DO, Derm, & Merger

[medicinemydear]

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Hi!

I’m a little confused on what I’ve been hearing regarding the merger — everyone says that this will make it harder for DO’s to get into competitive specialties (like derm).. however won’t this also mean that the programs DO’s have typically been shut out of (MD only) that we’d now have a shot at these? I’m sure there will still be some bias at the end of the day. But I thought this was supposed to ‘level the playing field’ in a sense? Or at least try. It would be very disheartening to see DO’s being shut out of some tough specialties completely. Any thoughts?

- A DO dreaming of derm

 

[Meekor]

Hi!

I’m a little confused on what I’ve been hearing regarding the merger — everyone says that this will make it harder for DO’s to get into competitive specialties (like derm).. however won’t this also mean that the programs DO’s have typically been shut out of (MD only) that we’d now have a shot at these? I’m sure there will still be some bias at the end of the day. But I thought this was supposed to ‘level the playing field’ in a sense? Or at least try. It would be very disheartening to see DO’s being shut out of some tough specialties completely. Any thoughts?

- A DO dreaming of derm

Nope you won’t still won’t have much of a shot. If they weren’t going to interview a DO before the merger, why would they interview one after? Even former DO programs will interview and rank MD applicants just like a lot of surgery programs did. That was my experience with surgery programs this year. The only ACGME interviews I got were ones that hisotorically ranked DOs or newer programs. Good luck!

 

[JPmoleymole]

DOs have always been able to apply to ACMGE residencies - nothing is changing with these

MDs have never been able to apply to AOA residencies. Meaning there will be more competition for these spots that were historically only open to DOs

 

[CyrusHabs7695]

Hi!

I’m a little confused on what I’ve been hearing regarding the merger — everyone says that this will make it harder for DO’s to get into competitive specialties (like derm).. however won’t this also mean that the programs DO’s have typically been shut out of (MD only) that we’d now have a shot at these? I’m sure there will still be some bias at the end of the day. But I thought this was supposed to ‘level the playing field’ in a sense? Or at least try. It would be very disheartening to see DO’s being shut out of some tough specialties completely. Any thoughts?

- A DO dreaming of derm

DOs have always been able to apply to MD residencies, just not the other way around.

 

[CyrusHabs7695]

DOs have always been able to apply to ACMGE residencies - nothing is changing with these

MDs have never been able to apply to AOA residencies. Meaning there will be more competition for these spots that were historically only open to DOs

Wow that was insane timing lol

 

[medicinemydear]

Nope you won’t still won’t have much of a shot. If they weren’t going to interview a DO before the merger, why would they interview one after? Even former DO programs will interview and rank MD applicants just like a lot of surgery programs did. That was my experience with surgery programs this year. The only ACGME interviews I got were ones that hisotorically ranked DOs or newer programs. Good luck!

So, is it that we can't apply to the ACGME programs right now? Or that they just point blank won't look at us, regardless of our stats?

I can't wrap my head around what this merger is accomplishing, other than allowing MD's to infiltrate the 'DO' only residency slots?

 

[medicinemydear]

DOs have always been able to apply to MD residencies, just not the other way around.

Oh wow. This is really frustrating in that case. I don't really understand what this accomplishes for us DO's, except making it 10000x harder to match into what we want.

 

[JPmoleymole]

Oh wow. This is really frustrating in that case. I don't really understand what this accomplishes for us DO's, except making it 10000x harder to match into what we want.

Potentially raises the standard of AOA residencies and make DOs one step closer to being equivalent to MDs

 

[CoomassieBlue57]

I can't wrap my head around what this merger is accomplishing, other than allowing MD's to infiltrate the 'DO' only residency slots?

The purpose of the new ACGME is derived from what are now old AOA residencies not going to qualify for fellowships. If they had remained separate, any DO student doing an AOA residency would not qualify for ACGME fellowships. With the new ACGME all residencies now have to be compliant with the standards for ACGME fellowships.

 

[medicinemydear]

Potentially raises the standard of AOA residencies and make DOs one step closer to being equivalent to MDs

Okay that makes sense. Hard to implement, but good in theory. It feel like this kind of all hinges on the ACGME programs.. I wonder if there is any point where the ACGME programs will start to look at us more and accept us into their programs and not have this bias towards only taking MD's

 

[Med Ed]

So, is it that we can't apply to the ACGME programs right now? Or that they just point blank won't look at us, regardless of our stats?

The latter.

I can't wrap my head around what this merger is accomplishing, other than allowing MD's to infiltrate the 'DO' only residency slots?

It will bring all osteopathic programs to ACGME standards, which is a good thing if you're thinking long-term.

One of the inciting events for the merger was the refusal of certain allopathic fellowship programs to consider graduates of certain osteopathic residency programs.

 

[Med Ed]

Okay that makes sense. Hard to implement, but good in theory. It feel like this kind of all hinges on the ACGME programs.. I wonder if there is any point where the ACGME programs will start to look at us more and accept us into their programs and not have this bias towards only taking MD's

If you look at the NRMP's match data, the percentage of DO matches continues to edge up every year (now >80%). In raw numbers, matches climbed from 2,738 in 2014 to 4,617 this year.

 

[medicinemydear]

The latter.



It will bring all osteopathic programs to ACGME standards, which is a good thing if you're thinking long-term.

One of the inciting events for the merger was the refusal of certain allopathic fellowship programs to consider graduates of certain osteopathic residency programs.

I see, that makes sense. I feel like the ACGME programs must at some point have to start looking at taking more DOs then? Otherwise I worry we will be resigned to FM and IM almost entirely; with virtually no shot whatsoever at the tough specialties. And this I feel like is opposite to what the merger is trying to accomplish

 

[Chibucks15]

Also...it isn't like matching derm/ortho was ever EASY...most people who come in wanting that don't end up having the application for it. It did get harder with the merger but it is what it is.

The DO bias will fade eventually...the people in power in the ivory tower still were around when DOs weren't able to practice medicine so they still view the field in that light. It'll take a while, but I feel like once the older docs retire and all that the bias will lessen. It already has (at least where I'm at in the midwest), but itll take longer in the cali/northeast hyper competitive regions

 

[Mad Jack]

So, is it that we can't apply to the ACGME programs right now? Or that they just point blank won't look at us, regardless of our stats?

I can't wrap my head around what this merger is accomplishing, other than allowing MD's to infiltrate the 'DO' only residency slots?

It's standardizing GME and ensuring that all applicants can apply to all residencies and fellowships (not that all applicants will be considered).

 

[Meekor]

So, is it that we can't apply to the ACGME programs right now? Or that they just point blank won't look at us, regardless of our stats?

I can't wrap my head around what this merger is accomplishing, other than allowing MD's to infiltrate the 'DO' only residency slots?

A lot for medical education. There are some AOA programs should not be training residents. Either due to lack of faculty, resources, patient base etc.,

Also New ACGME fellow requirements need a residency to have completed at least 3years in an ACGME. Residency to qualify.

We have always been allowed to apply to MD residencies. Whether they look at our app or not is a different thing. It’s like applying to Harvard with a 4.0 gpa and a 35 on your ACT. You can apply and you’re qualified.. but they won’t look at you because you didn’t take the SAT. Just an analogy but that’s whats it’s like applying as a DO.

 

[Mad Jack]

Also...it isn't like matching derm/ortho was ever EASY...most people who come in wanting that don't end up having the application for it. It did get harder with the merger but it is what it is.

The DO bias will fade eventually...the people in power in the ivory tower still were around when DOs weren't able to practice medicine so they still view the field in that light. It'll take a while, but I feel like once the older docs retire and all that the bias will lessen. It already has (at least where I'm at in the midwest), but itll take longer in the cali/northeast hyper competitive regions

I don't think DO bias will fade due to the massive school expansion and dropping average stats of DOs. If there were fifteen DO schools that produced consistent results that people had time to learn about it would be one thing, but with 30+ campuses and growing, DO schools are risking having a fly by night feel compared to MD schools, particularly when teaching resources, research, and other factors are taken into account

 

[medicinemydear]

A lot for medical education. There are some AOA programs should not be training residents. Either due to lack of faculty, resources, patient base etc.,

Also New ACGME fellow requirements need a residency to have completed at least 3years in an ACGME. Residency to qualify.

We have always been allowed to apply to MD residencies. Whether they look at our app or not is a different thing. It’s like applying to Harvard with a 4.0 gpa and a 35 on your ACT. You can apply and you’re qualified.. but they won’t look at you because you didn’t take the SAT. Just an analogy but that’s whats it’s like applying as a DO.

That's a great analogy. I think that's what makes it so incredibly frustrating though. I'm really hoping hoping some of these residencies will expand their horizons a bit on the DO front

 

[medicinemydear]

Also...it isn't like matching derm/ortho was ever EASY...most people who come in wanting that don't end up having the application for it. It did get harder with the merger but it is what it is.

The DO bias will fade eventually...the people in power in the ivory tower still were around when DOs weren't able to practice medicine so they still view the field in that light. It'll take a while, but I feel like once the older docs retire and all that the bias will lessen. It already has (at least where I'm at in the midwest), but itll take longer in the cali/northeast hyper competitive regions

That's very true.

I believe it will fade also, I think it is already fading as well. I think at the end of the day it's unfortunately up to the MD residencies to become more accepting of us as DOs in order for the playing field to truly be leveled

 

[Chibucks15]

I don't think DO bias will fade due to the massive school expansion and dropping average stats of DOs. If there were fifteen DO schools that produced consistent results that people had time to learn about it would be one thing, but with 30+ campuses and growing, DO schools are risking having a fly by night feel compared to MD schools, particularly when teaching resources, research, and other factors are taken into account

very true...some of these new ones are not helping the cause that's for sure. At least for the bigger/better DO schools it might slightly due to school name but schools that let in people with 2.8s and a 23 are not gonna help at all

 

[Chibucks15]

That's very true.

I believe it will fade also, I think it is already fading as well. I think at the end of the day it's unfortunately up to the MD residencies to become more accepting of us as DOs in order for the playing field to truly be leveled

MDs will almost always have an edge on DOs. That's the nature of the profession and how prestige-driven and at times, incestuous it can be. My only hope is that being a DO will not completely DQ you if you have the stats, but instead will be just a slight disadvantage instead of a complete block

 

[CoomassieBlue57]

very true...some of these new ones are not helping the cause that's for sure. At least for the bigger/better DO schools it might slightly due to school name but schools that let in people with 2.8s and a 23 are not gonna help at all

We may potentially start to see "true" tiering of DO schools where PDs start to filter out some of the newer schools because of this as well. This is just speculation btw.

 

[Mad Jack]

We may potentially start to see "true" tiering of DO schools where PDs start to filter out some of the newer schools because of this as well. This is just speculation btw.

The general vibe I have gotten was that they just don't care enough to sort through and learn all of the DO schools, so DOs all end up in the same pile unless they knew someone personally from a given school

 

[medicinemydear]

What's the consensus (if any) on the best vs worst DO schools as of now? I always feel like I hear mixed reviews on all of them

 

[CoomassieBlue57]

The general vibe I have gotten was that they just don't care enough to sort through and learn all of the DO schools, so DOs all end up in the same pile unless they knew someone personally from a given school

No doubt that this is the case now. Put it this way, for the past decade the sample size of ACGME PDs has been small enough that DO students could be lumped together. These programs (whether they are willing to interview/take a DO student) will be seeing more applications that otherwise wouldn't have been submitted. With more familiarity and a broader array of students applying, there's going to be more filtering based on some specific category. One of those categories may end up being the name of the school that student attends.

 

[Mad Jack]

No doubt that this is the case now. Put it this way, for the past decade the sample size of ACGME PDs has been small enough that DO students could be lumped together. These programs (whether they are willing to interview/take a DO student) will be seeing more applications that otherwise wouldn't have been submitted. With more familiarity and a broader array of students applying, there's going to be more filtering based on some specific category. One of those categories may end up being the name of the school that student attends.

Or, more likely, the PD will just sort all the DOs into the DO pile as they do now because they already have too many applications, and the DO pile will just grow larger. More applications means more high level filtering, not less. You don't have time to look over each and every school when you've got 1000 DO applications, but you might when you have 10.

 

[CoomassieBlue57]

Or, more likely, the PD will just sort all the DOs into the DO pile as they do now because they already have too many applications, and the DO pile will just grow larger. More applications means more high level filtering, not less. You don't have time to look over each and every school when you've got 1000 DO applications, but you might when you have 10.

1,000 applications. 990 from ACOM, BCOM, XCOM, YCOM, ZCOM, and 10 from UNECOM. I've found your 10 pretty easily.

 

[Mad Jack]

1,000 applications. 990 from ACOM, BCOM, XCOM, YCOM, ZCOM, and 10 from UNECOM. I've found your 10 pretty easily.

Usually not how it shakes down though. These middle of nowhere schools have kids that want to go to or back to the big city, so you'll be in NYC getting apps from every rural COM kid looking to escape the middle of nowhere

 

[Meekor]

Another thing to take note of is where you did your rotations. Every single PD from an ACGME program asked me where I did my 3rd year, whereas none of my AOA PDs bothered to ask. Where you get your LORs from and where you did your rotations also speaks to the prestige your application carries just like your school name. This is also where DO schools are severely lacking, the CONSISTENT quality of clinical rotations and CONSISTENT Volume of exposure to patients. I’m sure there are crappy ones at MD and big name institutions as well but they all carry a brand name. For example, I saw one patient my whole entire month of peds at my core hospital. And on obgyn there was about 1 vaginal delivery a week if I was lucky, the rest were c-sections. There was a week on surgery where there was not a single case scheduled. I can go on.

Other than a handful of schools, how many DO schools have a brand name behind their clinical rotation sites?

 

[CyrusHabs7695]

That's a great analogy. I think that's what makes it so incredibly frustrating though. I'm really hoping hoping some of these residencies will expand their horizons a bit on the DO front

Finish in the top of your class, get a 250+ on step 1 and pump out some publications with great LoRs and you wont need to worry about the bias. Obviously thats easier said than done, but thats what it takes to get into competative fields


Sent from my iPhone using SDN mobile

 

[Med Ed]

I think at the end of the day it's unfortunately up to the MD residencies to become more accepting of us as DOs in order for the playing field to truly be leveled

This isn't on ACGME residencies. It's on COCA and the DO schools to make a better product.

 

[Goro]

This isn't on ACGME residencies. It's on COCA and the DO schools to make a better product.

How I wish I could tattoo that on the foreheads of the people running the AOA!

 

[medicinemydear]

This isn't on ACGME residencies. It's on COCA and the DO schools to make a better product.

Seems like an administrative issue more than anything.

 

[Meekor]

This isn't on ACGME residencies. It's on COCA and the DO schools to make a better product.

Quality control isn’t the only problem, product branding is too. I went to rowan and one of two things happened on interviews 1) they thought I was from cooper rowan our MD program or 2) they only realized which school I was from once I said UMDNJ if they were familiar with its old name. Branding plays such a big and very understated role in how your interviewer and others perceive you from a residency application standpoint. Short of flooding the field with nameless DO schools, they don’t seem to have a good grasp with how to promote their brand properly.

As much as every PD wants the best applicants they can, the bias towards the familiar is always there.

 

[GTown]

Quality control isn’t the only problem, product branding is too. I went to rowan and one of two things happened on interviews 1) they thought I was from cooper rowan our MD program or 2) they only realized which school I was from once I said UMDNJ if they were familiar with its old name. Branding plays such a big and very understated role in how your interviewer and others perceive you from a residency application standpoint. Short of flooding the field with nameless DO schools, they don’t seem to have a good grasp with how to promote their brand properly.

As much as every PD wants the best applicants they can, the bias towards the familiar is always there.

Tangent - but did clarifying Rowan (formerly UMDNJ) make a difference in how you were perceived by PDs?

 

[Goro]

Quality control isn’t the only problem, product branding is too. I went to rowan and one of two things happened on interviews 1) they thought I was from cooper rowan our MD program or 2) they only realized which school I was from once I said UMDNJ if they were familiar with its old name. Branding plays such a big and very understated role in how your interviewer and others perceive you from a residency application standpoint. Short of flooding the field with nameless DO schools, they don’t seem to have a good grasp with how to promote their brand properly.

As much as every PD wants the best applicants they can, the bias towards the familiar is always there.

What many people don't realize is that medical schools are as much feeder schools to residencies as UG schools are to med schools. The grads are know products. When people kick open the door and show that a grad from XCOM is a good student, the PDs are a bit more confident that the next grad they'll accept will be of the same caliber.

The problem is that poorly trained DO graduates tar the entire profession. A degree of prejudice is occurring here. So for example:

MD student Joe mucks up:
PD: What an idiot Joe is!

DO student Jane mucks up.
PD: Well, that's a DO for you.