DO EM disadvantage

[corpsmanUP]

Just to let you know a DO I know matched at Vandi last march. So maybe country music has some love.

Not in Emergency Medicine they didn't! Perhaps in family medicine or something else. but not EM. They have no DO EM residents and never have that I know of.

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[FlemishGiant]

Also, for those programs that you really want, but think that it will be difficult to match there, do an away rotation and bust your ass. I don't think being a DO will hinder you in any way....at least in Emergency Medicine.

DOnut

Be careful w/ this one. You guys get very few chances to do "audition" rotations. So you don't want to waste them. I did one at well known NYC program, busted my furry butt, honored the rotation and got a great letter from them but... Didn't get an interview!?!? They're pretty big into pedigree over there. Then I did an Ultrasound rotation at another program... My attending pulled me aside one day and said, "hey you're doing a great job, and everyone loves you and you would totally fit in here but... You're a DO and the higher ups will take that as a big hit against you." In my attendings defense he was pretty frustrated about it too. And no, I didn't get an interview. But this is not to say I totally wasted these rotations. I learned a BOAT load in both of them and looked like a star at my next "audition" where I wanted to match at in the end. So the moral of the story: Make your auditions count ie. make sure the program is at least sort of DO friendly before you put in your time/money or make sure they are a fantastic teaching/learning experience before you fly off.

As always, sorry for the spellig.
FG

 

[OSUdoc08]

Be careful w/ this one. You guys get very few chances to do "audition" rotations. So you don't want to waste them. I did one at well known NYC program, busted my furry butt, honored the rotation and got a great letter from them but... Didn't get an interview!?!? They're pretty big into pedigree over there. Then I did an Ultrasound rotation at another program... My attending pulled me aside one day and said, "hey you're doing a great job, and everyone loves you and you would totally fit in here but... You're a DO and the higher ups will take that as a big hit against you." In my attendings defense he was pretty frustrated about it too. And no, I didn't get an interview. But this is not to say I totally wasted these rotations. I learned a BOAT load in both of them and looked like a star at my next "audition" where I wanted to match at in the end. So the moral of the story: Make your auditions count ie. make sure the program is at least sort of DO friendly before you put in your time/money or make sure they are a fantastic teaching/learning experience before you fly off.

As always, sorry for the spellig.
FG

We get 8 months of elective rotations.

 

[FlemishGiant]

We get 8 months of elective rotations.

Thats nice but are you going to do 8 EM rotations? And during the prime audition months space tends to be a little limited. All I'm saying is spend your time wisely.

God my spelling sucks.
FG

 

[OSUdoc08]

Thats nice but are you going to do 8 EM rotations? And during the prime audition months space tends to be a little limited. All I'm saying is spend your time wisely.

God my spelling sucks.
FG

That brings up an interesting point:

How many elective rotations should you do?

Is it more important to do non-EM rotations or to do the auditions?

What would be a good balance of auditions and non-EM rotations if you get 8 months of electives?

What are the essential non-EM elective rotations to do?


Thanks!

 

[GCS]

So, what are the few "good" osteopathic EM programs???

 

[MasterintuBater]

I would also be very interested in seeing a list of "10-12 quality DO EM programs". Having rotated in a DO EM program as well as 2 allopathic EM programs, I've found a key difference which markedly defines the differences in quality. It's the simple fact that allopathic programs are built upon the foundations of the RRC guidelines. This simply means that the allopathic programs ALL have big brother looking over their shoulder to ensure that these programs have all the components to provide adequate emergency medicine training. This includes all sorts of parameters including volume, exposure to trauma, off service rotations, amount of procedures,....the list is a mile long. There are a few D.O. programs that also provide a similar experience WITHOUT RRC guidelines. However, there are many DO programs that may now be deficient in certain areas, or may be in jeopardy of falling deficient in the future without strict guidelines to adhere to. So it's not really a difference in community vs. academic setting that makes a difference. Bottom line....allopathic programs have a component of "quality control" that DO programs do not have. Again, this is not to say that some DO programs can't provide a similar training experience without set guidelines.....however, my list of those programs that do is certainly shorter than 10 or 12. This is just more information to add into your decision making process.... and by the way flemish giant...your spelling does suk.

 

[FlemishGiant]

and by the way flemish giant...your spelling does suk.

Dude, I know. Just trying to be helpful.

FG

 

[Dr.MISHKA D.O.]

Okay I will start by saying that this is just my list and my opinions based on my own research, rotations, and conversations.

In Order by my rank: (this is only my opinion I am no expert)

1) Albert Einstein Philly Dual accreditted Allo/Osteo
2) Beth Israel Newark Dual accreditted Allo/Osteo
3) St James Olympia Fields (Chicago)
4) St Barnabas Bronx
5) Henry Ford Warren (Detroit)
6) Arrowhead Colton, Ca
7) St. John Oakland, MI
8) OUCOM Columbus
9) Mount Sinai Miami Beach
10) Southwest Oklahoma City
11) Freeman Joplin
12) St Vincent Erie, Pa

Obviously the dual accredited use the guidelines, but all the osteo programs must comply with the ACOEP residency guidelines, which by review are quite similar to the ACEP guidelines.

Next Issue: You must decide your residency Tactic. Be realistic. Do you want to stay in one or a couple areas of the country, do you want the absolute best you can get regardless of location, or do you want only an osteo or only an allo program? I chose to focus in one region of the country regardless of Osteo/Allo, with some other areas of the country for back-up (momma didn't raise no fool!)

If you chose this regional tactic your osteo options may/may not be limited.(osteo options in Michigan and Ohio are almost limitless. No Osteo EM in Texas)
If Osteo, do rotations early, like July, Aug. Sept. (most interviews are quite early compared to allo)
If Allo try Aug, Sept, Oct, Nov. (allo interviews tend to be later)

I did Three Audition rotations all in the same area. I did two EM and One IM subspecialty (as I am applying IM/EM and EM) as well as an EM my third year at my base hospital. You might want to do three electice EM, unless your required EM is one of your desired (such as OSUdoc08 in OKC).

Try different settings, I did one regional center, one community, one academic/tertiary/LevelI trauma center. You'll find which is the best fit, and probably learn a ton as well. I liked the community center the best.

Then fill in with rotations that improve your Knowledge/Skills - such as if you will do auditions later (want allo) do an Early month (July/Aug) of Gas/Rads,Surgery/plastic surgery, or Ortho - attendings will be impressed you can intubate/suture the face/do double or triple layer closure/cast/identify fractures/reduce dislocations.

Take ACLS prior to EM rotations - this knowledge impresses attendings as well. Rotate at the programs you are less interested in first to gain knowledge/skills for the programs you are more interested in later. (July = least interest, Oct/Nov. = most interest)

Lastly, if you are trying to stay in one area you may be able to only apply to one or two osteopathic programs, as any other osteo picks (out of that area)will pull you out of the Allo match and thus that area for your allo picks.

Choose the best program for you regardless of "the hype." I found one big name program to have very poor teaching and sub par residents compared to a "no name" osteopathic program. (In my humble opinion) Residency is a personal choice and you will only become your best at a place that fulfills your specific personal requirements.

The Mish

 

[DOnut]

I absolutely positively agree with the above post. I even agree with his list of programs. There are definitely VERY strong osteopathic programs out there. Some of which are MUCH better than a few allo programs. I can sight examples, but you never know who's reading....and who knows you. PM me for details.

I am completing my 3rd EM rotation now. Personally I think 2 rotations is plenty. 3 is a little overkill. Pick a place where you feel you will be happiest and get the type of experience you desire. If you want a very busy urban trauma center, don't rank a small level 2. If you would rather the slower pace teaching and labs at smaller programs, then hey...do that.

Hope everyone finds what they are looking for.

Peace

DOnut

 

[RBorhani]

Here is what I emailed to another student with same the same question as yours:

If you want MD program and you want to do that right after your 4th
year (without doing an internship, like I did, then know that you
will not be able to do this in Michigan. Michigan requires an AOA
internship).

However, if you are interested in a ACGME program (I will just call
it MD program from now on) then it really does not make that much of
a
difference if you have rotated at the specific program or not. I got
into my program without doing a rotation here or even any rotations
in the illinois area. What most MD programs look for are your
letters of rec (most want SLOR http://www.cordem.org/slor.htm ), your
deans letter, your board scores, and your class rank.

If you are interested in Calif (I am from San Diego (UCSD)myself so
know what you mean about the snow), then I highly suggest taking and
doing really well on the USMLE... (this was the main reason I did not
get many interviews in Calif...I have only taken COMLEX and did
pretty well on it but most of the programs in calif wanted USMLE
scores. This was not the case with many of the other programs that I
interviewed at, outside of Calif.

One other thing about MD programs is that if you do rotate at their
program and you do really well you might get a "courtesy" interview
that you would not have gotten if they did not know you.. However,
doing 600 ED rotations is definitely a negative thing on your
application ... at the most do 3 ED rotations and even with these see
if you can do a different rotation than just regular ED after you
have completed your first required ED(i.e. EMS rotation, ED research
rotation, ED Sub-Internship, Peds ED etc...)Make sure you do really
really well and get as many SLORs as you can when you do your core ED
rotation.

During your rotations be nice to the residents... most programs
(almost all programs) will have their current residents interview and
choose the new residents..

If you want to do a DO residency (I do not know much about the
process) but I can tell you that when I was a student it seems as if
they placed alot of emphasis on people that had rotated in their
facility and almost exclusively interviewed only the ones that they
knew... (this is definitely different on the MD side)...

As far as Michigan I spent my whole third year there.. mostly at
POH.... Unless things have changed alot since then, and they might
have, I would not do many rotations there.. The patient volume is
way too low and they have way too many residents for the number of
patients ... you will have a easy rotation but not too educational...
Small hospitals are good in that they have a much easier schedule and
you will get more attention from the attending but you will not be
able to do as many procedures (as not many get done in these
hospitals)... you will generally learn more if there is a strong
residency program in the rotation that you are doing as residents
will be your primary teachers....

Well I am being paged now....so I have to go.. sorry for all the
typos (I had to type this email really really fast)....

 

[Aloha Kid]

Okay I will start by saying that this is just my list and my opinions based on my own research, rotations, and conversations.

In Order by my rank: (this is only my opinion I am no expert)

1) Albert Einstein Philly Dual accreditted Allo/Osteo
2) Beth Israel Newark Dual accreditted Allo/Osteo
3) St James Olympia Fields (Chicago)
4) St Barnabas Bronx
5) Henry Ford Warren (Detroit)
6) Arrowhead Colton, Ca
7) St. John Oakland, MI
8) OUCOM Columbus
9) Mount Sinai Miami Beach
10) Southwest Oklahoma City
11) Freeman Joplin
12) St Vincent Erie, Pa



The Mish

I would add Lehigh Valley Osteopathic EM program to the list. We are definitely a strong academic program. It is a hidden secret but residency is just phenomenol. I am currently a pgy-1 and would have to agree that we are on par and better than half of all allopathic residencies out there. The strong financial funding makes that possible.

Grand rounds monthly includes national speaker from around the country. We have had ACEP presidents lecture and speak. This past month was the program director from Maryland. Our faculty are a good mix of DO and MD trained. MDs from Harvard, John Hopkins, etc.

Albert Einsteins EM residents rotate through our Trauma 1 EM facility for the magnitude of blunt trauma we get. We are the #1 trauma center in PA this year. This is truly not a rinky dinky program. The environment is collegial and friendly. Facilities are brand new, up to date, and computerized. Lehigh Valley hospital is ranked in US new top 100 in many areas!

I am happy to be here. The rank list last year went 19 deep for only 12 spots. Compared to St. Lukes Hospital, our adjacent DO/EM program, the match list went much higher. All of my fellow interns are truly exceptionally smart and talented.

If you are considering a quality program, and want to stay DO, I would highly reccommend Lehigh Valley EM program. Take a look at the website lvhemres.com.

 

[floweree]

1. Lehigh Valley
2. Genesys
3. Mount Clemens
4. Lansing
5. CCOM- Chicago
6. Doctor's- Columbus
7. Einstein
8. Beth Israel

these are the ones i applied to anyway and r in no particular order yet, still have to see what kind of flexibility my hubby's job has. i would avoid the d.o. st. john as they are on probation and residents that i knew fled the program. henry ford bi-county has reputation for being quite weak.

Okay I will start by saying that this is just my list and my opinions based on my own research, rotations, and conversations.

In Order by my rank: (this is only my opinion I am no expert)

1) Albert Einstein Philly Dual accreditted Allo/Osteo
2) Beth Israel Newark Dual accreditted Allo/Osteo
3) St James Olympia Fields (Chicago)
4) St Barnabas Bronx
5) Henry Ford Warren (Detroit)
6) Arrowhead Colton, Ca
7) St. John Oakland, MI
8) OUCOM Columbus
9) Mount Sinai Miami Beach
10) Southwest Oklahoma City
11) Freeman Joplin
12) St Vincent Erie, Pa

Obviously the dual accredited use the guidelines, but all the osteo programs must comply with the ACOEP residency guidelines, which by review are quite similar to the ACEP guidelines.

Next Issue: You must decide your residency Tactic. Be realistic. Do you want to stay in one or a couple areas of the country, do you want the absolute best you can get regardless of location, or do you want only an osteo or only an allo program? I chose to focus in one region of the country regardless of Osteo/Allo, with some other areas of the country for back-up (momma didn't raise no fool!)

If you chose this regional tactic your osteo options may/may not be limited.(osteo options in Michigan and Ohio are almost limitless. No Osteo EM in Texas)
If Osteo, do rotations early, like July, Aug. Sept. (most interviews are quite early compared to allo)
If Allo try Aug, Sept, Oct, Nov. (allo interviews tend to be later)

I did Three Audition rotations all in the same area. I did two EM and One IM subspecialty (as I am applying IM/EM and EM) as well as an EM my third year at my base hospital. You might want to do three electice EM, unless your required EM is one of your desired (such as OSUdoc08 in OKC).

Try different settings, I did one regional center, one community, one academic/tertiary/LevelI trauma center. You'll find which is the best fit, and probably learn a ton as well. I liked the community center the best.

Then fill in with rotations that improve your Knowledge/Skills - such as if you will do auditions later (want allo) do an Early month (July/Aug) of Gas/Rads,Surgery/plastic surgery, or Ortho - attendings will be impressed you can intubate/suture the face/do double or triple layer closure/cast/identify fractures/reduce dislocations.

Take ACLS prior to EM rotations - this knowledge impresses attendings as well. Rotate at the programs you are less interested in first to gain knowledge/skills for the programs you are more interested in later. (July = least interest, Oct/Nov. = most interest)

Lastly, if you are trying to stay in one area you may be able to only apply to one or two osteopathic programs, as any other osteo picks (out of that area)will pull you out of the Allo match and thus that area for your allo picks.

Choose the best program for you regardless of "the hype." I found one big name program to have very poor teaching and sub par residents compared to a "no name" osteopathic program. (In my humble opinion) Residency is a personal choice and you will only become your best at a place that fulfills your specific personal requirements.

The Mish

 

[DeLaughterDO]

Add:

Lansing
St. Luke's in PA

Thought I would make a correction:

St. Luke's in Bethlehem, Pa is not dually accredited. They have both allopathic and osteopathic programs at the same hospital, but not a dually accredited one. Subtle, but important difference.

To my knowledge (current as of about 6 months ago), the only dually accredited EM programs are Albert Einstein in Philly; Sparrow Hospital in East Lansing, Mi; and Newark Beth Israel Medical Center in Newark, NJ.

This is subject to change at any time, given the fanciful nature of the AOA...

Sorry if this has been corrected already..

jd

 

[pushinepi2]

First of all, good luck to everyone. As usual, there's some very good (and accurate) discussion taking place here on the SDN. From my own admittedly humble and narrow perspective, it is foolish to focus only on the COMLEX/USMLE question. If programs discriminate against you because of a 'hard to interpret' COMLEX score, then it seems reasonable to assume that the DO degree itself may function as yet another obstacle. Let's face it; application is tough.. the travel arrangements and selection process is even tougher. Applicants lack time and money enough to satisfy every single program director's concern. Talk to Quinn and other DOs on this forum, and you're likely to discover that, yes, some prejudice does exist w/regard to selection of osteopathic candidates. Fortunately, the EM specialty is soo well penetrated with DOs that the issue of comlex vs usmle is a non issue. I did quite a bit of my own research on this topic prior to going through the nrmp/acgme match. There are a few programs who admittedly don't give a damn about a comlex score. The majority of EM residencies, however, tend to evaluate candidates on a much grander scale. The application process at UMaryland, for example, is representative of the discussions that are currently taking place across the country. Though one of our associate pd's is a DO, most residency higher-ups are acutely aware of DO/COMLEX issues and do not take conscious steps to minimize their 'confusion.' Board scores and class rank function merely as 'screening' indicators of the applicant's ability. A COMLEX score of 90%, though not direclty comparable with a USMLE score, states volumes about a particular candidates qualifications. Poor board scores are just that, and function to move someone's ERAS papers to the bottom of the pile. My point is simply this: as a fourth year medical student, you've got sooo many more issues to consider than whether or not a program prefers comlex over the usmle. Though taking both boards re-affirms your scholastic aptitude, it says little about your personality and suitability as an intern. You still need to do your research and talk to the individual program directors. Taking both examinations may get your app noticed at a few more schools, but this matters little in the end game of the match. Talk with PDs and faculty at your local programs and at the regional SAEM/AAEM/ACEP conferences and ask about COMLEX scores directly. I was pleasantly surprised at just how few programs told me that completion of the USMLE was required for consideration. If you've got extra time, extra money, and frequent flyer miles, then this whole discussion will quickly fade away into irrelevance. In summary, if the original poster's heart is set on Vanderbilt , Carolines, or certain NYC programs, then you'd better start saving some cash. If not, let your academic accomplishments and interview skills speak for themselves. Good luck!

 

[deleted52758]

this maybe late but, im a TY at swedish covenant hospital in chicago, and they are in the process of being approved for a DO EM residency starting in the year 2007. the paperwork is still in process, but they expect to take 4-6 residents a year.

swedish is supposedly going to be the new DO hospital in chicago, as their affiliation with midwestern is getting stronger as the days go on.

 

[corpsmanUP]

this maybe late but, im a TY at swedish covenant hospital in chicago, and they are in the process of being approved for a DO EM residency starting in the year 2007. the paperwork is still in process, but they expect to take 4-6 residents a year.

swedish is supposedly going to be the new DO hospital in chicago, as their affiliation with midwestern is getting stronger as the days go on.

Affiliation with a DO school does not make a hospital a "DO" hospital. If it was a freestanding hospital with MD's before, it will still have MD's. It may very well be a new training hospital for the DO school CCOM but it is not a DO hospital just because of such.

 

[deleted52758]

Affiliation with a DO school does not make a hospital a "DO" hospital. If it was a freestanding hospital with MD's before, it will still have MD's. It may very well be a new training hospital for the DO school CCOM but it is not a DO hospital just because of such.

i stand corrected. semantics semantics semantics.

 

[Baditude]

Where do FMG/IMG MD's fall into the mix. Are they competetive for allopatheic residencies if they have good Step 1 and 2 scores? Do PD's tend to take DO's over them?

 

[OSUdoc08]

Where do FMG/IMG MD's fall into the mix. Are they competetive for allopatheic residencies if they have good Step 1 and 2 scores? Do PD's tend to take DO's over them?

EM in general pretty friendly to DO's. The only way I would think this would happen is in ACGME programs that don't typically accept DO's.