DO EM Hopefuls...

[Future Doc B]

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Hey everyone...

2 Questions for all DOs applying to Osteopathic programs:

1) Did you Rotate (and get a LOR) at a DO EM residency?

2) What is the "Magic Number" of Interviews required at Osteopathic programs to ensure a match?

 

[DrMom]

I've not seen any stats on how many interviews ensure a match like there are on the MD side.

The DO EM programs I'm familiar with will interview but not rank folks who haven't at least done a couple of shifts there. (my program, for example, told folks at interviews that we strongly recommended that they spend some time with us sometime before the Jan rank list date if they hadn't rotated with us already)

 

[RockfordWF]

Hey everyone...

2 Questions for all DOs applying to Osteopathic programs:

1) Did you Rotate (and get a LOR) at a DO EM residency?

2) What is the "Magic Number" of Interviews required at Osteopathic programs to ensure a match?

You are required to rotate at most programs to be considered for an interview. Some programs even give a courtesy interview but will not rank you if you did not rotate there. I was given interviews at 4 places, only 1 of which I rotated at. I did not receive an LOR from a DO EM residency.

 

[Red Beard]

Sorry for the bump, but wondering: how are you supposed to get into a DO program if you can only rotate at a couple of places?

At my school, our required EM rotation is during the 4th year, most not at a residency site, and we aren't allowed to do our third year elective in EM. It seems like this is pretty common among DO schools.

 

[DrMom]

even if you cannot do a full rotation somewhere, you can spend a weekend or some other short period of time at a program. they really just want to see how you work in their environment.

 

[RockfordWF]

Sorry for the bump, but wondering: how are you supposed to get into a DO program if you can only rotate at a couple of places?

At my school, our required EM rotation is during the 4th year, most not at a residency site, and we aren't allowed to do our third year elective in EM. It seems like this is pretty common among DO schools.

Why can't you do it in July, Aug, Sept, Oct, Nov, Dec, & Jan of your 4th year?

 

[DOnut]

My advice is to pick the right programs. I can only speak from my experience in NY, but Juan Acosta, Jerry Balantine and several other attendings at St. Barnabas are very well know. Both in th osteopathic and allopathic world. Jerry Balantine is currently the president of the NY American College of Emergency Physicians (ACEP), Juan Acosta is on the Board of directors. These are the people I got my letters of recommendation from.

I'm sure there are other influential people at other osteopathic programs across the country. So my advice is to choose the right program to rotate at if you can only do a few. Work very very hard, and get excellent letters from the right people. These letter will help more than you could imagine.

Hope this helps.

DOnut

 

[pianoman511]

I was just wondering if there is much of a difference between an allopathic and osteopathic EM residency program ?

 

[Greenbbs]

I was just wondering if there is much of a difference between an allopathic and osteopathic EM residency program ?

Not a whole ton. Most DO EM residencies tend to be in mid sized community based hospitals, where most allopathic are in larger tertiary care centers.

The curriculum is essentially the same. In my DO residency, there's not a whole ton of manipulation curriculum.

We also rotate through trauma months and peds EM months with the allopathic residents.

 

[nlax30]

Not a whole ton. Most DO EM residencies tend to be in mid sized community based hospitals, where most allopathic are in larger tertiary care centers.

The curriculum is essentially the same. In my DO residency, there's not a whole ton of manipulation curriculum.

We also rotate through trauma months and peds EM months with the allopathic residents.

Question for you: If there is, how is OMM integrated into an EM program? I know in practice it probably won't be used in the ED, but as it's a DO residency do they still integrate it to some degree?

 

[DrMom]

all we do is document if we use OMM on a patient (a list is kept for the entire residency to track the 3 of patients we use OMM on...the expected # is *very* low) and attend 2 OMM lectures a year. all I ever use OMM for is low back pain (sometimes if I have time) and the occasional headache.

 

[RockfordWF]

I was just wondering if there is much of a difference between an allopathic and osteopathic EM residency program ?

All osteopathic programs are 4 years, and only a small percentage of allopathic programs are 4 years.

Most allopathic programs are at academic trauma centers, and most osteopathic hospitals are at community non-trauma centers...

 

[Red Beard]

All osteopathic programs are 4 years, and only a small percentage of allopathic programs are 4 years.

Most allopathic programs are at academic trauma centers, and most osteopathic hospitals are at community non-trauma centers...

So I guess the question becomes: does training at your average community based AOA EM residency limit your job prospects? Are the same minimum proficiencies for BC met in AOA vs ACGME residencies?

 

[Greenbbs]

All osteopathic programs are 4 years, and only a small percentage of allopathic programs are 4 years.

Most allopathic programs are at academic trauma centers, and most osteopathic hospitals are at community non-trauma centers...

To some extent, yes, most allopathic programs are at academic trauma centers, although there are several that I know of that are community based trauma centers (the ones in Akron, OH for example).

There are osteopathic programs that are in trauma centers, however.

My hospital is a trauma center (granted, only a level III, but still trauma verified). We're also an ACS Chest pain center and a JACHO primary stroke center. We may be a smaller community based hospital, but we see the same stuff the big centers see, with much more personal interaction with the staff.

As one of my attendings says: you guys see more weird crap and really sick people and bizarrities than I saw in my 100k volume center for my residency

As for the OMM: we have to incorporate OMT into our lectures we give during didactics, and we have to at least suggest it at some point in the ER.

 

[RockfordWF]

So I guess the question becomes: does training at your average community based AOA EM residency limit your job prospects? Are the same minimum proficiencies for BC met in AOA vs ACGME residencies?

I don't think job prospects would be limited. I think it more has to do with what you want to get out of your residency and how long you want to do it.

 

[RockfordWF]

To some extent, yes, most allopathic programs are at academic trauma centers, although there are several that I know of that are community based trauma centers (the ones in Akron, OH for example).

There are osteopathic programs that are in trauma centers, however.

My hospital is a trauma center (granted, only a level III, but still trauma verified). We're also an ACS Chest pain center and a JACHO primary stroke center. We may be a smaller community based hospital, but we see the same stuff the big centers see, with much more personal interaction with the staff.

As one of my attendings says: you guys see more weird crap and really sick people and bizarrities than I saw in my 100k volume center for my residency

As for the OMM: we have to incorporate OMT into our lectures we give during didactics, and we have to at least suggest it at some point in the ER.

At the osteopathic residencies I rotated at, the residents fought for the very few critical patients that came in to get the experience. This is a severe disadvantage, unless you are in one of those rare programs like in Ohio.

 

[Greenbbs]

At the osteopathic residencies I rotated at, the residents fought for the very few critical patients that came in to get the experience. This is a severe disadvantage, unless you are in one of those rare programs like in Ohio.

I'm at one of those rare programs in Ohio. If you want to do EM and stay the DO route, the hospitals in Ohio are arguably the best for your opportunities. I know that places like Lehigh Valley that are dually accredited are pretty good too, but if you go to ABOEM's website, the 4 on the list are exceptionally strong (FYI...Cuyahoga Falls and Massilon/Affinity are wrapped up with South Pointe's program). Genesys in Michigan is strong too.

I rotated through both allopathic and osteopathic programs during my time in med school. There were things about both that I liked and disliked. I fell in love with my program because we had all the services of the big hospitals (Trauma, CT/Neurosurg, Chest pain/Stroke center, etc) but everyone was happy. Everyone knew everyone else in the hospital, and attendings (not necessarily the EM ones, but the others....IM, CT surg, Cardio, ICU, etc) were not malignant and treated you like peers instead of any other way. I could get that huge hospital feel, but really get to know people instead of being in a patient mill.

It just depends on what you're looking for in a program. At my place, we have enough critical patients to go around twice and three times over. But, you can go to any allopathic program and have the same issues....people fighting over the critical patients, etc....it's not immune to the osteopathic programs. You'll always have that no matter where you go. Everyone wants to take care of the septic guy who needs tubed and lined, but nobody wants to take care of the PID or the pharyngitis.

 

[RockfordWF]

I'm at one of those rare programs in Ohio. If you want to do EM and stay the DO route, the hospitals in Ohio are arguably the best for your opportunities. I know that places like Lehigh Valley that are dually accredited are pretty good too, but if you go to ABOEM's website, the 4 on the list are exceptionally strong (FYI...Cuyahoga Falls and Massilon/Affinity are wrapped up with South Pointe's program). Genesys in Michigan is strong too.

I rotated through both allopathic and osteopathic programs during my time in med school. There were things about both that I liked and disliked. I fell in love with my program because we had all the services of the big hospitals (Trauma, CT/Neurosurg, Chest pain/Stroke center, etc) but everyone was happy. Everyone knew everyone else in the hospital, and attendings (not necessarily the EM ones, but the others....IM, CT surg, Cardio, ICU, etc) were not malignant and treated you like peers instead of any other way. I could get that huge hospital feel, but really get to know people instead of being in a patient mill.

It just depends on what you're looking for in a program. At my place, we have enough critical patients to go around twice and three times over. But, you can go to any allopathic program and have the same issues....people fighting over the critical patients, etc....it's not immune to the osteopathic programs. You'll always have that no matter where you go. Everyone wants to take care of the septic guy who needs tubed and lined, but nobody wants to take care of the PID or the pharyngitis.

If you want to live in the south or west, these opportunities are just not available.

 

[Greenbbs]

If you want to live in the south or west, these opportunities are just not available.

For residency, that's very true.

However, of our graduates last year, one went to NC, one went to SC, and one went to AZ.

Training is one thing.....go where the best training is.

You can go anywhere for a job when it's over.

 

[RockfordWF]

For residency, that's very true.

However, of our graduates last year, one went to NC, one went to SC, and one went to AZ.

Training is one thing.....go where the best training is.

You can go anywhere for a job when it's over.

You can, but why be miserable for 4 years when all you have to do is apply to an ACGME program....

 

[Greenbbs]

You can, but why be miserable for 4 years when all you have to do is apply to an ACGME program....

Hence the reason I said go where the best training is. If you want to believe that you're going to get the absolute best training at an ACGME program, then so be it.

I've got nothing against ACGME programs. Hell, I applied to several, but chose the hospital I'm at because of the things I said above.

If going to an ACGME program is going to validate you as a human being and a physician, then that's your bag of tricks. But, realize, there's a decent amount of DO students that choose to do DO residencies, and we're not miserable. I'm actually happier at my program than I would have been at one of the 3 ACGME residencies within a half hour of my house.

I actually think I get more teaching at my hospital than I would at some of the ACGME programs because we have such good relationships with our attendings. We have attendings at my hospital that are on staff at CCF and University in Cleveland that you know when they're at those hospitals rounding with residents or talking to them, that they only give 'em a couple of minutes. I had a patient with vertigo unremittable to treatment when I was a floor senior with the interns on my last floor month, and we were talking to a consulting neurologist who's on staff at CCF, he sat down for a half an hour having an open discussion about vertigo, the DDX, what to look for and how to treat it. I know we wouldn't have gotten that kind of time and level of teaching at the mothership.

Choosing a residency is making an educated guess as to where you're going to be most comfortable and where you'll get to see and do the most. Nobody knows what you'll get out of residency by a couple weeks in an ER during a rotation. So much more depends on the other stuff the hospital offers.....your other months are just as formative as your time in the ER. The better experience you have elsewhere in the hospital will make you better overall.

 

[WallowaWanderer]

Choosing a residency is making an educated guess

That's scary, but seems quite true.

Nobody knows what you'll get out of residency by a couple weeks in an ER

And you can only rotate at a few places! That means that at 90% of the places I interview I will have to make this decision having spent only a few HOURS in the ED, if that. ***begin palpitations . . . nausea . . .***

 

[SomeDoc]

All osteopathic programs are 4 years, and only a small percentage of allopathic programs are 4 years...

For DO EM programs, including some other specialties, the internship year is now counted as the first year of training. Not sure if that means they're now three years total... what do u think...?

https://www.do-online.org/index.cfm?au=S&PageID=sir_main

 

[Greenbbs]

For DO EM programs, including some other specialties, the internship year is now counted as the first year of training. Not sure if that means they're now three years total... what do u think...?

https://www.do-online.org/index.cfm?au=S&PageID=sir_main

By having the intern year wrapped up in the residency, it's a pgy 1-4 inestead of a 2-4 like it is now.

Still gonna be 4 years, but more EM focus during the intern year than current internships

 

[RockfordWF]

For DO EM programs, including some other specialties, the internship year is now counted as the first year of training. Not sure if that means they're now three years total... what do u think...?

https://www.do-online.org/index.cfm?au=S&PageID=sir_main

The only change is that you don't have to apply to years 1 and 2-4 separately. They are still the same. And there is still only 1 DO residency in the south and the west at a real trauma center.