DO questions

[drlo59]

So what exactly is the difference between MD and DO schools?

I honestly have to say I have never seen even one DO at the hospital I volunteered at. Does anyone know how new the degree is?

Any answers are greatly appreciated!
Thanks.

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[J.Duke]

The real difference between DO and MD...
That is a good question.
You could get answers that range from:
There really is no difference, only one or two classes in medical school.
To the answer that the American Osteopathic Association would give, that goes something like this. Osteopathic Physicians are taught a philosophy that treats the patient in a more holistic approach.

When you really get down to the nitty gritty of it, many health care workers don't even know a doctor they are working with is a DO.
This includes physicians.

There are some MD's out there that will tell you that DO's are inferior physicians because they went to a school that had a lower average MCAT, and lower average GPA in the matriculating class.
This is an answer designed to make the person telling you this feel better about themselves by denigrating someone else.
In all truth DO's can take the USMLE as well as the COMLEX (boards), and the pass rates are frequently comparable to those of MD programs.

The DO degree has been around since 1892 or 1894. My school UHS-COM in KC,MO (sorry I have to write in acronyms) was founded in 1916.

 

[Neurogirl]

I'm not trying to start a flame board, but I'd like to add some perspective. Any MD who believes DOs are inferior because they have relatively lower MCATs and GPAs should remember that everything is relative. As competition for medical school increases, so do numbers. DO students today generally have higher numbers than the MDs of 10 years ago. Does anyone think THEY are inferior?!?! Of course not! As an aside, I'd like to reiterate that the only time this topic comes up is on internet BBs. I'm a 4th yr student and have had a number of MD attendings (at both osteopathic and allopathic hospitals) and honestly, it's never been an issue.

 

[AZMom]

The obvious difference is osteopathic manipulation. DO's learn it in school, MD's don't.

Secondly, as far as one degree over another for actually practicing medicine, it generally doesn't matter. In research, however, an MD is generally preferred.

As an aside note, I do know of one physician (MD) who does his best to denegrate the DO profession and have encountered at least half a dozen others who have the superiority complex when it comes to DO's.

 

[UHS2002]

Who cares?!

 

[Dr JPH]

I'm with UHS2002.

------------------
Joshua Paul Hazelton, CNA, EMT-B
[email protected]
University of the Sciences in Philadelphia (2002)
"D.O. Wannabe"

 

[mj]

10 grand a year depending on the school

 

[bereave]

mj,

"10 grand a year depending on the school."

What IS the average salary for an osteopathic physician?

 

[Hawkeye01]

I think that mj, was referring to the cost of education. Osteopathic schools are private and tend to have a high tuition. Overall, I believe that the salary for a D.O. is the same as an M.D. M.D.s specialize more than DO's so the average salary for a group of MDs maybe higher than the average salary for a group of DO's, this is mainly due to the specialties of many MD's. Joe Doe, M.D. $100,000

 

[Hawkeye01]

I think that mj, was referring to the cost of education. Osteopathic schools are private and tend to have a high tuition. Overall, I believe that the salary for a D.O. is the same as an M.D. M.D.s specialize more than DO's so the average salary for a group of MDs maybe higher than the average salary for a group of DO's, this is mainly due to the specialties of many MD's.

 

[EZEK]

Medical School are not necessarily more expensive at DO schools. The major difference is between state schools and provate schools. For example, PCOM's tuition is approximately 23,500. University of PENN, MCP-Hanemann, Temple are all around $30,000. These are all in the same city. As you can see the MDs are more expensive than the DO school at least in one city.

 

[medibyte]

I have great respect for all people who help humanity, whether DO's or MD's. However, I ask why would one go to DO school instead of MD? If they are the same profession, why should there by a discriminating line?

My father is a physician with Kaiser, where not even one of his Kaiser collegues are DO's.

 

[UHS2002]

Originally posted by medibyte:
I have great respect for all people who help humanity, whether DO's or MD's...If they are the same profession, why should there by a discriminating line?

My father is a physician with Kaiser, where not even one of his Kaiser collegues are DO's.

I have great respect for all human beings, whether Caucasian or African American.If African Americans and whites are both human beings, why should there be a discriminating line?
My cousin is a Caucasian medical student at school X (an allopathic school which shall remain unnamed), where not even one of his classmates is African American.

Do you see the fallacy of your argument?!

Let's see: just because one group may be the recipient of discrimination by some ignorant few, that doesn't make the ignorant few superior and the members of the discriminated group inferior.

Just because none of the physicians at the specific Kaiser location your father works at are DO's that doesn't make DO's lesser physicians. I never met a DO who was not practicing medicine (unless he was already retired). Obviously, you will not find DO's at every medical facility in this country, given the fact that there are probably hundreds of MDs to every DO. For starters, do the math. On a minor point, if there weren't any DO's at Mayo, Harvard, Hopkins and other renowed medical institutions, then I would be somewhat concerned. That fact that there aren't any DO's at one particular HMO facility really is not enough to make me loose my sleep...

 

[dolly]

Hi medibyte,
I have always gone to DOs since I was a kid. I even have a DO who is an otolaryngologist. Ok, this is why I stay with them (or why I now go to them). This past year I ended up clenching my teeth and having a sore right jaw, the tense muscles pulled the jaw out of alignment...major ouch. I also had back pain from my backpack (love those orgo books). Then I went on a hike and awoke the next morning to a swollen leg that was extremely painful to walk on (I was afraid I had a bloodclot). In one (count them one, uno, eins) 20 minute session, my DO fixed my jaw, my back and my leg (I had popped my ankle out of place on the hike). I ran down the stairs of his office immediately following the adjustment without pain and without any perscription drugs. That is why I go to a DO. MDs are not trained in skeletal manipulation. And once in a while, that is all it takes.

 

[jrunyan]

Originally posted by J.Duke:
In all truth DO's can take the USMLE as well as the COMLEX (boards), and the pass rates are frequently comparable to those of MD programs.

[/B]

This may be a rather dumb (uneducated) question, but, if you take the USMLE and pass, are you an MD as well as a DO? Or are the boards for allopathic physicians a different exam (that's the uneducated question)?

 

[turtleboard]

MDs must take and pass all three parts of the United States Medical Licensing Examination (USMLE, which our Registrar pronounces as "You Smile").

DOs must take and pass all three parts of a similar exam which they call the Comprehensive Osteopathic Medical Licensing Examination (COMLEX). DOs also have the option of taking the USMLE, BUT TAKING THIS EXAM ALONE WOULD NOT QUALIFY THE DO FOR LICENSURE ANYWHERE IN THE UNITED STATES. DOs have the option of taking the USMLE because there are some residency programs which prefer to see USMLE scores, but only a fraction of DOs actually take the exam despite this.

A DO who takes the USMLE and passes it is STILL a DO. Taking the USMLE does not make a DO into an MD. The letters physicians use at the end of their names are granted by their medical schools and not by some governing board like the National Board of Medical Examiners (NBME) or the AMA.


Tim of New York City.

 

[dostudent]

Medibyte,
At UHS we have a new D.O. professor that just came from Kaiser about 3 months ago, you may want to recheck your information.

FYI - the Chief of Pediatric Neurosurgey at the Mao is a D.O.

My take is that Osteopaths can do anything an M.D. can plus manipulation. Also, an osteopathic student can apply to an M.D. residency as well as a D.O. residency (sounds like more options to me).

 

[turtleboard]

It may sound like more options, but have you seen the program offerings at most osteopathic institutions? They're generally of lower academic quality because of a lower amount of resources.


Tim of New York City.

 

[Dr. P]

yes, but when you consider highly competitve fields such as Derm or ENT, then DOs have more options. Besides, I am not sure how "inferior" osteopathic residencies are as a whole. I think you have to consider it on a case by case basis.

PS; just to add to the kudos, the Associate Chair of Radiology at Harvard is an osteopathic physician.

Why would someone get the DO instead of the MD? Generally osteopathic medical students go DO for one of the following reasons:

They did not gain acceptance into allopathic medical school in the UNited States

They have a friend, realtive, or know a physician who is a DO and as such are well-versed with the philosophy and prefer it.

THey have researched the similarities/differences on their own and prefer the osteopathic philosophy and OMM.

That is not to say that students who initially would have gone MD later on regret DO. Most, I think are satisfied with their education and proud of the degree once they finish medical school. Once you enter hte real world, you find that there is as much functional difference as you want there to be, if you want any at all. When you specialize, you become a "pediatrician, a surgeon, an internist". Your academic medical degree loses significance.

Check with your father's firm, because I have seen that some companies/hospitals just list all physicians as MDs when they may very weel have DOs on staff. I know of 2 NY area hospitals that did that, not intentionally, just by default, until the point was brought up.

 

[Pilot]

Originally posted by turtleboard:
....DOs also have the option of taking the USMLE, BUT TAKING THIS EXAM ALONE WOULD NOT QUALIFY THE DO FOR LICENSURE ANYWHERE IN THE UNITED STATES.

Actually, I believe the Louisiana requires all D.O.'s to take the USMLE as the licensing exam, and does not recognize the COMLEX yet.

 

[turtleboard]

Good point. Actually, does anyone know for sure? That is does a DO in Louisianna have to take the COMLEX even though that state doesn't recognize it as a licensing exam for DOs? I'd assume that a DO in the State of LA would still have to take COMLEX because if he/she were to EVER leave Louisianna (and who never does, really?

), he'd/she'd have a problem with practicing elsewhere. It would only be in the best interest of the DO to take the COMLEX.


Tim of New York City.

 

[Peregrin]

Just my 2 cents.

Michigan has the good pleasure of having a very competitve *public* osteopathic school at MSUCOM. As a result, there are a rather high number of DO's in the MI area and everyone I have talked to understands that there are MD's and DO's (though many do not know the differences...) But suffice to say that in this state, DO's are quite common and are well accepted by many.

I, myself, was drawn to the MSU philosophy (both MD and DO) and found myself facing the difficult decision of which to attend.

I have personally oberserved that there is a certain "old guard" of MD's who seem to take it upon themselves to discredit the hard work and educational attainment of their DO bretheren. As a result, I have the impression that DO's potientially face more adversity than their MD counterparts. For instance, there are a number of MD's who will not refer to DO's at all as if they are not recognizing their presence in the community and are instead "second class" physicians. Now granted, this is anectdotal at best, but it figured into my decision process. Is this something that is common elsewhere, or is my experience unique? I am in a temporary faculty position at a local university (I don't start until Aug) and receive many questions along these lines. I personally defend DO's (as I was very seriously considering becoming one) although a little more ammunition would be helpful.

I ended up choosing to go the MD route at MSUCHM, although I plan to audit OMM classes because I think that anything of theraputic value is worth investigating.

I appreciate any input.

 

[drusso]

Almost all schools require that DO's pass steps I and II of the COMLEX before graduating. Louisiana does not (yet) recognize the COMLEX as a primary route for medical licensure. Although this will change in the near future. The pressure is so great for Louisana to catch-up to the rest of the nation in terms of medical licensure policy that they will change it. However, Louisana was the last state to raise its drinking age to 21 and qualify for federal highway funds so suffice it to say, things move slowly in the swamp. In the mean time, they will only recognize DO's who have taken and passed all three steps of the USMLE (The third steps of the USMLE and COMLEX are taken near the end of your first year of residency). Lousiana could care less about the COMLEX; they just want USMLE scores. There are several DO's in Louisana (I have classmates doing residencies in ER, Peds, Family, and PM&R at Tulane). As a DO, if you want to go to Lousiana (first ask yourself why?) you have to take the USMLE; if you want to practice in certain other states you have to take the COMLEX. Solution: Take both. It's no different to study for both exams at once and in some ways the USMLE was an easier test (more clearly written, less "mind-reading" fewer third and fourth order questions in my opinion...) It can be expensive though.

Also, I think that DO's have a certain advantage with having taken the USMLE (at least the first two steps) when applying to a select set of competitve ACGME residencies. Nevertheless, I've heard from other classmates that the issue has come up infrequently, but when it does, it is nice to have your ducks in a line. For the most part though, residency programs that are familiar with DO's have no problems accepting the COMLEX. The savvy student should contact potential programs well in advance and ask the residency director if he or she prefers DO applicants to have taken the USMLE in addition to the COMLEX or just the COMLEX alone. Most program directors recognize the added cost, burden, and inconvenience of having to sit for TWO national medical board examinations and will gladly accept the COMLEX.

 

[Dr. P]

I have honestly not seen overt discrimination here in New York or New Jersey. People refer according to who their local specialist is, who they are friendly with and who they trust. I quote one dermatologist from NYU School of Medicine with whom I spoke with about this topic extensively before applying as saying "for me the difference is the letters I write after their name in my rolodex. That's it." "Some of the best physicians I know happen to be osteopathic." - end quote

 

[Doc Oc]

Originally posted by turtleboard:
It may sound like more options, but have you seen the program offerings at most osteopathic institutions? They're generally of lower academic quality because of a lower amount of resources.


Tim of New York City.

???? Are you referring to the entire 4 year curriculum, or a certain part, such as basic sciences or clinicals? Which schools, and what spcifically makes the programs at these particular schools "of low academic quality"? While we're at it, which MD schools do you feel have poor programs and why?

I ask for two reasons. One, I do not feel that the basic science courses taken at any medical school are too different from eachother in content. They may be taught differently, and perhaps different things are emphasized since to be licensed MD and DO students will be prepping for different exams (unless the DO student choose to take both), but still biochem and anatomy are biochem and anatomy. It's not like DOs call things different names

I don't think that the profs with their PhD in some science teach it differently depending on what medical degree their students will ultimately earn, and I'd be surprised if the instructors at DO schools are any less "degreed" than at the other. A job teaching biochem is a job. Two, it's a huge generalization to say that most osteopathic institutions have programs of lower quality. There are only 19, so I suppose it is possible that you have read all of their curriculums, but I'm not sure what you would be comparing them to to judge the quality. Did you also read the programs on all MD schools, and then compare the DO schools to that? I just reread this, and realized that the tone of this post is defensive and accusatory. I hope it doesn't seems like I am attacking your opinion, turtleboard, because I am not. I am interested in your criteria for deeming a school of high academic quality, and also in specifics about which DO schools you feel falter in this category and your reasons for such. The above quoted statement is so broad, I don't see how it would help anyone, other than to turn them off of DO schools completely. However, if you were a bit more specific, then someone who is reading this thread for advice may know some other things to look for when evaluating which schools to apply to. I'm sure your post wasn't meant to be derogatory to all DO schools, because your posts are usually helpful. I'm just trying to clear up what it was supposed to mean. Thanks, and I apologize if any of this seems offensive

 

[turtleboard]

I wasn't referring to the 19 osteopathic colleges, I was referring to their residency prorgams. Because osteopathic residency programs are GENERALLY of lower academic quality than their allopathic brothers, most DOs today still opt for an MD residency. Any published work on the subject will cite "lower academic quality" as a top reason for DOs choosing MD residencies.

All medical schools, MD and DO, have very similar first and second years. When comparing the third and fourth year, all MD schools have a very structured program with a dedicated teaching faculty. Many osteopathic students have cited here and on other forums that their third and fourth years are 1) disorganized and 2) offer a poor didactic componenet because of the utilization of "voluntary" teaching faculty. What is "voluntary?" These are sometimes just doctors who decide they wouldn't mind a med student sitting in, but who don't necessarily know enough (beyond their clinical practice experiences) to offer you an actual education.


Tim of New York City.

 

[Doc Oc]

Okay, that makes more sense. I have also heard about the "voluntary" teaching at some schools I interviewed at, and also from students, who say that you can almost tell which profs are being paid. It didn't even occur to me that you may be talking about residencies. Do you know a good site to read about residency programs, both allo and osteo?

 

[turtleboard]

Well there's really no great website that "reviews" either MD or DO residencies, so you're out of luck there. There is AMA-FREIDA (www.ama-assn.org/freida) which has a listing of all accredited MD residencies in the country. It's great if you're looking for a lot of information on a particular program in a particular city in a particular hospital.

DO residency information on the internet is almost nonexistent, save for the AOA website. (www.aoa-net.org/opportunities) It's tough to find out which schools even sponsor programs, let alone which hospitals sponsor these programs. I actually have NO CLUE how DO students go about finding information regarding the osteopathic programs, but I'd venture a guess that most couldn't care less. It's unfortunate but true.


Tim of New York City.

 

[mj]

Tim,

Could you please clarify your last statement: "I actually have NO CLUE how DO students go about finding information regarding the osteopathic programs, but I'd venture a guess that most couldn't care less. It's unfortunate but true."

Are you saying that DO students are not interested in information on DO residency programs?

mj

 

[turtleboard]

If osteopathic history has taught us anything, it's that DO students generally don't want DO residencies. It's been said here, it's been debated at national osteopathic meetings, and it's an issue that's come up again and again.

The last number I remember is that about 67% to 75% of graduating DO seniors go for MD residencies. The osteopathic profession has lost the ability to train its own, and many DO graduates have gladly taken positions at MD hospitals.

There's a book available entitled, "The Definitive Guide for DOs seeking MD residencies," or something to that effect. While I haven't read it, to have a book like this in print might speak to the demand that exists within the osteopathic profession among its students for allopathic residencies.


Tim of New York City.

 

[mj]

Well that statistic is a little misleading considering that there aren't enough DO residencies offered for all DO grads, don't ya think. That alone creates "demand" all on its own, before quality even enters the picture.

Not that I wouldn't agree that there are issues with DO residencies, but to say that DO grads "couldn't care less" about DO residency choices seems strong. It's just like applying to med school -- a doctor is a doctor, so what if I have to go DO to get there -- a neurosurgeon is a neurosurgeon, so what if I have to go DO to get there. It may not be their first choice, but all the DOs I know certainly didn't dismiss DO residencies.

mj

 

[UHS2002]

I tend to agree with Tim on the GME part, although, in all fairness, it is hard to draw a comparison between ACGME and AOA residency programs because there are so few overall AOA residency programs when compared to allopathic programs. But most AOA programs are at small hospitals and that leaves one wondering if there is enough variety in the pathology encountered to give you a well rounded training. I think they are more than appropriate for family practice programs and general surgery, but it is possible that you will not get all the training you want if you are planning on a sub specialty of any kind. Then, again, I am only an MS3 and this is my impression at this time.

As for the 3rd and 4th years of medical school, being at a large medical center is not always what is touted to be. You are at the bottom of the pile. If there is a procedure to be done, the residents get the first pick, and they are all trying to get as many procedures as possible for their logs. So you can end up doing a lot of scut and very little of hands on. Following the entourage during morning rounds and being ingnored until it is time for some pimping is a stapple at major teaching hospitals. On the other hand, small community hospitals that don't have lots of residents or other med students offer you a chance to do lots of stuff and being more of an active member of an inservice team. Clinician offices, though lacking the "glamour" of inservice, actually give you a lot more volume and patient contact. It is important to do lots of inservice as you learn to manage the more complicated cases, but it is equally important to have a reasonable amount of office time, as you get used to seeing lots of patients and perfect your clinical skills.

Most allopathic schools will give their students huge chunks of inservice rotations and very little office, while DO schools, as a rule, will be heavier on the office time and lean on inservice. Neither is good. People who spend lots of time on inservice end up short on the basic physical assesment skills, hence residents out there that have trouble picking up stuff on physical exam but are fantastic at managing train wrecks in the ICU - they probably trained at major medical centers. On the other hand, others never miss even the most subtle grade 1 murmur but are totally stumped by ABGs - these probably spent a lot of time on office and clinic rotations...One should really strive to have a balanced education, which is easier said than done!