DO and Specialties

[wilsonlaguna]

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Hey guys and gals. Are there any specialties you have heard of where DO are practically non-existant? Also, have the majority of DO you've met work in the hospital or private practice setting?

My fiance is going back to school and she wants to be a physician. trying to see if whether the MD or DO route would be better.

 

[ColoradoCSU]

Some more competative programs ENT, onco, cardiopulm, and others may make it harder to transition from DO (according to residency directors I have asked). But if you do well and take both the USMLE and COMPLEX steps all the way through you could be just as competative. There are still some people who hold grudges, but for the most part programs look at the individual.

That being said, you should know why you would choose DO over MD or the other way around. The DO training is distinct, and more people choose to go into primary care.

Hope that helps

 

[ScottMontgomery]

MD or DO = Physician

The numbers in most places will always be lower for a DO. Look at how many MDs come out of school vs how many DOs. MD makes up the majority of physicians without a doubt.

What does your fiance want to do? Age? School background?

A lot of hospitals in Michigan are over 50% Osteopathic. Sure tons of DOs go the family practice and primary care route, but you can do anything you want. Sure its competitive for some programs. The best get the jobs.

I think her reasoning's behind going DO over MD would be philosophical more than anything. DO is a more natural approach to healing the human body as a whole, vs where MD stays near the source of whats wrong. MDs also do not practice OMM/OMT (Osteopathic Manipulative Medicine).

All really depends on what she wants to do. If she just wants to be a physician, have good undergrad and apply both MD and DO, take what you get.

 

[womp]

i think her reasoning's behind going do over md would be philosophical more than anything. Do is a more natural approach to healing the human body as a whole, vs where md stays near the source of whats wrong.

b.s.

 

[Morsetlis]

Right now it's BS and nobody knows the difference anymore (except the whole OMM thing which could be treated as its own specialty).

 

[wilsonlaguna]

MD or DO = Physician

The numbers in most places will always be lower for a DO. Look at how many MDs come out of school vs how many DOs. MD makes up the majority of physicians without a doubt.

What does your fiance want to do? Age? School background?

A lot of hospitals in Michigan are over 50% Osteopathic. Sure tons of DOs go the family practice and primary care route, but you can do anything you want. Sure its competitive for some programs. The best get the jobs.

I think her reasoning's behind going DO over MD would be philosophical more than anything. DO is a more natural approach to healing the human body as a whole, vs where MD stays near the source of whats wrong. MDs also do not practice OMM/OMT (Osteopathic Manipulative Medicine).

All really depends on what she wants to do. If she just wants to be a physician, have good undergrad and apply both MD and DO, take what you get.

Well, she's want to be a Radiation Oncologist. I've heard that it's a competitive field for everybody, MD or DO. She's 29, going back to college for a second bachelors since her grades for the first bachelors would practically exclude her from all programs anyways. She currently attends a community college too. As a medical applicant myself, I think it's going to be tough, but I wanted to hear everyone elses input.

Thanks ScottMontgomery,
Thanks everyone else too.

 

[JaggerPlate]

Wow, horrible answers ...

The truth is that medical school is medical school ... MD or DO. No mystical differences, the force isn't stronger on one side, etc. Obviously DO schools teach manipulation, and if you are interested in that ... one more tool in your bag, but I wouldn't get caught up on some unique philosophy.

As far as specializing goes - it's way to early to start thinking about that. Two types of residencies exist - ACGME residencies, which are technically for MD students, and AOA residencies, which are for DO students and can only be applied to by students who have graduated from a DO school. DO's can apply to both ACGME and AOA programs, but some of the highly sought after residencies on the ACGME side will have a definite DO bias. However, these are the residencies that are difficult for anyone to get, not just DOs.

The truth of the matter is that when you get right down to it ... you need to be a good student, work hard, have the grades, networking, letters, etc, for it, wish for some luck, and apply smart. If you do this, and go into it with a sense of realism - IE I probably won't have a shot at an integrated plastics spot at Harvard Mass General, but I'm a good student so I can definitely match into an AOA G-surg residency (associated with a PRS program) work hard, network, and probably land that plastics fellowship - you'll be alright.

Again, this probably sounds overwhelming and weird ... and I'm basically trying to sum up pre-DO SDN in one post, but stick around, use the search engine, and check out this link to all the DO residencies (only DOs can apply to these). You'll learn/figure it all out:

http://opportunities.osteopathic.org

 

[csmittyB]

Well, she's want to be a Radiation Oncologist. I've heard that it's a competitive field for everybody, MD or DO. She's 29, going back to college for a second bachelors since her grades for the first bachelors would practically exclude her from all programs anyways. She currently attends a community college too. As a medical applicant myself, I think it's going to be tough, but I wanted to hear everyone elses input.

Thanks ScottMontgomery,
Thanks everyone else too.

You heard right. Rad Onc is very competitive. The people who match rad onc are generally superstar students (great grades/USMLE).

 

[JaggerPlate]

You heard right. Rad Onc is very competitive. The people who match rad onc are generally superstar students (great grades/USMLE).

There was a ACGME RadOnc match out of Western in like 08 I think ... very impressive.

 

[Morsetlis]

The only radiation oncologist I ever saw scared me. He had perfect hair, an immaculate shirt, and looked like a lawyer.

I then researched his CV and saw that he had 40 publications within 14 years.

 

[csmittyB]

There was a ACGME RadOnc match out of Western in like 08 I think ... very impressive.

Very impressive👍 I wonder where the program was and the persons stats.

 

[womp]

Well, she's want to be a Radiation Oncologist. I've heard that it's a competitive field for everybody, MD or DO. She's 29, going back to college for a second bachelors since her grades for the first bachelors would practically exclude her from all programs anyways. She currently attends a community college too. As a medical applicant myself, I think it's going to be tough, but I wanted to hear everyone elses input.

You're right, rad onc is very competitive even for MD students. You need to do research during medical school to be competitive for rad onc, and most DO schools are pretty lackluster on that front. Last year 121 out of 129 rad onc PGY2 spots were filled by US MD seniors. So the odds are definitely against the DO grad.

If her grades in the first bachelors were that bad, then it's going to a real struggle to get into an MD since all your undergrad grades are averaged together. With DO, she can replace her old grades with new ones, which would make doing a second bachelor more worthwhile.

 

[Morsetlis]

So that's 129 new radonc a year, out of the ENTIRE UNITED STATES?

Haha.

 

[JaggerPlate]

Very impressive👍 I wonder where the program was and the persons stats.

I think it was Kaiser in LA. So ... DO + Rad Onc + Matching it in CA - damn boy, damn.

 

[wilsonlaguna]

The only radiation oncologist I ever saw scared me. He had perfect hair, an immaculate shirt, and looked like a lawyer.

I then researched his CV and saw that he had 40 publications within 14 years.

Hahahah, I guess you won't like me then. I am the exact image of Greg Montgomery from Dharma and Greg. And I'm Applying to the MD/JD programs.

 

[wilsonlaguna]

So that's 129 new radonc a year, out of the ENTIRE UNITED STATES?

Haha.

Why is that? Do we just not need more than that? And you wonder why we're short like 100k doctors (most of them probably primary care though).

 

[wilsonlaguna]

You're right, rad onc is very competitive even for MD students. You need to do research during medical school to be competitive for rad onc, and most DO schools are pretty lackluster on that front. Last year 121 out of 129 rad onc PGY2 spots were filled by US MD seniors. So the odds are definitely against the DO grad.

If her grades in the first bachelors were that bad, then it's going to a real struggle to get into an MD since all your undergrad grades are averaged together. With DO, she can replace her old grades with new ones, which would make doing a second bachelor more worthwhile.

Yeah, you're right. That's what I told her too. I'm applying for MD admissions, so I haven't researched DOs thoroughly yet.

Since DO allows you to replace old grades, do you have to report them all? Or just selectively pick the new ones over the old ones?

 

[JaggerPlate]

Search function + FAQ are your friends ...

 

[wilsonlaguna]

Search function + FAQ are your friends ...

Thanks. I'll do that. But, would the time it take for you reply to me, you could have answered the question?

 

[womp]

Yeah, you're right. That's what I told her too. I'm applying for MD admissions, so I haven't researched DOs thoroughly yet.

Since DO allows you to replace old grades, do you have to report them all? Or just selectively pick the new ones over the old ones?

You have to report them all, but the GPA calculation will only use the higher in determining your cumulative and science GPAs. When you report the grades, I think there is a column for you to specify as "Retake."

All the 2009 match data is available here:
http://www.nrmp.org/data/resultsanddata2009.pdf

Last year, only 1 DO graduate secured a rad onc PGY2 residency spot, out of the 120 or so spots.

Here's a summary of ACGME residencies secured by DO grads in 2009 across the entire US:
Dermatology: 0
Urology: 0
ENT: 0
Radiation oncology: 0 (1 PGY2)
Neurosurgery: 1
Plastic Surgery: 1
Orthopedic Surgery: 5
Diagnostic Radiology: 8 (31 PGY2)
Neurology: 10 (35 PGY2)
PM&R: 15 (86 PGY2)
General Surgery: 31
Pathology: 34
Anesthesiology: 53 (48 PGY2)
Psychiatry: 102
OBGYN: 108
Emergency Medicine: 163 (8 PGY2)
Pediatrics: 190
Family Medicine: 244
Internal Medicine: 306

Clearly things aren't as equal for DOs as people like to imply here...

 

[JaggerPlate]

Thanks. I'll do that. But, would the time it take for you reply to me, you could have answered the question?

I simply cannot comprehend this statement???

 

[wilsonlaguna]

I simply cannot comprehend this statement???

What it means is that you could have said "yes, you have enter all grades" as oppose to you telling me to basically "search it yourself," which is what your statement screams of.

Sorry. Had a rough and weird day. had to file two police reports today for a total of three in two week period. All the weirdos are coming out and it's not just at night anymore.

 

[wilsonlaguna]

You have to report them all, but the GPA calculation will only use the higher in determining your cumulative and science GPAs. When you report the grades, I think there is a column for you to specify as "Retake."

All the 2009 match data is available here:
http://www.nrmp.org/data/resultsanddata2009.pdf

Last year, only 1 DO graduate secured a rad onc PGY2 residency spot, out of the 120 or so spots.

Here's a summary of ACGME residencies secured by DO grads in 2009 across the entire US:
Dermatology: 0
Urology: 0
ENT: 0
Radiation oncology: 0 (1 PGY2)
Neurosurgery: 1
Plastic Surgery: 1
Orthopedic Surgery: 5
Diagnostic Radiology: 8 (31 PGY2)
Neurology: 10 (35 PGY2)
PM&R: 15 (86 PGY2)
General Surgery: 31
Pathology: 34
Anesthesiology: 53 (48 PGY2)
Psychiatry: 102
OBGYN: 108
Emergency Medicine: 163 (8 PGY2)
Pediatrics: 190
Family Medicine: 244
Internal Medicine: 306

Clearly things aren't as equal for DOs as people like to imply here...

Wow, thanks for digging this up. I have to time whatsoever to try to find something like that. What really stands out is the number of people in non-primary care.

 

[JaggerPlate]

What it means is that you could have said "yes, you have enter all grades" as oppose to you telling me to basically "search it yourself," which is what your statement screams of.

Sorry. Had a rough and weird day. had to file two police reports today for a total of three in two week period. All the weirdos are coming out and it's not just at night anymore.

You can feel free to ask my questions anytime ... I'll do my best to answer them in a timely manner and I've been around here for a while, so can usually give alright insight (on the pre-medical stuff at least). My comment was more that these questions have been asked a LOT, and are covered well in the search results and FAQ. I could have answered them ... but it's just more efficient all around to keep these threads to a minimum and always defer to the FAQ and search function (in my opinion at least).

 

[JaggerPlate]

Wow, thanks for digging this up. I have to time whatsoever to try to find something like that. What really stands out is the number of people in non-primary care.

Keep a few things in mind:

-DOs have a 70% match rate into ACGME (not too shabby, foreign medical students are around 48% or so without AOA residencies to fall back on)

-ACGME ROADS specialties are harder for DOs to match, on average, for a number of reasons. However, it does happen.

-If someone applies for both an AOA residency and ACGME residency (lets say in Ortho Surg) and matches AOA, then are automatically removed from the ACGME spots. So, and correct me if I'm wrong here somebody, there could have been people gunning for competitive spots - like Ortho again for example - who ranked both MD and DO programs (to be safe), matched a DO program, and were therefore removed from the MD programs, meaning you'll never find them on that posted list, despite the fact that they may have been a qualified, desired candidate for the program.

- As I showed you before ... there are a whole set of AOA residencies only available to DO students. Every Rads, Gas, ENT, PRS, derm, etc, is filled by DOs who finish residency and put up a shingle just like any other MD or DO who went ACGME.


** sorry for any factual blunders or hyperbole in that post ... again, it's hard to sum up so many basics in one post (FAQ and Search ftw )

 

[wilsonlaguna]

Keep a few things in mind:

-DOs have a 70% match rate into ACGME (not too shabby, foreign medical students are around 48% or so without AOA residencies to fall back on)

-ACGME ROADS specialties are harder for DOs to match, on average, for a number of reasons. However, it does happen.

-If someone applies for both an AOA residency and ACGME residency (lets say in Ortho Surg) and matches AOA, then are automatically removed from the ACGME spots. So, and correct me if I'm wrong here somebody, there could have been people gunning for competitive spots - like Ortho again for example - who ranked both MD and DO programs (to be safe), matched a DO program, and were therefore removed from the MD programs, meaning you'll never find them on that posted list, despite the fact that they may have been a qualified, desired candidate for the program.

- As I showed you before ... there are a whole set of AOA residencies only available to DO students. Every Rads, Gas, ENT, PRS, derm, etc, is filled by DOs who finish residency and put up a shingle just like any other MD or DO who went ACGME.


** sorry for any factual blunders or hyperbole in that post ... again, it's hard to sum up so many basics in one post (FAQ and Search ftw )

Wow, thanks. And again sorry for before. I was nervous about the outcome about said incident. I just found out the outcome was in my favor.

 

[wilsonlaguna]

Some more competative programs ENT, onco, cardiopulm, and others may make it harder to transition from DO (according to residency directors I have asked). But if you do well and take both the USMLE and COMPLEX steps all the way through you could be just as competative. There are still some people who hold grudges, but for the most part programs look at the individual.

That being said, you should know why you would choose DO over MD or the other way around. The DO training is distinct, and more people choose to go into primary care.

Hope that helps

Yes, that does help. Thanks

 

[peeberbot]

There were at least two DOs who matched into allo urology this year.

 

[wilsonlaguna]

There were at least two DOs who matched into allo urology this year.

Where did you hear this from? My buddy is in DO school right now and he wants to go into Urology

 

[peeberbot]

I know one guy who matched. He told me another one of his classmates matched as well. Both go to CCOM.

 

[womp]

I know one guy who matched. He told me another one of his classmates matched as well. Both go to CCOM.

2 from the same school? There were 0 for the entire country last year. Maybe they prematched (which is really unlikely in competitive fields like urology)? Are you sure it was allo urology? CCOM usually places one or two students into osteopathic urology residencies (usually at MSU or Olympia Fields).

Anyway the 2010 NRMP match data should be out soon.

 

[peeberbot]

Prematched @ SLU. I was told the other guy prematched allo as well.

 

[womp]

Prematched @ SLU. I was told the other guy prematched allo as well.

Nice...

 

[Morsetlis]

Urology used to be outside of the Match even in allo.

 

[JaggerPlate]

2 from the same school? There were 0 for the entire country last year. Maybe they prematched (which is really unlikely in competitive fields like urology)? Are you sure it was allo urology? CCOM usually places one or two students into osteopathic urology residencies (usually at MSU or Olympia Fields).

Anyway the 2010 NRMP match data should be out soon.

I thought pre-matching was pretty common for competitive fields???

 

[p30doc]

A NSUCOM alum, spoke to us this past fall who matched allo rad onc at unc - chapel hill(i think). Realistically anyone's chances to match rad onc are pretty poor whether you are a md, do or if your skin is green.

 

[JaggerPlate]

A NSUCOM alum, spoke to us this past fall who matched allo rad onc at unc - chapel hill(i think). Realistically anyone's chances to match rad onc are pretty poor whether you are a md, do or if your skin is green.

I try to make this argument using ROAD stuff all the time ... it usually gets dismissed in a MD vs DO for specializing thread.

 

[Skippygonenuts]

if i may respectfully add on to what Wilsonlaguna said, below is a list of all the Allopathic residencies filled by Osteopathic students in 2009. The total comes out to 1,618 students matched, while there were only 2,015 active applicants. This means that 80% of the DO students that applied to MD residencies were placed.

Of course, always remember to take this information with a grain of salt because these residencies may have been number 1 on their rank list, or number 25. So whether you want to consider these "good" statistics is up to you, but I think it is same to say that MD residencies are not fully discriminatory against DOs.

Now maybe they didn't all match into the most competitive residencies, but one student even matched into Plastic Surgery. There's a chance to get anywhere depending on how hard you are willing to work.

Information below was obtained from www.nrmp.org

PGY- 1
Anesthesiology- 53
Dermatology- 0
Emergency Medicine- 163
Emergency Med/Family Med- 0
Family Medicine- 244
Internal Medicine (Categorical)- 306
Medicine-Dermatology- 0
Medicine-Emerg Med- 2
Medicine-Family Medicine- 1
Medicine-Medical Genetics- 0
Medicine-Neurology- 0
Medicine-Pediatrics- 27
Medicine-Preliminary (PGY-1 Only)- 59
Medicine-Preventive Med- 0
Medicine-Primary- 10
Medicine-Psychiatry- 2
Medical Genetics- 0
Neurological Surgery- 1
Neurology- 10
Obstetrics-Gynecology- 108
Orthopaedic Surgery- 5
Otolaryngology- 0
Pathology- 34
Pediatrics (Categorical)- 190
Pediatrics-Dermatology- 0
Pediatrics-Emerg Med- 1
Pediatrics-Medical Genetics- 0
Pediatrics-P M & R- 0
Pediatrics-Primary- 1
Peds/Psych/Child Psych- 0
Physical Medicine & Rehab- 15
Plastic Surgery- 1
Preventive Medicine- 0
Psychiatry (Categorical)- 102
Psychiatry-Family Medicine- 1
Psychiatry-Neurology- 1
Radiation Oncology- 0
Radiology-Diagnostic- 8
Surgery (Categorical)- 31
Surgery-Preliminary (PGY-1 Only)- 16
Thoracic Surgery- 0
Transitional (PGY-1 Only)- 16
Urology- 0
Vascular Surgery- 0
Total PGY-1: 1408

PGY- 2 Positions
Anesthesiology- 48
Dermatology- 1
Emergency Medicine- 8
Neurology- 35
Physical Medicine & Rehab- 86
Preventive Medicine- 0
Psychiatry- 0
Psychiatry-Neurology 0
Radiation Oncology- 1
Radiology-Diagnostic- 31
Total PGY-2 210

GRAND TOTAL 1618

Total DO Students that Applied 2,015

 

[JaggerPlate]

if i may respectfully add on to what Wilsonlaguna said, below is a list of all the Allopathic residencies filled by Osteopathic students in 2009. The total comes out to 1,618 students matched, while there were only 2,015 active applicants. This means that 80% of the DO students that applied to MD residencies were placed.

Of course, always remember to take this information with a grain of salt because these residencies may have been number 1 on their rank list, or number 25. So whether you want to consider these "good" statistics is up to you, but I think it is same to say that MD residencies are not fully discriminatory against DOs.

Now maybe they didn't all match into the most competitive residencies, but one student even matched into Plastic Surgery. There's a chance to get anywhere depending on how hard you are willing to work.

Information below was obtained from www.nrmp.org

PGY- 1 Positions DOs Accepted Anesthesiology 53 Dermatology 0 Emergency Medicine 163 Emergency Med/Family Med 0 Family Medicine 244 Internal Medicine (Categorical) 306 Medicine-Dermatology 0 Medicine-Emerg Med 2 Medicine-Family Medicine 1 Medicine-Medical Genetics 0 Medicine-Neurology 0 Medicine-Pediatrics 27 Medicine-Preliminary (PGY-1 Only) 59 Medicine-Preventive Med 0 Medicine-Primary 10 Medicine-Psychiatry 2 Medical Genetics 0 Neurological Surgery 1 Neurology 10 Obstetrics-Gynecology 108 Orthopaedic Surgery 5 Otolaryngology 0 Pathology 34 Pediatrics (Categorical) 190 Pediatrics-Dermatology 0 Pediatrics-Emerg Med 1 Pediatrics-Medical Genetics 0 Pediatrics-P M & R 0 Pediatrics-Primary 1 Peds/Psych/Child Psych 0 Physical Medicine & Rehab 15 Plastic Surgery 1 Preventive Medicine 0 Psychiatry (Categorical) 102 Psychiatry-Family Medicine 1 Psychiatry-Neurology 1 Radiation Oncology 0 Radiology-Diagnostic 8 Surgery (Categorical) 31 Surgery-Preliminary (PGY-1 Only) 16 Thoracic Surgery 0 Transitional (PGY-1 Only) 16 Urology 0 Vascular Surgery 0 Total PGY-1 1408

PGY- 2 Positions
Anesthesiology 48 Dermatology 1 Emergency Medicine 8 Neurology 35 Physical Medicine & Rehab 86 Preventive Medicine 0 Psychiatry 0 Psychiatry-Neurology 0 Radiation Oncology 1 Radiology-Diagnostic 31 Total PGY-2 2 210

GRAND TOTAL 1618

Total DO Students that Applied 2,015

Nicely done 👍

 

[womp]

I thought pre-matching was pretty common for competitive fields???

Nah, I was under the impression it was far more common for IM and FM. This way the program can have an otherwise strong applicant commit before the match and they can guarantee that they'll fill their slots.

But urology might be a little weird since they have their own matching system.

 

[Skippygonenuts]

I thought pre-matching was pretty common for competitive fields???

would somebody mind explaining what pre-matching is? i've never heard of it..

 

[JaggerPlate]

Nah, I was under the impression it was far more common for IM and FM. This way the program can have an otherwise strong applicant commit before the match and they can guarantee that they'll fill their slots.

But urology might be a little weird since they have their own matching system.

Shrug??? You're probably right. I'm definitely not at that point in the game yet, so I'm just repeating stuff I've heard.

 

[AD28]

i would have to say for radonc it's probably more difficult to match as a DO for the following reasons:

1. i couldnt find any AOA residencies in radonc, meaning you have to get an allopathic one
2. if you look at NRMP's matching statistics for radonc, research is really important - the vast majority of people who matched had at least 3 publications and DO schools are generally very light on research.
3. radonc seems to like alpha omega alpha membership and ranked research uni a little more than other specialties. DO schools may have their own honor society but i don't know how this factors in.

that said, it's not impossible, but definitely harder than as a MD .

 

[faith2]

This may seem stupid but why do you have to match twice? Meaning what is a PGY-1 and a PGY-2? A friend of mine said she did real well on her MD and DO boards but had to scramble for ObGyn is that possible?

 

[Bacchus]

If she ranked very competitive programs then that could explain it. She may have interviewed well but others could have as well and ended up ranked higher than her on the program's own list.

PGY1 = intern/preliminary year. Some residencies (derm, rads, ophtho, gas, etc.) require a preliminary year prior to starting their residency. The PGY-2 year refers to the year after intern year and the year the student starts their categorical residency.

For example: Sue matches:
PGY-1- X Hospital Prelim Medicine
PGY-2- Y Hospital Anesthesiology

Transitional year is a PGY-1 year (intern year) but tends to be cushier than straight preliminary medicine or surgery years. You rotate through different specialties, like 3rd year of med school, and you tend to have more electives and less call. They're pretty competitive spots to get.

From MrBurns10

 

[faith2]

OMG i remember the program i did at UM where we shadowed the residents, and one young lady told me she was going to start a residency in TX for derm, but I met her on the IM rotation at Jackson south and I did not ask any more questions because I was confused. Now it makes sense. THANKS... why some EM programs have to do this and not others.

If she ranked very competitive programs then that could explain it. She may have interviewed well but others could have as well and ended up ranked higher than her on the program's own list.



From MrBurns10

 

[Bacchus]

It might have to do with the residency being AOA vs. ACGME but I'm not sure. AOA EM residencies are four years, ACGME are 3. Someone else can probably answer better than that.

 

[faith2]

Is one better than the other?

It might have to do with the residency being AOA vs. ACGME but I'm not sure. AOA EM residencies are four years, ACGME are 3. Someone else can probably answer better than that.

 

[Bacchus]

SDN mantra is if you plan on doing a fellowship, ACGME is the way to go. I'm not entirely sure about fellowship though (if you can cross over from AOA to ACGME or vice versa).

 

[faith2]

I really appreciate your help
What is the differnce between fellowship and residence please?
What would be an example of a EM fellowship?

SDN mantra is if you plan on doing a fellowship, ACGME is the way to go. I'm not entirely sure about fellowship though (if you can cross over from AOA to ACGME or vice versa).