joints. Plenty of unmatched DOs in those two fields last two years.
2) The bias is really when DOs try to get in as faculty members after fellowship training. Most places are happy to train you, but you'll hardly find a DO that trained through the AOA route for residency at large academic center as faculty, regardless of their fellowship pedigree. I can count the DOs trained through AOA route on one hand that are currently faculty at Large academic ACGME programs.
Bottom line, if you are lucky enough to match ortho, you will most likely get the fellowship in your desired field as a DO, there will def be some bias at top programs. However, if you're set on having an academic practice at a large ACGME center, you'd have a hard time. Of course this is my observation and some anecdotes, therefore n is pretty small, but I find it to be pretty accurate.”
What specialties are we talking about? Competitive specialties will be near impossible even with a competitive app unless you have connections within the specialty that can get you interviews. Even the "backwoods" ophtho/ent/ortho/neurosurgery/derm residencies likely won't touch you (coming from a DO school) even if you are their most competitive applicant, unless they have someone telling them they should consider you. Step 1 scores are not the issue.
You'll hear SDN anecdotes here and there, especially second hand stories from people who don't know what they're talking about because they never worked in any capacity with anybody who can give them real information. A lot of the matches you hear about on SDN are incomplete stories, and you don't know what the person had to do to get in. That's why you need to be careful about what you read on this site. I can tell you what PDs and residents/fellows in a couple of the top ENT and Ophtho programs in the country told me straight to my face when I discussed these issues with them - in these specialties, the PDs really need a good reason to interview a DO, and that's letters or phone calls from trustworthy people in the field. And the fellows were coming from residencies at several non-"top tier" programs and helped in resident selection there, so it's not just the top programs in those specialties that are like this.
And in the future, you should ask these types of questions on the resident sub-forums, as the information you get there will be of higher quality than the DO premed/med sub-forums.
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AnatomyGrey12
You are so insistent on this yet every single DO I have talked to that is in a competitive specialty at a competitive ACGME program says otherwise. I think you're simply trying to convince yourself that the people you knew from before med school will really have that big of an impact for you. Yes you need good letters but no you don't need some influential PD calling programs trying to get you interviews. I know for a fact there were at least 4 DOs this year with more than 10 ACGME ENT interviews...
edit: to clarify before anyone rides in here on their white chariot, I am NOT saying it is easy to get into these programs or specialties, simply that you don't need the level of connection that the above poster insists you must have.
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OP, I think everyone is right that you really need to decide how much you want ortho.
I applied this cycle to both MD and DO schools as a borderline applicant (GPA above 50th percentile for practically every American school, below average MCAT). I received 6 DO IIs, went on 5, and was accepted to all 5. I received 1 MD II and was placed on the waitlist.
If I get off of the waitlist, I will obviously be grabbing that acceptance because the sentiment that MD > DO is true in basically every scenario. But, for me personally, when I got my MCAT score back I made a calculated decision to apply this cycle and take the best acceptance I could get, be that MD or DO, rather than retake the MCAT. I did this because I knew I wasn't interested in anything really competitive (yes, I realize that for practically every residency, even the not-so-competitive ones, the DO applicant will have to be superior to the MD applicant). For me, for a variety of personal factors, taking another year off wasn't worth it. I wanted to start school sooner. The point is, no one else can make this decision for you. It's very individualized and personal, and based on what you want for your life.
Do you want ortho so bad that you're willing to take a gamble that you still might not make it into MD schools next cycle? If you're dead set on ortho, and don't mind being a year older when you "start your life", I would suggest to take the year off and try applying MD. But, you also have to be realistic when you make this decision...do you honestly think you can do better on the MCAT, raise your GPA, whatever in time for next cycle?
If you don't mind the time off, are dead set on ortho, and genuinely think you can improve your app substantially, try applying MD next cycle. Otherwise, just take your DO acceptance.
I applied this cycle to both MD and DO schools as a borderline applicant (GPA above 50th percentile for practically every American school, below average MCAT). I received 6 DO IIs, went on 5, and was accepted to all 5. I received 1 MD II and was placed on the waitlist.
If I get off of the waitlist, I will obviously be grabbing that acceptance because the sentiment that MD > DO is true in basically every scenario. But, for me personally, when I got my MCAT score back I made a calculated decision to apply this cycle and take the best acceptance I could get, be that MD or DO, rather than retake the MCAT. I did this because I knew I wasn't interested in anything really competitive (yes, I realize that for practically every residency, even the not-so-competitive ones, the DO applicant will have to be superior to the MD applicant). For me, for a variety of personal factors, taking another year off wasn't worth it. I wanted to start school sooner. The point is, no one else can make this decision for you. It's very individualized and personal, and based on what you want for your life.
Do you want ortho so bad that you're willing to take a gamble that you still might not make it into MD schools next cycle? If you're dead set on ortho, and don't mind being a year older when you "start your life", I would suggest to take the year off and try applying MD. But, you also have to be realistic when you make this decision...do you honestly think you can do better on the MCAT, raise your GPA, whatever in time for next cycle?
If you don't mind the time off, are dead set on ortho, and genuinely think you can improve your app substantially, try applying MD next cycle. Otherwise, just take your DO acceptance.
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I'm an OMSIII applying Ortho and I have a 243 USMLE and a 697 comlex. Even if I was an MD with a 243 I would be on the lower end of accepted applicants. My 697 comlex and the fact that I consistently get good feedback on evaluations puts me on the higher end of DO Ortho. I'm glad I'm applying AOA
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Good for you but the AOA option won’t be around much longer so OP must keep that in mind.
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But those residencies will still be there
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Your point was about taking the advantage of the AOA match though
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I'm taking advantage of the programs that prefer a comlex score and audition over the usmle. Most of the programs I'm auditioning at are ACGME accredited
And if it anything like general surgery this year they will either be splitting those spots this year or only doing acgme next year. Which means your applicant pool will exponentially increase. Still won’t help the OP in 2020 and beyond. Speaking from a general surgery perspective, from last year to this year AOA spots dropped from 155 to 121 with record numbers in applications. This was Due to program switching over or closing, if that happens to the AOA ortho pool for you next year... it’s not a guarantee anymore.
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If every program that gained ACGME accreditation decides to only participate in NRMP the number of spots in the AOA will drop from 121 to ~80 spots. I still think there will be 120 DO Orthopedic surgeons.
Edit: worst case scenario 100. But because people will be applying to more ACGME places now more than 3 (2017 number) will match into a historically ACGME program
For any of my conjectured response to be accurate we'll have to look at the general surgeons this year. If there are still 150 DO general surgeons then the sky isn't falling.
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you're assuming an equal number of applicants from the DO side will also forego AOA programs/interviews as well... which is not the case. Just one example, Geisinger's AOA Gen Surg program got initial accreditation and their application numbers went from ~250-300 from DO only to almost 800 MD/DO. A large majority of which were MD applicants. The final pool of people they decided to pick to interview from was close to 600. just because spots drop to 80 how many fellow classmate do you know apply ortho are ready to only pursue programs and interviews only in the NRMP. I'll tell you right now have 4-5 interviews from former DO programs will not match you into an Ortho program, youd be hard pressed to find an MD candidate that feels comfortable with that many interviews as well.
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AnatomyGrey12
This is my hunch too. I don’t think people really know how baller some of these DO applicants really are. Like I mentioned above I know for a fact that at least 4 DOs have 10+ ACGME ENT interviews this year. All of them matched AOA. When they don’t have to risk pulling out of a guaranteed AOA spot the sky is the limit for these types of applicants.
I have a buddy with multiple first author top ortho journal pubs and I don’t see a universe where he doesn’t match ortho unless he sucks it up on boards somehow, which I don’t see happening.
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AnatomyGrey12
Did you match AOA GS?
Yes I matched the AOA match, but i had ranks in both matches.
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AnatomyGrey12
Can I PM you?
sure
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If someone auditions at 5 historically AOA but now ACGME orthopedic programs and they are offered interviews from those 5 programs as well as 1-2 other programs. Let's say 5 programs participate in NRMP while 2 programs participate in NMS. Almost every DO would take their chance with NMS first. But some people won't match in the NMS, and will proceed to see how their other 5 ranked programs do. People will then match through the NRMP. Unless I'm missing something, this is how I see it playing out.
More MDs will have spots that are up for grabs in the NRMP, but DOs will be applying to more programs that they never would have before, so I feel it will even out.
3 things: 1) the # of applicants per spot you'd be competing with for those 5 spots, 2) The PD, 3)#of interviews/# of programs applied.
Lets say you applied to every ortho program in the NRMP but only got interviews at the 5 programs you auditioned at and maybe one other random program. your yield is 5-10%... that doesn't bode well for matching because it means you weren't that strong of a candidate to begin with. Now if you applied to 15 programs and got 15 interviews without auditioning that says a lot more about the quality of the applicant on paper. Also the PD has so much more power than you know, you never know what they want to do year to year.
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4-6 interviews for Ortho as a DO is actually pretty mainstream. The PDs at previously AOA programs in the past have only seriously considered those who rotated, regardless of what the other applicants looked like on paper. If they keep that mindset, 1000 people could apply, but theyre only considering the 30 that came through. If you look good on paper then you will now have a chance at the other programs that were not historically AOA, and will get your 5 interviews from auditions + interviews from being a stellar applicant.
DOs will match at programs outside previously AOA spots past 2020. MDs will match at previously AOA programs. But there won't be a huge flux.
A good example to look at to see how inaccurate this logic might be is ACGME Ophthalmology, which matches PRIOR to AOA Ophtho. We see the same poor numbers for DO applicants trying for ACGME Opthalmology. After the merger, things will be objectively more difficult for a DO to become an ophthalmologist, not easier. You really cannot just assume that the DO applicants were competitive for ACGME Ortho in the first place.
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I guess it comes down to the applicant then, and not the title MD or DO after their name.
quite the contrary. the bias exists, i've experienced it first hand.
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Well, I guess I'm glad I graduate in 2019 and not 2020. I still feel there will continue to be 100-120 DO Orthopods every year, they just might need 250s and not 240s like myself.
The entire point of this discussion the difficulty of obtaining a competitive specialty (specifically Ortho) coming from a DO school vs. an MD school. It absolutely has everything to do with the title MD or DO. As a DO, in order to match ACGME *insert competitive specialty here*, you have to jump through so many hoops and accomplish so many more feats in order to get to where you want to go (and sometimes you just can't get these things done in time). As an MD, your path is set as long as you come up with the research and decent Step score(s). Even after all the struggle, a DO still has a horrible chance at ACGME Ortho compared to his MD counterpart.
As I said, ACGME Ophthalmology is a great example of applicants from the DO side having letters, decent scores, decent research, and still not matching into that field (18 of the 28 applicants this year did not match) - it's not simply that they matched into AOA Ophtho and pulled out of ACGME. People should look at this and ask themselves again if they really think those Ortho DO applicants would be better off in a joint match.
It's really less about the scores and about research/who you know, to be honest.
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well keep in mind programs will not be allowed to match in 2019 if they do not have initial accreditation, and they must transfer their residents out. Read section 10.6 because in essence the merger is complete by 2019... not 2020 anymore for matching purposes: http://www.osteopathic.org/inside-a...g-standards/Documents/Basic-Doc-Section-X.pdf
so please keep that in mind when youre applying and ranking your program list.
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Residents can finish training in the program past 2020 and don’t need to be transferred out. They will still get AOA board certification due to the limited ability of the AOA to continue accreditation past 2020.
See attached memo:
http://www.acgme.org/portals/0/PDFS/Nasca-Community/Resident-protection-agreeement-memo-3.31.17.pdf
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They updated since that memo. See the merger thread. Now you need initial accreditation, not just pre-accrediation like in the past if I understand. They effectively speed up the merger:
"Programs with pre-accreditation: Programs with pre-accreditation, not yet reviewed by the RC, will not be able to participate in the 2019 AOA Match. Should these programs receive ACGME accreditation after May 1, 2018, they will be able to participate in the 2019 AOA Match. Programs can also request waivers from PTRC for any policy in Section X."
http://osteopathic.org/inside-aoa/E...ts/Section-X-Revisions-For-Public-Comment.pdf
Looks like the slots are dropping for 2019.
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AnatomyGrey12
Yes they won’t be able to participate in the match but the residents currently in their program will still be allowed to finish. They won’t be transferred out like was mentioned above.
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AnatomyGrey12
Eh, we had an Optho applicant last year fail to match. He wasn’t really a great applicant, although still got a few interviews. It wouldn’t surprise me to find out that a number of those who apply to ACGME Optho, or any competitive field honestly, aren’t competitive for it or have terrible application strategies. The advising at DO schools is extremely terrible.
If you’ve got an app worthy of X specialty you have pretty decent chances you’ll end up in X specialty. Multiple people have told me that who are in competitive programs in competitive fields.
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Read Standard 10.5.C section ii & Standard 10.6 section A again.
Programs that have “continued pre-accreditation” status, which is all but the 2 ortho programs planning to close, can recruit residents as long as they submit their planned path to accreditation by June 1st, 2018.
That document is an AOA document outlining how they will hold up their end of the agreement by ensuring programs are makng a “good fairh effort” to become ACGME accredited. The other memo requires them to determine who is making the “good fairh effort” in order to extend AOA accreditation past 2020.
All the ortho programs I know of are making dilligent efforts to address their ACGME citations. Therefore, I’m confident most of the current “continued pre-accreditation” programs will be taking residents in 2019. Im also confident most will become ACGME accredited by 2020.
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So to make this thread as simple as possible using myself as an example.
I have a publication as a first author in Orthopedics. I am an author for USMLE-Rx. Top quartile of my class with good clinical grades.
243 usmle and 697 comlex
Pretending I'm an MD do I have a better or worse chance of matching Orthopedics?
