Do not know what to do

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Dad1719

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So before I start this I know I am going to get a lot of crap for this post. I have a DO acceptance and no MD acceptances. I have a family and DO schools, especially the one I got accepted into, are expensive. Not only are they expensive but with Step 1 being pass/fail the year I would take it but they historically have very unorganized 3/4th years. The P/F change is going to be a big F U to DO students across the board. All of the uncertainty of the DO schools makes me want to go retake my MCAT, which I did not do great on and try to reapply to more MD schools next cycle and hope for the best. The drawback to that is I am 27 and medical school is not getting any shorter. I just want to start the path to my career but I do not want to be shooting myself in the foot in the process. I am just looking for honest suggestions and appreciate the advice in advance.
 
OK, so let's talk about you. What do you bring to the table? What are your scores? How many times have you taken the MCAT? How much research do you have? What specialties are interesting?
 
sGPA:3.8
cGPA:3.6
MCAT:501
Minimal research
Ex medic in US Army
Work full time in a pediatric cardiac ICU
Married with wife and 2 toddlers
Interested in EM, Gas and Surgery


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I have only taken the MCAT once.


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Dude. Don’t be a fool. You were fortunate to get the DO acceptance with a 501. Take the blessing and become the physician you were meant to be.

you family won’t care what letters are behind your name, especially when you have the big house, Porsche, and new kitchen.

EM, Gas, and surg are attainable 100%. Given your military history you might want to look at HPSP. Better financial situation while in school to help with expenses.

thanks for your service! 🙂

but seriously I cannot stress this enough, saying goodbye to a guaranteed path to physician is FOOLISH.

half my MD class is going into Peds, IM, and fam med anyway. They could’ve gone DO with zero difference in career trajectory
 
I'd take the DO acceptance, so long as it's a reputable institution. Unfortunately, your MCAT is just a little bit too low for almost all MD programs. The specialties that you mentioned are not extremely focused on Step 1. EM, to my understanding, cares much more about Step 2, SLOEs, and away rotations. Anesthesiology matches well even at the lower end of Step 1 scores. Surgery probably cares the most about Step 1 of all those you mentioned, but it's going to be a moot point once it's pass/fail. You'll be able to distinguish yourself with aways, Step 2, etc. I'd say take the sure thing.
 
That’s exactly how I feel but there is a little voice in the back of my mind giving me doubt. Thanks though I appreciate it.


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It is crap and I always appreciate honesty. In my defense will studying my wife gave birth to my son and he had colic. Literally the entire 2 months I got to study before I took it. But yes I am thankful for any acceptance with an MCAT as bad as mine.


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It is crap and I always appreciate honesty. In my defense will studying my wife gave birth to my son and he had colic. Literally the entire 2 months I got to study before I took it. But yes I am thankful for any acceptance with an MCAT as bad as mine.


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Which school are you planning on attending?
 
Unless you truly want a surgical subspecialty or derm, take the acceptance
 
Each of those specialties will be obtainable as a DO, it is the ultra competitive specialties and more “academic” residencies that are SPECULATED to be off the table now. We will see what happens in the future, but as of right now no one truly knows how this will play out. Also, don’t turn down that DO acceptance. You will be blacklisted from all DO schools in the future, which you are marginally competitive for as is. The gamble you would be taking is far too great. Take the DO acceptance and run with it.
 
Become a physician now. We also had two young children when I started medical school. I understand the hesitation about tuition. If you aren’t interested in active duty and HPSP, look at options through compos 2 & 3. MDSSP, HPLRP and STRAP might be able to help you a bit.


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DO schools, especially the one I got accepted into, are expensive.

Postponing school by one year is an automatic -$239,000 (one year salary as a family doctor)

(Income Offered to Top 20 Recruited Specialties - Family Medicine - 2019 REVIEW OF PHYSICIAN AND ADVANCED PRACTITIONER RECRUITING INCENTIVES by Merritt Hawkins).

Not only are they expensive but with Step 1 being pass/fail the year I would take it but they historically have very unorganized 3/4th years. The P/F change is going to be a big F U to DO students across the board.

Maybe, maybe not. These are the top 5 parameters used by PDs to assess applicants:

USMLE Step 1/COMLEX Level 1 score (used by 94%, with an average importance of 4.1/5)
Letters of recommendation in the specialty (used by 86%, with an average importance of 4.2/5)
Medical Student Performance Evaluation (MSPE/Dean's Letter) (used by 81%, with an average importance of 4.0/5)
USMLE Step 2 CK/COMLEX Level 2 CE score (used by 80%, with an average importance of 4.0/5)
Personal Statement (used by 78%, with an average importance of 3.7/5)

Usually, changes to a multi-variate system don't occur in a vacuum. Smart money's on Step 2 replacing Step 1 as the big screener.

As a caveat, I agree the P/F change is bad for DOs.

(Page 3, NRMP Program Director Survey Results, 2018)

All of the uncertainty of the DO schools makes me want to go retake my MCAT, which I did not do great on and try to reapply to more MD schools next cycle and hope for the best.

The average retake increase is 3 points for students with an original score of 501.

The error bars are fairly large and I have personally met someone who went from 500 to 520 - this isn't to say that you can't have a successful retake. I just want to point out that, statistically, the retake is not likely to boost you into the 80th %ile.

AAMC's Using MCAT® Data in 2019 Medical Student Selection
(Page 11, https://www.aamc.org/system/files/c/2/462316-mcatguide.pdf)


The drawback to that is I am 27 and medical school is not getting any shorter. I just want to start the path to my career but I do not want to be shooting myself in the foot in the process.

Thank you for your service!

Deciding on a medical school, and your application strategy, is a deeply personal decision. I think it's wholly fair to be concerned about the impact of P/F Step 1 (as am I - I'll be matriculating to a DO school this summer). To me, it was not worth foregoing the acceptances.
 
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There is no guarantee you will bring your mcat score up to a point where it will generate an admission to an MD school.
Take the DO admission and run. Provided you dont want a surgical subspecialty or derm.
 
Given the interest in EM and gas, I'd take the admit. These are not specialties that are shut off to DOs at all
 
If this is a new or bad school, I would 100% reapply and use SDN to do the "right" things. I can tell you that lots of us in the DO forum regret not applying MD correctly the first time (or at all) and that DO school really is as bad as people say on here.

That said, it doesn't mean you will improve on MCAT and given how little you actually told us about your application strategy, timing, or numbers, we don't know if you are a person who just didn't do it right the first time. And, at MD or DO school you will have to do the work to get where you want to go. The deck just happens to be stacked 10x harder against you and your everyday life will suffer more ata DO school.
 
Programs you apply to out of medical school won't care what your MCAT score is, just your STEP scores that you take during medical school. I'd say take the DO position and study hard for STEP.
 
You know what to do... Take the acceptance and thank God that you gonna be a doctor. Imagine how many people who are about to lose their job right now due to that COVID-19.
 
EM, Gas and gen surg are DOable. Surgical sub specialties? Time to hit the mcat prep books again and go for the MD
 
Don't be an idiot. Take the acceptance.

Even if you did want a surgical specialty, dropping a DO acceptance for no good reason is akin to career suicide if you don't make an MD acceptance.
 
I understand the sticker shock, but you're thinking about this all wrong. Let's put this in purely financial terms:

Right now you have an acceptance to a US medical school. This nearly guarantees that you will be making $200k+ income until you retire. Except in unusual circumstances, you will be able to comfortably pay off your loans with lots of extra spending money to spare.

You are considering trying for MD school to reduce your debt.
- The benefit: to decrease tuition costs. Even though a $20k+/year difference in tuition may seem huge to you now, you need to put this in the perspective of a $200k+ annual income for the next couple decades. Even if you got into a significantly cheaper school, your gain from reducing your tuition isn't likely to have an enormous impact on your life. As others have stated, there are also ways to reduce tuition costs (military scholarship, etc).
- The risk, of course, is that schools don't take too kindly to being rejected. It's very possible for you to decline your DO acceptance, spend another couple thousand on MCAT classes and reapplying, and leave empty-handed or with a school that is just as expensive. In addition, you will have lost out on at least one year of your attending salary. Now your salary may be different with an MD degree if you go for a more competitive specialty...but given your career interests, there isn't likely to be a difference. So the risk of reapplying is likely to be at least $200k+...and maybe as high as millions in opportunity cost if you shoot yourself in the foot.

Of course there are lots of individual things to consider, like whether going to a cheaper school will allow your significant other to work less while you're in training, whether you have significant prior loans or are at high risk for disability in the next few years, whether you want to send your kid to a $$ preschool. But overall, you possess a ticket to an exceptionally stable and high-paying career, so please take it and run.
 
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