DO opportunities

[Ging7452]

First off I want to start this off by saying my father is a DO, my uncles are all DOs and I have nothing but respect for them, which is why the "advice" I was given about not applying or going DO in terms of specialties was very shocking.

I am applying this cycle and am currently constructing my school list and I am looking at MDs and DOs. My family has both DOs and MDs in it and never have I thought much of the difference between the two. Recently I was told that if I go to a DO school I pretty much only have a few options in terms of specialties. Yes, I know it is very, very early to be thinking about this and that I will change my preference for specialties 2149 times once I am in medical school. Yet, I think it is important to consider this going forward since I was pretty much told if I go DO I will only go into family practice, pediatrics or internal. Is this true? I understand there are more MDs than DOs in America and certain residency programs prefer MDs etc. but is it improbable to think I can get into a surgery specialty as a DO? I have been looking around sdn trying to find some numbers on this. As a DO I surely have to have more options open to me? I mean come on, it's an American medical degree! Even other doctors I have talked to since, have communicated to me that DOs struggle to get most residencies and end up mainly in internal specialties. I understand there is nothing wrong with family medicine (what my dad practices,) but I do have interests in other fields and would like to access the opportunities I will have down the road to pursue said interests in terms of DO vs MD. I know everyone loves surgery and its a very competitive program, I just want to know if I truly won't have a realistic shot at being a practicing surgeon one day if I go to a DO school. If not, what specialties/opportunities will I have reasonable access to? So I figured I would ask some experts that are DOs or currently undergoing the process.

Thank you!

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[FistLength]

MD opportunities >> DO opportunities
It is the reality of life. Thankfully I matched my # 1 in a very competitive MD specialty (which I still cannot fathom), but it was painfully apparent the disparity of resources and biases I observed. 1 Chair of the department questioned why I was applying to the field as a DO (out of sympathy) and another influential member of the admission committee frankly told me that as a DO that it was going to be much harder for me to match. MD's have far greater resources for research, better mentorship, and in general better 3rd year rotations.

I love being a DO in an MD world, but the general rule is to go MD if you can. You won't regret it.

 

[Goro]

First off I want to start this off by saying my father is a DO, my uncles are all DOs and I have nothing but respect for them, which is why the "advice" I was given about not applying or going DO in terms of specialties was very shocking.

I am applying this cycle and am currently constructing my school list and I am looking at MDs and DOs. My family has both DOs and MDs in it and never have I thought much of the difference between the two. Recently I was told that if I go to a DO school I pretty much only have a few options in terms of specialties. Yes, I know it is very, very early to be thinking about this and that I will change my preference for specialties 2149 times once I am in medical school. Yet, I think it is important to consider this going forward since I was pretty much told if I go DO I will only go into family practice, pediatrics or internal. Is this true? I understand there are more MDs than DOs in America and certain residency programs prefer MDs etc. but is it improbable to think I can get into a surgery specialty as a DO? I have been looking around sdn trying to find some numbers on this. As a DO I surely have to have more options open to me? I mean come on, it's an American medical degree! Even other doctors I have talked to since, have communicated to me that DOs struggle to get most residencies and end up mainly in internal specialties. I understand there is nothing wrong with family medicine (what my dad practices,) but I do have interests in other fields and would like to access the opportunities I will have down the road to pursue said interests in terms of DO vs MD. I know everyone loves surgery and its a very competitive program, I just want to know if I truly won't have a realistic shot at being a practicing surgeon one day if I go to a DO school. If not, what specialties/opportunities will I have reasonable access to? So I figured I would ask some experts that are DOs or currently undergoing the process.

Thank you!

As a DO, Gen Surg is hard, but not impossible. Surgical subspecialties are a LOT harder, to close to impossible.

And yes, your opportunities are greater by going MD.

 

[radkat101]

Going to a DO school is definitely going to to make matching competitive fields much much more of a challenge. It can be done, but you have to be realistic about your odds of outperforming most of your peers, and being one of the few students from each class who manage to pull this off each year. Unfortunately, this is hard to determine until you actually attend med school. Is DO your only option because you struggled a bit in undergrad? Do you have difficulty with standardized testing? If one of these answers is yes, then the likelihood of getting the scores to match a competitive field will be slim. This uncertainty is further exacerbated by the ongoing merger of residencies, and how it's going to affect DO students in the next couple of years. If you are already going into med school with your heart set on a surgical field, then yeah, I would say do everything in your power to pursue the MD degree. This is actually a field that's fairly average in competitiveness for a US MD, but very difficult as a DO. I'm not sure there is any field with more discrepancy than general surgery. If MD is simply not a possibility, then my advice for you, or any prospective DO applicant would be to go into this process comfortable with the idea of matching into one of those less competitive fields (IM, Peds, FM, Neuro, PM&R). There's also a reasonable chance of matching the ones in the middle (ObGyn, EM, Psych, Anesthesia) but even with these, there's a lot of applicants who have to settle for something else every year. It's also very hard to know how cool you would be with any field until your rotations. It's a tough decision, but you should shoot for MD.

 

[AnatomyGrey12]

Thank you for your response! Would you say the difference in opportunities and residencies is so extreme that it makes it worth holding off to go to an MD then? I really didn't expect it to be that inhibitory to be honest :/

Unless it’s going to be 2+ years of trying to go MD then yes. At that point you probably won’t be the kind of applicant that goes into competitive specialties anyway so it most likely won’t be as much of an impact. But for a year or two? Yes it is worth it if you are interested in anything competitive.

 

[Rekt]

Yes. Absolutely hold off at least two cycles of trying MD before DO. The detriment of being a DO on this forum is often understated since a lot the DOs here are quite high achievers anyway.

 

[UnoMas]

MD school>> DO school, no argument there in terms of residency matching, resources, research and to a certain extent, clinical rotations.

So many people in my class who were gung-ho about going into ortho, gen surg, neurosurg as 1st year only to end up in IM, FM or EM. Half of that cohort don't have the grades or board scores to make it into those specialties, a few realize they absolutely hate those fields, a small minority fall in love with IM, FM or EM during their 3r year.

Turning down an MD acceptance to go to a DO school is probably the dumbest thing anyone can do. However, advising someone to hold off 2 cycles to try MD before DO is also not very smart. That's 400k+ in attending salary that you will be missing out on assuming you will be making 200k a year as an attending, not counting the compounding interests on your saving during the 2 years and also the annual increase in medical school tuition; and wth are u going to do during the 2 years? volunteering? research tech for 30k a year? I would hang myself if I had to go back and work as a hospital volunteer again. You read all these threads on SDN about medical students missing out on life events compared to their friends, holding off 2 cycles will prolong that process by 2 years. At some point during your 3rd year, you will realize that medicine is just a ****ing job and 3 years residency is already too ****ing long.

The reality is that half of graduating medical students will go into some sorts of primary care specialties (FM, IM, Peds, OBGYN, Psych etc) be it MD or DO; and those specialties are wide open for DO students. As a premed, your insight into each specialty is also very poor so you will most likely change your specialty of interest about 5 times before you submit your ERAS application.

Just want to offer another perspective that is different than the purely academic one you often get here on SDN. At the end of the day, you know yourself best. Good luck!

 

[Solodyn]

MD school>> DO school, no argument there in terms of residency matching, resources, research and to a certain extent, clinical rotations.

So many people in my class who were gung-ho about going into ortho, gen surg, neurosurg as 1st year only to end up in IM, FM or EM. Half of that cohort don't have the grades or board scores to make it into those specialties, a few realize they absolutely hate those fields, a small minority fall in love with IM, FM or EM during their 3r year.

Turning down an MD acceptance to go to a DO school is probably the dumbest thing anyone can do. However, advising someone to hold off 2 cycles to try MD before DO is also not very smart. That's 400k+ in attending salary that you will be missing out on assuming you will be making 200k a year as an attending, not counting the compounding interests on your saving during the 2 years and also the annual increase in medical school tuition; and wth are u going to do during the 2 years? volunteering? research tech for 30k a year? I would hang myself if I had to go back and work as a hospital volunteer again. You read all these threads on SDN about medical students missing out on life events compared to their friends, holding off 2 cycles will prolong that process by 2 years. At some point during your 3rd year, you will realize that medicine is just a ****ing job and 3 years residency is already too ****ing long.

The reality is that half of graduating medical students will go into some sorts of primary care specialties (FM, IM, Peds, OBGYN, Psych etc) be it MD or DO; and those specialties are wide open for DO students. As a premed, your insight into each specialty is also very poor so you will most likely change your specialty of interest about 5 times before you submit your ERAS application.

Just want to offer another perspective that is different than the purely academic one you often get here on SDN. At the end of the day, you know yourself best. Good luck!

I completely agree with this. Apply with your best application. If you only get into DO schools, take it. I would not even wait another cycle. You are meant to be where you are meant to be and you will make the best of your situation wherever you are. You can wait 3 cycles to get into Yale Med, then you will have to compete with the cohorts in Yale Med. The fact it takes you 3 cycles to get in, means you are likely end up middle of the pack or lower. The GATTACA thing don't work in med school. Everyone studies their butts off. If you ended up bottom 25% at Yale Med, you are probably going primary care anyways.

If you get into the DO school in the first try, you will have a better chance to excel and ironically, you may even have better opportunities. Life is better as a DO ophthalmologist than MD family practice. Just because MD Opportunities>>DO Opportunities doesn't mean everyone will utilize it. Life has a funny way of guiding all of us to where we need to be. Just be where you are, do your best, and enjoy the ride.

A career in your dream specialty will still just become a job. It will just be the job you don't hate as much.

 

[mwsapphire]

I completely agree with this. Apply with your best application. If you only get into DO schools, take it. I would not even wait another cycle. You are meant to be where you are meant to be and you will make the best of your situation wherever you are. You can wait 3 cycles to get into Yale Med, then you will have to compete with the cohorts in Yale Med. The fact it takes you 3 cycles to get in, means you are likely end up middle of the pack or lower. The GATTACA thing don't work in med school. Everyone studies their butts off. If you ended up bottom 25% at Yale Med, you are probably going primary care anyways.

If you get into the DO school in the first try, you will have a better chance to excel and ironically, you may even have better opportunities. Life is better as a DO ophthalmologist than MD family practice. Just because MD Opportunities>>DO Opportunities doesn't mean everyone will utilize it. Life has a funny way of guiding all of us to where we need to be. Just be where you are, do your best, and enjoy the ride.

A career in your dream specialty will still just become a job. It will just be the job you don't hate as much.

@Mods, Please Make this a sticky.
This is exactly how I think about DO vs MD programs. It explains why there are DO trauma surgeons and MD applicants who could only match rural FM. It's because you're meant to be what you're meant to be.

 

[Instatewaiter]

Turning down an MD acceptance to go to a DO school is probably the dumbest thing anyone can do. However, advising someone to hold off 2 cycles to try MD before DO is also not very smart. That's 400k+ in attending salary that you will be missing out on assuming you will be making 200k a year as an attending, not counting the compounding interests on your saving during the 2 years and also the annual increase in medical school tuition; and wth are u going to do during the 2 years? volunteering? research tech for 30k a year? I would hang myself if I had to go back and work as a hospital volunteer again. You read all these threads on SDN about medical students missing out on life events compared to their friends, holding off 2 cycles will prolong that process by 2 years. At some point during your 3rd year, you will realize that medicine is just a ****ing job and 3 years residency is already too ****ing long.

You miss a few points. First, if you are not one of the lucky DOs who can specialize but would have been able to specialize by going MD- that cost actually works in the opposite direction. From my own experience, had I opted to apply DO instead of using extra time to buff my application and to get into an MD school, I would never have been able to match the places I did or have the opportunities I currently have. I also would likely be making about $200K less per year! So that extra year for me, will work in the opposite direction.

Next it isn't all about the money. Being happy that you have met your potential and that you are doing what you like are more important than a pile of money. Wanting ortho and settling for FM in the SOAP is a humbling and humiliating thing and you would never be happy as an FM.

As to your assertion that residency is too long- actually it is just the opposite. You will realize when you actually get to the end of your training (especially if you only spend 3 years in training) that you will feel unprepared and nervous having all of that responsibility with no attending to back you up. It is usually the med students who say training is too short and the senior residents and attendings who say it isn't.

 

[Instatewaiter]

I completely agree with this. Apply with your best application. If you only get into DO schools, take it. I would not even wait another cycle. You are meant to be where you are meant to be and you will make the best of your situation wherever you are. You can wait 3 cycles to get into Yale Med, then you will have to compete with the cohorts in Yale Med. The fact it takes you 3 cycles to get in, means you are likely end up middle of the pack or lower. The GATTACA thing don't work in med school. Everyone studies their butts off. If you ended up bottom 25% at Yale Med, you are probably going primary care anyways.
.

For a large swath of students, this is just bad advice. It is all dependent on why you wait those extra cycles. A student who eeked by on the MCAT and tried their hardest in college and still has a medicore GPA is very different than the person who partied too much in college and has to remediate their grades. The first shouldn't waste their time with waiting to reapply.

For the second person, The "Gattaca thing" does happen regularly. This is why those who do SMPs often do exceedingly well and this is why medical schools readily admit these students despite having a lack-luster undergraduate GPA. In my medical school class I can remember off the top of my head that we had 2 ortho, 1 ENT, 1 ophtho, 1 hopkins IM, 1 duke IM and 1 hopkins child neuro just from the people who did the medical school's SMP to get in.

Now as to your assertion about the worst student at Yale: The guy at the bottom of the class at Yale still matches to a very strong academic IM program. The DO in the middle of the class matches to a low tier university, often community IM program. This further limits what you can do with that IM residency. From a low tier program, you're unlikely to match into a good fellowship.

I recommend people look at the match lists and come back. The worst IM match from Yale 2017 was University of Colorado a strong IM program in a desirable area- again this was the WORST match. The 2nd worst was Vanderbilt (a near top tier IM program). The next worst was a tie for Mayo or Stanford- what most would consider top programs for IM. After that was those programs at the tippy top of IM (MGH, the Brigham, Hopkins, Penn, Columbia, UCSF). This matters because of fellowship opportunities. So those at a low tier/community IM Program are often religated to stay in IM even if they don't want to. Prestige doesn't matter once you have a job but those at strong clinical training programs can basically choose what and where they want to go (fellowship and after). I can tell you for my current job, my training mattered.

 

[UnoMas]

You miss a few points. First, if you are not one of the lucky DOs who can specialize but would have been able to specialize by going MD- that cost actually works in the opposite direction. From my own experience, had I opted to apply DO instead of using extra time to buff my application and to get into an MD school, I would never have been able to match the places I did or have the opportunities I currently have. I also would likely be making about $200K less per year! So that extra year for me, will work in the opposite direction.

Next it isn't all about the money. Being happy that you have met your potential and that you are doing what you like are more important than a pile of money. Wanting ortho and settling for FM in the SOAP is a humbling and humiliating thing and you would never be happy as an FM.

As to your assertion that residency is too long- actually it is just the opposite. You will realize when you actually get to the end of your training (especially if you only spend 3 years in training) that you will feel unprepared and nervous having all of that responsibility with no attending to back you up. It is usually the med students who say training is too short and the senior residents and attendings who say it isn't.

I do see your points but I guess to each his own. The premed students that are sure he or she wants to do something competitive or just to keep their options open, an MD will help their cause. However, if it were me, I wouldnt wait 2-3 years applying MD knowing what I know now. I have met DO IM residents who matched into Cardiology, Pulm-Crit, Heme-Onc from low, mid-tier university programs/community programs; from reading SDN, I didn't think this was was possible.

It is not 100% about money but partially it is, you will not see competitive students applying to Derm in droves if the compensation were to drop to 150k a year. Low-tier IM residents and JHU IM residents if they both matched into Heme-Onc, in 3 years, they will be both Heme-Onc attendings making similar amount of money except that the JHU one probably will stay academic and make less than their private practice counterparts. Then again, do what makes you happy. If you want to do Cardiology, make sure you will be ok doing General IM for the rest of your life cause there is a good chance you will not get Cardiology. An IM physician from JHU or podunk community program will be doing most likely the same job making the same amount of money.

I personally want to get **** done quickly, learn what I need to learn and get on with my life. Don't get me wrong I enjoy clinical medicine a whole lot but medicine is just a job for me at this point, I don't want to invest any more time in it than I need to.

My comment about 3 years being too long is tongue-in-cheek, the overall training is already long, tackling on another 2-3 years for medical school application is not worth it, at least for me. I understand there isnt enough time in the world to train but on the other hand you have midlevels with half the training claiming to be equivalent and doing the same thing, massive student loan with accumulating interest etc.

Bottom-line for the pre-med students, your priority will change, your specialty of interest will change, do what makes you happy. If you are going to a DO school, make sure you are ok going into FM, IM and its subspecialties, Gas, Rad, Path, Psych, peds, OBGYN etc. Surgical specialties will be hard but then again, make sure you 100% sure you know what these surgical subspecialties are like as an attending

 

[hallowmann]

...I was pretty much told if I go DO I will only go into family practice, pediatrics or internal. Is this true?

No, but you will certainly be limited compared to MDs in your options for residencies. There are plenty of DO friendly specialties, but surgical specialties will be very difficult to attain as a DO.

...I understand there are more MDs than DOs in America and certain residency programs prefer MDs etc. but is it improbable to think I can get into a surgery specialty as a DO?

Its not certain residencies, virtually all ACGME residencies prefer US MDs over DOs. You will be very limited and will have to work much harder to attain a surgical residency as a DO than as an MD. It is still very much true that for the sake of residency placement US MD > DO.

...As a DO I surely have to have more options open to me?

You do, but they won't necessarily be surgical options. You should prioritize going US MD if that is what you want.

...I know everyone loves surgery...

...

...I just want to know if I truly won't have a realistic shot at being a practicing surgeon one day if I go to a DO school.

Possible, yes. Probable, no. Some DOs become surgeons, most do not. If surgery is what you want, you should prioritize US MD schools. Now if you can't get into a US MD school, then literally your next best way to become a surgeon is to go DO, but I would certainly try hard to get into a US MD school first if your goal is to leave your residency options open.

...If not, what specialties/opportunities will I have reasonable access to?

Reasonably attainable: FM, IM, Peds, EM, Anesthesia, PM&R, Psych, Neuro, probably Rads with a solid app. Attainable, but require a very strong app: Ophtho, Uro, GenSurg, & RadOnc. Rest are so difficult to get into that I wouldn't even expect it as an option.

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As for all the other stuff on here, I'll be honest, I don't think I would have matched somewhere better had I gone to an MD school. At best I would have matched to a roughly equivalent program. The fields I applied to were DO friendly though.

We've got a DO on here saying, "yeah I ended up in a really competitive field, but I'm amazed that I did because DO bias is so bad" and "I'm an MD, and if I went DO I would have never matched into my field". Take apart those statements and think about what kind of evidence they're based one vs. the actual content/experience of those posters.

Like I said, MD is the better way to go in terms of residency placement, but lets not pretend that even the majority of DOs would end up anywhere all that different had they been MDs.

As for someone applying Ortho never being happy as a FM doc, I actually know two people that applied Ortho, had great scores, but just didn't apply broadly and maybe didn't interview well. They ended up scrambling into Surg pre-lim, then did FM. They actually really like where they're at. One is going for Sports Med, the other for UC/EM stuff. They actually like that they'll only be in residency for 3-3.5 yrs (some of their pre-lim rotations were credited). They like that their hrs are averaging in the mid-60s/wk rather than ~100, because they can actually spend time with and enjoy their kids.

Sure there are some people that are always going to regret where they are, and there are some people that really want something, and they're crushed when the don't accomplish it. The truth is though that most people can be happy being in a few different specialties.

Anyway, this is just a tangent. OP, MD will give you more residency options. If you have a choice, go MD. If you have to wait 2+ yrs to try to get MD but can start DO now, DO is probably the better option. If you could potentially improve your app enough for MD schools in 1 yr, then its probably worth trying one more cycle. This also depends on a lot of things like your age, your opportunities before med school, etc.

 

[nimbus]

I completely agree with this. Apply with your best application. If you only get into DO schools, take it. I would not even wait another cycle. You are meant to be where you are meant to be and you will make the best of your situation wherever you are. You can wait 3 cycles to get into Yale Med, then you will have to compete with the cohorts in Yale Med. The fact it takes you 3 cycles to get in, means you are likely end up middle of the pack or lower. The GATTACA thing don't work in med school. Everyone studies their butts off. If you ended up bottom 25% at Yale Med, you are probably going primary care anyways.

If you get into the DO school in the first try, you will have a better chance to excel and ironically, you may even have better opportunities. Life is better as a DO ophthalmologist than MD family practice. Just because MD Opportunities>>DO Opportunities doesn't mean everyone will utilize it. Life has a funny way of guiding all of us to where we need to be. Just be where you are, do your best, and enjoy the ride.

A career in your dream specialty will still just become a job. It will just be the job you don't hate as much.

I disagree.

You can absolutely match in a competitive specialty from the bottom 25% of Yale med. Same goes for Stanford, Columbia, etc. Just look at their match lists. Their classes are filled with the top 10% of med school applicants. And no one at these schools needed 3 cycles to get into med school.