DO or SGU? Need to Decide Quick!

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lol. I get your point about being misinformed about the AOA intership. I did know that it was only one year long, and I did know that the requirement could be petitioned in those five states, but from looking around SDN and what not, some of the other posters seemed to suggest that you would need a good reason to petition it (ie. there wasn't a DO residency in your specialty in the area that you went to do your training, or something similar to this).

As far as the CME's go:

From the Medical Board of California:

"I have not been licensed for four calendar years and my license is due for renewal. How many hours will I need to submit to renew my license?

An average of 25 Category 1 Continuing Medical Education (CME) hours must be completed per calendar year for each full calendar year licensed. A physician who has not been licensed for four calendar years, will be required to report progress towards compliance with the CME requirements by signing the certification statement on the renewal form."

"Does the American Medical Association's Physician Recognition Award (PRA) meet the CME requirement?

To obtain a PRA, a physician must participate in 150 hours of CMEs of which 60 hours are Category 1 approved. If more than 60 hours of Category 1 CME are obtained to receive a PRA, a copy of the PRA application should be submitted to receive the appropriate amount of credit."

http://www.medbd.ca.gov/CME_FAQ.htm

From the Osteopathic Medical Board of California:

"Required Continuing Medical Education (CME)
(a) Each Physician shall submit satisfactory proof of CME to the Board upon the conclusion of the three-year reporting period.
(b) A physician shall complete 150 credit hours within a three-year period.
(c) Minimum of sixty hours of the 150 hours must be in AOA Category 1-A or 1-B."

"Sanctions for Noncompliance
(a) Any physician who has not completed 150 hours of approved CME or the prorated share during the three-year period shall be ineligible for renewal of his or her license to practice medicine until such time as the deficient hours of CME are documented to the Board.
(b) It shall constitute unprofessional conduct for any physician to misrepresent his or her compliance with the provisions of this article or who fails to comply with the provisions of this article.
(c) Each physician shall retain records for a minimum of four years of all CME programs attended which indicate the title of the course or program attended, dates of attendance, the length of the course or program, the sponsoring organization and the accrediting organization, if any."

http://www.dca.ca.gov/osteopathic/cme.htm

Seems pretty unfair to me.
 
DazedNConfused9 said:
To all of those who responded to my original post, I truly appreciated it; most, if not all, of the comments were very well-received and offered much insight onto this situation....I may be completely wrong, but my understanding is that if I do not do an AOA residency, I will not be able to practice in five states within the United States; this will also preclude me from obtaining a faculty position at an osteopathic school or in an osteopathic organization such as the AOA itself. However, in the event that I do go through with an AOA residency, I will be precluded from working as a program director or an administrator in a hospital that offers ACGME-accredited residencies only; I also will likely not be able to find employment in one of these major institutions, considering that nearly all of the other physicians working at these select hospitals will have done their residency training in an ACGME-approved site, most of which the employers in question will have some experience with (as opposed to hiring a D.O. from a no-name, unheard of AOA residency, for which they cannot assess the quality of). As a result, I will be forced to practice in an osteopathic hospital instead, most of which are small community hospitals that do not nearly have as much volume or even bed space. Lastly, if I go through an AOA residency, I probably will also not be able to serve on the faculty of an undergraduate campus or in an allopathic school, although for the latter I actually don't know of any DO's that are doing this anyway.

I think my point is that, this whole idea of osteopathic graduates having more opportunities available to them is pretty much taken out of context. It looks as though whether I do an ACGME-accredited residency or not, I will be excluded from some position, somewhere that I might want to eventually obtain. Also, this requirement about doing an AOA internship for those select five states is an outdated policy that should be abolished; it is a form of discrimination that is self-imposed by the AOA, and as a result, it really does not necessarily make true the statement that DO's can be licensed in all 50 states (it can be done, but there are limitations to whatever option is chosen, as I described above).

Something interesting I also found out, and this is not helping me in my decision either. For my state medical board, M.D.'s are required to do only 25 hours of CME credit/year, whereas my state's osteopathic medical board requires D.O.'s to do 50 hours of CME credit/year. If an M.D. does 150 hours of CME credit in my state (in 3 yrs), they receive some type of physician recognition award - I believe this is non-existent for D.O.'s, and even in the case that it was, the D.O. would have to do more than 150 hours of CME credit within those three years. That is bogus in my opinion - again, all self-imposed by the AOA or whatever governing body of D.O.'s.

I really believe the AOA and all of these state osteopathic medical boards need to get their act together; ie. replace the older generation of DO's with the new, progressive ones that will make the needed changes that the students are demanding, such as the combined match and more dual accredited residencies; and lets not forget, more quality GME residency training as well.

I may be completely off on some of those exclusions I listed, so if any D.O. here would please like to correct me, I would really appreciate it. I could use all the information I can get if I want to make a proper decision (with no regrets, of course).

About OMM, I believe it works, but I am not exactly very gung-ho about it; ie. I wouldn't mind learning it, but if I didn't have to, that would work just as well. The minor thing I am concerned about there is undressing in front of my entire class, but I suppose I could easily get over that, considering everyone else will be required to do the same thing too.

To one of the posters that said I failed to mention anything about the pro's of SGU, I'm sorry I forgot. SGU does indeed have many pro's, including a low attrition rate (less than 10%), high graduation rate (over 84%), good transfer rate (3-7%), and a high USMLE first-time pass rate (90%). SGU also has a beautiful campus from some of the pictures I have seen, and they do indeed have a good residency matching list. The other thing is that although the class-sizes tend to be larger, the ages of the students are very well-representative of mine (avg. age is 22), and the students are typically straight out of college; considering that these two factors are similar to my own position, I may find that I would have an easier time fitting in. The male:female ratio of SGU is also nearly 1:1, something that I would not have been able to find at either of the osteopathic schools I would have attended. The caveat to the SGU match list is that most of the residencies are on the east coast, and I am hoping to do my residency on the west coast. For example, if I wanted to do my residency training in CA, I would probably not be able to get it, since the California letter is required of IMG's - it takes 60 days to process after the date of graduation, and certain institutions (mostly UC-associated) will not interview IMG's without the letter. If I attempted to get into one of these spots, I would have to do a preliminary year elsewhere, which essentially might be like wasting a year after graduation.

However, I may have to do the same thing as a DO. I say this because only 70% of DO's matched into ACGME residencies, whereas 99% of SGU grads matched. If I do not match into an ACGME residency the first time around, I may have to do an AOA internship for the first year and then transfer into an ACGME residency. Depending on whether the residency will take my AOA internship year or not, I may or may not waste a year.

The other thing about the SGU match list is that it does not differentiate between whether not the graduates got preliminary general surgery or categorical spots; I have a feeling it is probably preliminary, but I could be wrong. I don't think I would want to do a GS residency anyway, but if I ever decided to, as a D.O. going into a GS ACGME-accredited residency, this would seem quite hard. If what I said is true about the SGU match list, then it would also be hard that way as well.

Things are getting complicated. That's all I can say....Now it's time to contemplate just a little bit more.

Well, you DO have to give DazedNConfuzed some credit. The most difficult thing to understand about DO school is the political reality of post graduate training. Indeed, NSUCOM offers students little information on the finer points of the NMRP vs. AOA match and how to secure the best internships and residencies. Talk to most third year students about AOA internship requirements and resolution 42, and you'll get a variety of equally confusing replies. If you think concerns over internship are exhaggerated, consider that osteopathic colleges are very serious about the AOA boards. There was an allopathic FP program director who opened his residency up to DOs via the avenue of dual accreditation. The AOA, though pleased, made this board certified (ABFP) physician dole out several thousand dollars to take the AOA FP boards prior to official approval!!!! Could you imagine? An osteopathic family practitioner of many years who was pushed by the AOA into sitting for the american osteopathic board of family practice exam? Sheesh!! The merits of such a policy are beyond the scope of my reply.. However, there are some political realities to keep in mind when graduating from one of this nation's fine osteopathic collegies. Among them:
1. The possibility of dual board certification. AOA schools do like it when you are certified via osteopathic specialty boards. This is especially important if you want any leadership position (dean, department chair, etc) within the osteopathic college.
2. The concept of dual state medical boards. Five states DO require an intersnhip or equivalent prior to licensure. Though avenues exist for approval of allopathic training, it is still possible to be locked out of Fl, MI, Penn, OK, and the other two if your internship is not AOA approved.
3. The currently dual match system. Though this will change in the near future, osteopathic applicants are dropped from the NMRP once they match to an AOA slot. Statistically, you are more likely to match in an AOA slot as compared to an allopathic slot.
4. CME requirements differ for MDs and DOs in those states with separate medical boards
5. AOA DOES offer a physician's recognition award- I think you are correct in assuming that it is given for 150 contact hours
6. OMM class is an undress fest. Dont forget that when having your pelvic diaphragm domed. 🙂

These are just a few examples. Rather than the "nonsensical" question of prestige, inquiries like these lie at the center of the osteopathic vs allopathic debate. As US medical schools try to distinguish themselves among the world's finest, I would hope that the AOA continues to work with the AMA to ensure the excellence and quality of stateside medical education. Good luck.

Fed ex that deposit...

-PuSh
 
DazedNConfused9 said:
Seems pretty unfair to me.


So what your saying is...."to make sure that you continue your education and stay atop of current literature so your patients receive the best care" is unfair?
Do you know how easy it is to accumulate CMEs? And do you know where conferences are routinely held? He!! you can fill out a form at the end of a journal article for a couple....do that ever month for a few different journals and you make up the difference....this is NOT a big deal, and it does make you stay current....

Again, what difference does the AOA internship mean to you? As you stated, you want to be on the West coast....NONE of the 5 states that require it are West of the River....So why do you care??!?!?!?!?!?!?!?!?!?!?!
 
Thanks pushinepi2 and stomper627 for the comments.

I was lucky enough to get an extension on the deadline for my deposit, so I have about 2 more weeks before I have to mail it.

I know that it's possible to get CME credits pretty easily, whether it be online, from journals, or at conferences/conventions; I also know it doesn't have to be a hassle, especially if you end up traveling somewhere.

The point about the CME credit that I brought up was just to illustrate that even though osteopathic and allopathic physicians are considered legally equivalent, there are some major discrepencies between the two, and most of them are self-imposed. 50 hrs of CME credit annually might not seem like a big deal, but considering that it has to be done every year that a doctor is licensed, then it does amount to quite a bit. Either way, whichever way you look at it, in this particular state (and maybe elsewhere), domestic allopathic and foreign grads alike only have to do half the amount of CME credits that osteopathic physicians need to do. It seems strange to me, that's all.

About the AOA internship, again, it probably will have no effect on where I plan to practice, but it is another hassle still in the system.

Aside from the CME's and the internship, two things I am not really worried about, the most important thing to me at this point is to know that I will have enough available employment opportunities as an osteopathic physician in the state of CA, whether or not I comple an AOA or ACGME accredited residency. By that, I mean, will I be free to do whatever I want once I get licensed? Or will I be excluded from certain positions, like I described in my previous post? Those are the most fundamental of the questions that I have.
 
Without having read through all the posts, I just wanted to say that at my core hospital site I have rotated with students from SGU and AUC all year long. Some of the common themes that I have heard have been that they wished they would have stayed in the states and gone the osteopathic route simply because of the cost. Also, there is no guarantee that the SGU or AUC student gets to come back to the US for core clerkships. Many of them get shipped off to England because there are not enough sites to do their 3rd year in the US. I have lunch with these guys daily, and everyday I hear about how roughly 100 students every year don't make it back to the US for 3rd year clerkships. And some of the ones that do come to the US have to travel all over the US to do their 3rd year, because they don't have a core hospital site. Granted there are some DO schools with this same situation, but at least you know as a 2nd year that you are not going to be shipped overseas for your 3rd/4th years! That would suck tremendously. Not to mention cost a fortune when you are already heavily in debt.
 
50 hrs of CME credit annually might not seem like a big deal, but considering that it has to be done every year that a doctor is licensed, then it does amount to quite a bit.

You will need 50 CME's every year at many hospitals anyway to maintain your staff priviledges. Also recently, once you are board certified, you'll have to renew your boards every 10 years. And part of that is submitting CME's every year. If your hospital offers CME for grand rounds and you attend one conference or CME activity per year, you'll have more CMEs than you need.
 
As Ive said, CMEs arent that big of deal, and can be quite a vacation for you and your spouse or kids. My dad used to take 1 of us (4 kids) or my mom on the trip...we would rotate who got to go, spending quality time with dad. He would spend the mornings in the lectures (while we slept in) then in the afternoon and evening it would be quality time.
Dude, seriously its not an issue....and because you do have hangups with the AOA, the more PROACTIVE you are in the association, the more you get to try to change and all of it counts for your CMEs....see very simple, problem solved...
Again, however, CMEs are different for every state, so are you going to complain about how unfair it is to practice in WV while in MT you only have to do this? No, that is immature and not a big deal.
AGAIN, CMEs are there so that you are FORCED to stay on top of current literature....why does this bother you so much?!?! I seriously dont get it?
Fair? I hope your old enough to realize that life isnt.
stomper
 
It doesn't bother me that I am going to have to stay on top of literature; I know that's what the purpose of CME's are. Also, as I said before, I only brought up the CME differences to illustrate a point - I already know it is not that big of a deal.

You are right about being proactive. I know that someone needs to lobby for changes, but I also know that it will not be done overnight; by being proactive, I know that I may be able to make a difference for the future generation of osteopathic physicians, but not for my own. Generally, it doesn't work that way - it takes a large amount of time and (constant) effort.

After being in several leadership roles in college and influencing the various departments to change their policies or institute new ones, I would rather not continue this in medical school. I already know that a lot of work is awaiting me in fall, and I would rather not exert any more pressure on myself. I may be proactive in smaller measures, but I doubt I'd volunteer myself for a role in the student government or any other position dealing with student representation on the AOA.

Maybe this seems selfish, maybe it doesn't. I don't think I'm asking for too much either by wanting to know about the real issues in postgraduate training for osteopathic physicians. It's better to know now than later.
 
Skip Intro said:
But, my personal experience with the many osteopathic students I've rotated with is that there is little interest among the majority of them, as well as little real opportunity to use this modality other than in a clinic or personal office. Even then most patients you'll see really aren't all that interested... which holds double-true if you end-up in an ACGME residency or a specialty where it isn't really that practical (e.g., how many anesthesiologists are really going to use OMM?) or encouraged.

Just some other things to consider. 🙂

-Skip

I actually have a few classmates who are going into anesthia and hope to do a pain management fellowship and ultimately have a pain clinic where they will incorporate OMT. So you can really do OMT in any specialty, although not always practical.
 
Pikevillemedstudent said:
I actually have a few classmates who are going into anesthia and hope to do a pain management fellowship and ultimately have a pain clinic where they will incorporate OMT. So you can really do OMT in any specialty, although not always practical.

True, but practical often equates to payment. If I am not mistaken, most anesthesiologists who pursue pain managment do so due to the high rate of PROCEDURAL (epidural, intrathecal, intra-articular injection, etc..) reimbursement.Besides, many patients referred to pain managment clinics have failed manual modalities. Physical therapists are expert manipulative medicine providers and share more than a few techniques in common with their osteopathic colleagues. How many patients with (1) refractory chronic back pain (2) referred to pain specialists (3) on hard hitting daily narcs (4) who have completed five + courses of agressive PT do you think would be amenable to an OMM trial?

I don't want to digress any further from the initial inquiry; there's already much to think about on this thread!

🙂

Push
 
DazedNConfused9 said:
I doubt I'd volunteer myself for a role in the student government or any other position dealing with student representation on the AOA. Maybe this seems selfish, maybe it doesn't.

Please go to SGU.

We want colleagues who are proud to be DOs; those who will work to improve the field.
 
villileblanc said:
Please go to SGU.

We want colleagues who are proud to be DOs; those who will work to improve the field.

Has absolutely nothing to do with which school. As I said already, I am going to want to maintain some balance in my life when I start medical school, if that's even possible. Volunteering for yet again, another role, in student government, is only exerting more unnecessary pressure on myself. Most of the lobbying for changes doesn't come from students, honestly - the changes are made usually due to the demands of physicians in practice. Students as a collective force are not going to go on a "strike" like some type of unionized profession would; students are here to learn, and their voices are often not taken for what their worth.

Otherwise, don't you think we would have a combined match by now?

I'll be proud to be any type of physician, DO or MD. That, my friend, has nothing to do with the degree by any means.

One other thing - you need to do an osteopathic residency in order to qualify for a role in the AOA. I mentioned before, I will (likely) not do this. If you disagree with this, you should probably also talk to the other 60% of DO's that are in ACGME residencies, or better yet, the 90% of students in osteopathic medical schools that are not on the student government association.
 
DazedNConfused9 said:
Has absolutely nothing to do with which school. As I said already, I am going to want to maintain some balance in my life when I start medical school, if that's even possible. Volunteering for yet again, another role, in student government, is only exerting more unnecessary pressure on myself. Most of the lobbying for changes doesn't come from students, honestly - the changes are made usually due to the demands of physicians in practice. Students as a collective force are not going to go on a "strike" like some type of unionized profession would; students are here to learn, and their voices are often not taken for what their worth.

Otherwise, don't you think we would have a combined match by now?

I'll be proud to be any type of physician, DO or MD. That, my friend, has nothing to do with the degree by any means.

One other thing - you need to do an osteopathic residency in order to qualify for a role in the AOA. I mentioned before, I will (likely) not do this. If you disagree with this, you should probably also talk to the other 60% of DO's that are in ACGME residencies, or better yet, the 90% of students in osteopathic medical schools that are not on the student government association.

Well you are kinda contradicting yourself. You don't want to participate in Student Gov. but you want to be involved with the AOA. That doesn't make sense. Most of the future AOA guys are highly active in SGA or SOMA. You will find a hard time getting into to that good ole boys club without early participation and making contacts to progress up the ladder. I don't think SGU has produced alot of powerful AMA guys but I could be wrong. Another thing, if want to be involved, you can join the AMA as a DO and be very active.

You do not know what specialty you want yet or whether you will go to an AOA or ACGME residency. You think you know but you really don't until 3rd/4th year. Take it from someone who was a die hard FP/OMT guy starting out and now I am going into a surgical specialty.

You need to choose the school that will better prepare you to be a physician period. All this other stuff is truly secondary and really has nothing to do with patient care. Once you answer that question, the choice is simple.

BTW, AOA residency quality is not nearly as bad as some say they are. Most people complaining do not have any experience with them.
 
I quickly read through this thread b/c I am making a similar decision about going D.O. vs SGU and Ross. Personally, I like the idea of the extra training the DO's get so that is not an issue. And I'm not worried about the stigmas associated with each school. What I'm trying to figure out is which path will leave the most doors open for future residencies. I haven't been able to find much information about which path will close any doors completely, if either one does... or if either path will help me pursue certain residency/fellowship career paths more than the other. Thanks for any information you can send my way
 
gflanag said:
I quickly read through this thread b/c I am making a similar decision about going D.O. vs SGU and Ross. Personally, I like the idea of the extra training the DO's get so that is not an issue. And I'm not worried about the stigmas associated with each school. What I'm trying to figure out is which path will leave the most doors open for future residencies. I haven't been able to find much information about which path will close any doors completely, if either one does... or if either path will help me pursue certain residency/fellowship career paths more than the other. Thanks for any information you can send my way

It is not guaranteed that you can be licensed in any state as a foreign medical graduate.

D.O.'s are guaranteed licensure in every state, as long as they are certified within the AOA.

D.O.'s have an easy in with any AOA residency programs, and thus have many more programs to apply to, if the ACGME programs are included.

Foreign medical graduates can only apply to ACGME programs, and must compete with MD's and DO's, as well as put up with discrimination.

Obviously there is no DO discrimination among AOA residencies.
 
The DO route will give you better options with residency placement, this has been said time and time again. DOs are eligible for the osteo residencies plus all the MD residencies. Granted it is more difficult for DOs at the more competitive MD programs. However, in nearly all areas of the US most program directors will tell you that they are preferential to US MDs, then DOs, then FMGs.


To inform yourself, do a search for match lists and compare the DO school you're considering versus the carib one. I was looking at AZCOM's match list the other day as it is one of my top choices among both MD and DO schools and it's sweet. 70% of people in MD residencies, with people in anesthesia, rads, ER, surgery, etc. Someone did IM at Hopkins. People in derm, ortho and neuro surg in DO residencies. AZCOM would far and away let me achieve what I want (med/peds or FP in the phoenix area) as people matched into ALL the phoenix programs in the primary care fields including at Mayo. So that's me. I would go to AZCOM over a LOT of MD schools if I get in...Just look at some match lists and go from there as what ultimately matters is residency placement.

This has been discussed at length in the osteo and caribean forums so if you do a search you'll find more debate on the topic. If you don't mind living in 3rd world conditions for 2 solid years, and traveling quite a bit at a large expense in your clinical years, AND you just REALLY want the MD, maybe go to the carib. But as far as residency placement goes it remains that DOs have an edge over FMGs.
 
Wow you guys do go on and on about the negatives.

I personally would love to start in a profession that is considered an underdog. Work with the association to make it better.. and continue to improve on patient care and professional relationship with AMA. That would include setting a good example by students and by graduates of the program.

Maybe this thread should be closed. Cause it is becoming tireding.

PS. CME credits can be picked up from reading articles, attending seminars, lectures, conferences. I am not a physician and I assure you, if I was counting I could of had 50 points thus far this year.
 
whoooaaa.....are you saying that of all DO students applying for residencies -- 30% did NOT match? that seems a bit unreal? Is this correct? so 1/4 of my class might not match....makes no sense.
 
I cant find if that's for allo residencies or not. That would make a difference with that DO number.
 
~70% has always been the number I've seen for DO's matching successfully in the ACGME match.

So I imagine overall it's higher if you consider the AOA match as well.
 
I would only attend a Carribbean school if all these criteria presented itself

(1) I want to be an M.D. and the initials do matter to me personally although I'm aware my practice won't suffer when I graduate. This is is just personal goal of mine and I feel more comfortable personally with the M.D. initials

(2) I don't have a realistic chance of getting into an M.D. school if I reapply next year or the year after because my GPA and MCAT is really low.

(3) I have no desire to specialize and primary care is okay by me

I would attend an Osteopathic school if all these criteria are met

(1) I don't mind having the DO label

(2) I want to keep my options open to specializing

(3) I want to study at home and not worry about dealing with the paperwork and bureacracy of being an FMG/IMG the rest of my life although I'm aware it's not that bad but just something I would rather avoid if possible.

I would do a postbac and retake the MCAT and apply several times to a U.S. M.D. school if

(1) I really want to do some specialized surgical field like ENT, Neurosurgery, Plastics, Cardiothoracic etc. Osteopathic programs don't have as many surgery related residencies established both in terms of volume and quality. If I was hell bent on being a surgeon, I would reapply to a U.S. M.D. school until I got in.

Bottom Line

Remember, there are exceptions to all the rules above. Some SGU students specialize and get competitive fields and some DO's match in competitive surgical fields. I don't like to gamble. I like to know what I'm getting myself into. If I'm fortunate and I beat the odds, great but I would never go to SGU with the intent that I would finish in the top 10 so that I would be one of the exceptional students and match surgery or radiology out of SGU. Likewise, if i wanted to be a Neurosurgeon, I wouldn't go to a DO school with the intent I would be in the top 5% of my class so that I could apply to one of the 4 Neurosurgery programs available or however few exist. That type of thinking is just not practical. Be realistic and know what you want deep down and not what others want for you.
 
JKDMed said:
http://www.scutwork.com/other/match2004/2004advdata.pdf

Scroll down. You will see something interesting.


Graduates........%unmatched
U.S.................6.5
D.O...............31.0
US IMG..........54.5

Unfortunately they don't separate the "Big 3" with the crappy schools.

That's because DO's applying for competitive fields like orthopedic surgery and radiology apply to both ACGME and AOA residencies and often match in AOA residencies but fail to match in the ACGME one. But your IMG doesn't have the AOA residencies to turn to if they don't match.

If you want to match in a field like internal medicine in an allopathic program, it's guaranteed because many programs go unfilled and thus they are forced to take IMG's. If they could get a DO, most programs would take the DO over the IMG in this case.

Also, if you want do your residency on the West Coast, you shouldn't even consider SGU. The West Coast is particularly anti-IMG/FMG whereas there are several DO schools on the west coast and their grads match locally such as COMP and TOURO students. Many AZCOM students match on the west coast as well particularly in Phoenix. You won't have any trouble rotating in California during your rotations. I did several of my rotations in California.
 
You say IM is pretty much open....how about at more competitive hospitals in NY city for instance -- if i am interested in specializing in say GI or cardio. What would it take to land a good spot at a university hospital in the city area.
 
DotheDo said:
You say IM is pretty much open....how about at more competitive hospitals in NY city for instance -- if i am interested in specializing in say GI or cardio. What would it take to land a good spot at a university hospital in the city area.

If you want to match in a prestigious academic program in New York City, That's much harder. My guess is top 25% and 230 Step I. I was just referring to alloathic IM in general. Obviously academic programs are more challenging than community based programs but many communcity allopathic IM programs have fellowships and they take their own grads. So you don't have to attend an academic program if you want GI or Cards. But on another note, someone in my class matched at Hopkins this year. The only fields that are not DO friendly these days are surgical fields. IM is DO friendly. If you have the grades, you can pretty much match anywhere in IM as a DO.
 
in terms of specializing of completely IM: when applying for fellowships, do they primarliy look at what you did in residency rather than step I and such. How does it work?
 
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