DO rotations

[DrStephenStrange]

You definitely need to be exposed to more honest MD students. There's a world of difference between MS 3 as an MD and a DO without a legit teaching hospital. Perhaps you were one of the lucky ones who got to do all of 3rd year at a real academic institution, but most DO students are not that fortunate.

The thing is we are human, and therefore we will always find something to complain about. Things could always get better no matter the situation.

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[Espressso]

Met someone recently from a DO school (an M4) who is only now doing their second inpatient rotation. This is insanely troubling to me.

This is kind of the point of my original post for this thread. It's tough to argue that DO schools are less likely to have a strong base hospital or two that most of their students can rotate in. Instead, they have all these outpatient clinics scattered around the state that have doctors they have contracts with. But these contracts seem to be variable and basically tentative year to year, so you don't know if you'll have them for next year. This then results in the clinical exposure/experience being different each year for students. Some doctors have never taught students before as well, which is annoying as well.

 

[ciestar]

But that's the thing, it shouldn't be site specific. I was at one of the best sites for my school and my surgery rotation was outpatient. WTF? Until DO schools get their act together and realize that MS 3 year and the quality of rotations matters way more than whether or not they have the coolest anatomy lab, this won't change.

Outpatient surgery? What?
That is an extreme disservice to you.

 

[AnatomyGrey12]

I am inpatient with residents for every single one of my core rotations. I present on all my assigned patients every single day and get pimped on my plan.

It sucks there are DO schools that have such a poor rotation set up that the students with high quality rotations get thrown under the bus by association.

 

[Sardonix]

What time period do people usually begin reaching out/applying for auditions?

I would recommend have a pretty good idea/list of programs you are interested in auditioning at by December/January. Likely few things will be open in January on VSAS, but non-VSAS programs might be starting to open up and have due dates listed.

Spring of M3 is essentially an annoying process of monitoring programs you like while also getting everything in order for application deadlines on VSAS. Rest assured that while non-VSAS programs may be a gray area, you're gonna wanna have your application ready on the first day of whatever programs you apply to over VSAS.

 

[Espressso]

I am inpatient with residents for every single one of my core rotations. I present on all my assigned patients every single day and get pimped on my plan.

It sucks there are DO schools that have such a poor rotation set up that the students with high quality rotations get thrown under the bus by association.

You're lucky. Does your school have a dedicated teaching hospital most students rotate at?

 

[DNC127]

Can anyone confirm this?

literally residents and or their attendings / coordinator told me this. I have no reason to lie lol. I go to all the AOAO meetings and this was talked about by a bunch of the programs at the PD panel.

 

[Giovanotto]

literally residents and or their attendings / coordinator told me this. I have no reason to lie lol. I go to all the AOAO meetings and this was talked about by a bunch of the programs at the PD panel.

No, I mean, are ACGME interviews in January mostly? Or did I misunderstand. Cause our school has been telling us otherwise.

 

[Mass Effect]

The thing is we are human, and therefore we will always find something to complain about. Things could always get better no matter the situation.

What? What I said above wasn't about finding something to complain about. It was about a very real and meaningful lapse in DO education and one of the primary reasons there's any DO bias out there when it comes to the match.

No, I mean, are ACGME interviews in January mostly? Or did I misunderstand. Cause our school has been telling us otherwise

No, ACGME interviews are not in January mostly. Most programs have some January dates, but often, the late January dates are "make-up" dates for earlier dates they may have rescheduled due to weather, etc. Most programs begin interviews in October and begin to wrap up in January.

 

[BorntobeDO?]

What? What I said above wasn't about finding something to complain about. It was about a very real and meaningful lapse in DO education and one of the primary reasons there's any DO bias out there when it comes to the match.



No, ACGME interviews are not in January mostly. Most programs have some January dates, but often, the late January dates are "make-up" dates for earlier dates they may have rescheduled due to weather, etc. Most programs begin interviews in October and begin to wrap up in January.

This is how my aways have said they do thier interviews. January is for make ups and people that rotated and they somehow missed.

 

[AnatomyGrey12]

You're lucky. Does your school have a dedicated teaching hospital most students rotate at?

Yes. Not every student rotates there but pretty much every one that wants to gets to because it has the most sites.

 

[DrStephenStrange]

What? What I said above wasn't about finding something to complain about. It was about a very real and meaningful lapse in DO education and one of the primary reasons there's any DO bias out there when it comes to the match.

I meant that even MD students find something to complain about. And even at DO schools like OSU that have way better rotations, students still complain. So...

 

[Mass Effect]

I meant that even MD students find something to complain about. And even at DO schools like OSU that have way better rotations, students still complain. So...

I don't understand your point. What does the fact that MD students complain about stuff have to do with the valid significant con of DO clinical education? Or are you arguing that having important core clerkships as outpatients isn't that big a deal?

 

[DrStephenStrange]

I don't understand your point. What does the fact that MD students complain about stuff have to do with the valid significant con of DO clinical education? Or are you arguing that having important core clerkships as outpatients isn't that big a deal?

You said this

You definitely need to be exposed to more honest MD students. There's a world of difference between MS 3 as an MD and a DO without a legit teaching hospital. Perhaps you were one of the lucky ones who got to do all of 3rd year at a real academic institution, but most DO students are not that fortunate.

Then I said this

The thing is we are human, and therefore we will always find something to complain about. Things could always get better no matter the situation.

You reply this

What? What I said above wasn't about finding something to complain about. It was about a very real and meaningful lapse in DO education and one of the primary reasons there's any DO bias out there when it comes to the match.

My point was things could always get better no matter the situation. Meaning we'll always complain. I'm not arguing your original post, and I'm not denying the fact DO has it worse than MDs.

 

[Mass Effect]

You said this

Then I said this

You reply this


My point was things could always get better no matter the situation. Meaning we'll always complain. I'm not arguing your original post, and I'm not denying the fact DO has it worse than MDs.

I guess what makes your post so troublesome to me is that this isn't a who-has-it-worse contest. That wasn't my point. DOs have it worse when it comes to competitive matches. DOs have it worse when it comes to expansion. But this is a significant deficiency in DO education that affects the future training/career of DO students. It's not just fodder for complaints.

 

[FourniersGreenGang]

What? What I said above wasn't about finding something to complain about. It was about a very real and meaningful lapse in DO education and one of the primary reasons there's any DO bias out there when it comes to the match.

I used to think this as well but after going on aways at academic MD institutions and meeting with big wigs high up in the department, I've realized that they have no idea what goes on at DO schools. Nor do they care. The biggest reasons for bias are twofold: the different name of the degree, DO, as they believe that it would be confusing to the actual patient, and secondly that we have no reputation among the MD schools. Meaning, we have no academic faculty who are nationally known, we have very little research output, we often do not have home departments or renowned teaching hospitals. I'm sure you can find exceptions, but this is much more of a problem on our side that needs addressing with the upcoming merger.

 

[getfat]

I used to think this as well but after going on aways at academic MD institutions and meeting with big wigs high up in the department, I've realized that they have no idea what goes on at DO schools. Nor do they care.

This 100p. My research mentor (at an MD school) thought my DO school was an online school.

 

[DO2015CA]

This 100p. My research mentor (at an MD school) thought my DO school was an online school.

That would make him a *****.

 

[Giovanotto]

This 100p. My research mentor (at an MD school) thought my DO school was an online school.

I'd play along honestly. At that point its willful ignorance.

 

[getfat]

That would make him a *****.

Dude is insanely smart. Just like @FourniersGreenGang mentioned earlier don't care to learn anything about DO schools.

I'd play along honestly. At that point its willful ignorance.

haha i wish i could the convo was basically, "why can't you put in lab time over the school year? Isn't your classes online?". Too bad I go to one of the schools that had mandatory attendance otherwise I probably would've played along.

 

[Mass Effect]

I used to think this as well but after going on aways at academic MD institutions and meeting with big wigs high up in the department, I've realized that they have no idea what goes on at DO schools. Nor do they care. The biggest reasons for bias are twofold: the different name of the degree, DO, as they believe that it would be confusing to the actual patient, and secondly that we have no reputation among the MD schools. Meaning, we have no academic faculty who are nationally known, we have very little research output, we often do not have home departments or renowned teaching hospitals. I'm sure you can find exceptions, but this is much more of a problem on our side that needs addressing with the upcoming merger.

That may be your experience, but as someone who also did not only aways, but residency and fellowship at top ACGME programs, trust me when I say, a huge concern of PDs is our clerkships. I would put very little stock in a person who told you it's that patients will be confused. That's a BS reason if I ever heard one. Sounds like their own personal bias and nothing to do with patients.

Dude is insanely smart. Just like @FourniersGreenGang mentioned earlier don't care to learn anything about DO schools.

Willful ignorance fits and sounds like someone you wouldn't want to work with.

 

[DO2015CA]

Dude is insanely smart. Just like @FourniersGreenGang mentioned earlier don't care to learn anything about DO schools.


haha i wish i could the convo was basically, "why can't you put in lab time over the school year? Isn't your classes online?". Too bad I go to one of the schools that had mandatory attendance otherwise I probably would've played along.

You can be intelligent and a *****. Any one that realizes a DO could enter ACGME programs and thought it was an online school, but was not outraged and actively fighting the ability for such students to enter is a *****.

 

[getfat]

You can be intelligent and a *****. Any one that realizes a DO could enter ACGME programs and thought it was an online school, but was not outraged and actively fighting the ability for such students to enter is a *****.

Ill-informed maybe. I wouldn't go that far to call the guy a *****. The point of my post is that a lot of people assume DO education is extremely different compared to MD colleges.

 

[Sardonix]

Ill-informed maybe. I wouldn't go that far to call the guy a *****. The point of my post is that a lot of people assume DO education is extremely different compared to MD colleges.

Gotta say this stuff is getting old.

I get that attendings have no reason to be up to date on the minutiae of current medical school changes. But good lord, 30% of physicians are DOs. I can't tell you the number of times a physician/nurse has said, "Wait what's a DO? Are you guys doctors or something?" when like a couple feet away is a DO who has worked in their department for over 10 years.

*Sigh

 

[getfat]

I get that attendings have no reason to be up to date on the minutiae of current medical school changes. But good lord, 30% of physicians are DOs. I can't tell you the number of times a physician/nurse has said, "Wait what's a DO? Are you guys doctors or something?" when like a couple feet away is a DO who has worked in their department for over 10 years.

Agreed. I will say one thing I've noticed is that the DO bias is definitely region dependent. Grew up in Florida and did pre-clinicals in GA. Nobody had any idea what a DO was. A lot of people in my area in GA had no idea there was a medical school in my neighborhood. Here in PA have received no such thing. Rotate with Drexel + Penn state students and nobody has questioned my degree.

 

[Mad Jack]

Why is there not a stronger emphasis on the quality of the rotations at the level of administration? It just baffles me, really. We seem to often get really great preceptors. But the variability is obnoxious.

Is there any hope?

This is no longer just a DO problem. Having worked with a lot of MDs from new schools at this point, quality control is similar at their programs. We need a new Flexner Report, to be perfectly honest

 

[BorntobeDO?]

Gotta say this stuff is getting old.

I get that attendings have no reason to be up to date on the minutiae of current medical school changes. But good lord, 30% of physicians are DOs. I can't tell you the number of times a physician/nurse has said, "Wait what's a DO? Are you guys doctors or something?" when like a couple feet away is a DO who has worked in their department for over 10 years.

*Sigh

Explaining why there is a DO and MD degree is really tiring to me. I have friends that ask, so I try and give an short answer, but its pretty obvious there is no need for two different degrees at this point. The funny thing is, its the ones who work in the hospital/healthcare who are most confused. They work with DO's, they know they are obviously physicians, but they really aren't sure why or what the difference is. I have a spewl about historical differences in philosophy, medication usage, and some extra training in manipulative medicine, but its one my least favorite things to explain.

 

[deleted407021]

Explaining why there is a DO and MD degree is really tiring to me. I have friends that ask, so I try and give an short answer, but its pretty obvious there is no need for two different degrees at this point. The funny thing is, its the ones who work in the hospital/healthcare who are most confused. They work with DO's, they know they are obviously physicians, but they really aren't sure why or what the difference is. I have a spewl about historical differences in philosophy, medication usage, and some extra training in manipulative medicine, but its one my least favorite things to explain.

I use the DMD/DDS comparison most of the time. While it’s not really analogous it gets the point across to laypeople.

 

[DO2015CA]

Explaining why there is a DO and MD degree is really tiring to me. I have friends that ask, so I try and give an short answer, but its pretty obvious there is no need for two different degrees at this point. The funny thing is, its the ones who work in the hospital/healthcare who are most confused. They work with DO's, they know they are obviously physicians, but they really aren't sure why or what the difference is. I have a spewl about historical differences in philosophy, medication usage, and some extra training in manipulative medicine, but its one my least favorite things to explain.

I don’t anymore. I just say it’s the degree my medical school conferred to me.

 

[Oh_Gee]

This 100p. My research mentor (at an MD school) thought my DO school was an online school.

at my away at an MD school, an attending, who was from Australia, asked if we learned pathophysiology at my school

 

[DO2015CA]

at my away at an MD school, an attending, who was from Australia, asked if we learned pathophysiology at my school

That’s when you just laugh and move along

It’s only the ignorant that choose to stay that way. It’s not just 6 schools world wide. It’s 30% of medstudents. It’s a choice... especially with google

 

[Ho0v-man]

Agreed. I will say one thing I've noticed is that the DO bias is definitely region dependent. Grew up in Florida and did pre-clinicals in GA. Nobody had any idea what a DO was. A lot of people in my area in GA had no idea there was a medical school in my neighborhood. Here in PA have received no such thing. Rotate with Drexel + Penn state students and nobody has questioned my degree.

I think we all just don’t realize how many people don’t have a clue about anything in healthcare in general. In Kirksville literally no one knew there was a med school there, or what a DO was. That town has the DO school, an undergrad, a DO hospital full of DO residencies, billboards that advertise physicians with DO credentials, and a Wal-Mart. There’s nothing else for 100 miles in any direction and no one there knows what a DO is. The town has about 15,000 people and the schools been there over 125 years.

 

[BorntobeDO?]

I use the DMD/DDS comparison most of the time. While it’s not really analogous it gets the point across to laypeople.

That is what I do for patients. Its people that I am more friendly with who always end up asking why there is two degrees and I have to try and explain out of courtesy. I don't do it for everyone, but I don't like doing it for anyone.

 

[BorntobeDO?]

I don’t anymore. I just say it’s the degree my medical school conferred to me.

I should do that. They can ask Dr. Google for more details.

 

[ciestar]

I should do that. They can ask Dr. Google for more details.

They do for anything else lol

 

[Chibucks15]

Dude is insanely smart. Just like @FourniersGreenGang mentioned earlier don't care to learn anything about DO schools.


haha i wish i could the convo was basically, "why can't you put in lab time over the school year? Isn't your classes online?". Too bad I go to one of the schools that had mandatory attendance otherwise I probably would've played along.

Maybe the “classes online” part wasn’t a jab at DOs but an actual question. I literally never went to class and the docs realize we all just watch the lectures online

 

[Mass Effect]

at my away at an MD school, an attending, who was from Australia, asked if we learned pathophysiology at my school

Pretty sure in Australia, osteopaths are chiropractors, which is why that attending was likely confused. That's actually understandable.

I've spent quite a bit of time in Kirksville and never got the impression that literally no one knows what a DO is. Quite the opposite actually. Everyone seemed pretty well aware of the med school and hospital, about as much as I'd expect in such a small town.

 

[FourniersGreenGang]

That may be your experience, but as someone who also did not only aways, but residency and fellowship at top ACGME programs, trust me when I say, a huge concern of PDs is our clerkships. I would put very little stock in a person who told you it's that patients will be confused. That's a BS reason if I ever heard one. Sounds like their own personal bias and nothing to do with patients.



Willful ignorance fits and sounds like someone you wouldn't want to work with.

I'm also not questioning your experience. I'm thinking it could be program and specialty dependent. I was told these things by the chair of the department for a competitive surgical specialty that admittedly has had few DOs on the acgme side historically. Hopefully I addressed some of the concerns he had and paved the way for consideration of future DOs as well. He really did not ask much about my rotations and was in fact interested in the difference and what unique things I could bring. He definitely thought it would be confusing having two different degrees, however in my personal experience, I've never been questioned by a patient. In fact the only time it has been brought up is in a positive light. And that was only twice.

 

[Mass Effect]

I'm also not questioning your experience. I'm thinking it could be program and specialty dependent. I was told these things by the chair of the department for a competitive surgical specialty that admittedly has had few DOs on the acgme side historically. Hopefully I addressed some of the concerns he had and paved the way for consideration of future DOs as well. He really did not ask much about my rotations and was in fact interested in the difference and what unique things I could bring. He definitely thought it would be confusing having two different degrees, however in my personal experience, I've never been questioned by a patient. In fact the only time it has been brought up is in a positive light. And that was only twice.

I'm not doubting this happened. I'm saying anyone who told you that is either BSing you or is clueless, chair of a department or not. It's the exception, in my experience, not the rule. Admittedly, I have zero experience with ACGME surgery, but patient confusion being a reason to not take DOs is just an absurd reason. The reason I'm debating it is because the more we gloss over the true, fixable issues with DO education that are causing a lot of the stigma, the more we give a pass to DO schools to continue the status quo instead of changing things.

 

[fldoctorgirl]

I use the DMD/DDS comparison most of the time. While it’s not really analogous it gets the point across to laypeople.

Same here. Had a family friend and his wife-- who know I'm a med student-- tell me that their nephew or something was going to start med school at Nova, "but did I know that they don't get an MD, they get a DO? What is that, like a chiropractor?". Had to awkwardly respond with "nah, it's just another degree, my school also gives the DO degree". They looked extremely puzzled, so I just pulled out the DMD/DDS comparison and then it made sense to them, so I've been sticking with that since.

 

[Sardonix]

I think we all just don’t realize how many people don’t have a clue about anything in healthcare in general. In Kirksville literally no one knew there was a med school there, or what a DO was. That town has the DO school, an undergrad, a DO hospital full of DO residencies, billboards that advertise physicians with DO credentials, and a Wal-Mart. There’s nothing else for 100 miles in any direction and no one there knows what a DO is. The town has about 15,000 people and the schools been there over 125 years.

To be fair, 125 years is pretty fast moving for Missouri.

 

[Medic741]

Explaining why there is a DO and MD degree is really tiring to me. I have friends that ask, so I try and give an short answer, but its pretty obvious there is no need for two different degrees at this point. The funny thing is, its the ones who work in the hospital/healthcare who are most confused. They work with DO's, they know they are obviously physicians, but they really aren't sure why or what the difference is. I have a spewl about historical differences in philosophy, medication usage, and some extra training in manipulative medicine, but its one my least favorite things to explain.

“DO is just the first 2 letters of doctor, MD stands for medical doctor, not really sure why they don’t call them the same thing honestly”

No OMM bull**** and bam they’re satisfied.

 

[hallowmann]

Its a tired response. I had all inpatient with residents for my cores. I rotated alongside MDs for a number of rotations as well. I had maybe one rotation in 4 yrs that I would call mostly shadowing. Had people in my own city tell me that the problem with DO schools is that I don't do cores with residents as a DO and do mostly shadowing. I lightly corrected them and moved on.

I'm aware of people that went out of their way to do outpatient only or small clinical site rotations with no residents. You shouldn't be able to do that, but inconsistency is still a big issue at DO schools and I agree we should fight it and strive for better. That said, in all seriousness tons of MDs have the same complaints and I met more that did less wards team-based rotations than I did and actually did more shadowing. They had more consistency across their class though.

Outpatient surgery for a core certainly is a joke, but again my surgery cores were 1.5 blocks of Gen Surg with surgery residents (scrubbed into a number of choles, appys, hernia repairs, and a few colon resections) followed by half a block of Ortho (with a rotating ortho resident) and still got to scrub into BKAs, SCFEs, knee replacements, and random pinning (mainly lower extremity stuff though). Again though, it was variable because I went to a medium sized hospital and I know some students that barely scrubbed because of low volume when they did their rotations.

 

[sunshinefl]

Its a tired response. I had all inpatient with residents for my cores. I rotated alongside MDs for a number of rotations as well. I had maybe one rotation in 4 yrs that I would call mostly shadowing. Had people in my own city tell me that the problem with DO schools is that I don't do cores with residents as a DO and do mostly shadowing. I lightly corrected them and moved on.

I'm aware of people that went out of their way to do outpatient only or small clinical site rotations with no residents. You shouldn't be able to do that, but inconsistency is still a big issue at DO schools and I agree we should fight it and strive for better. That said, in all seriousness tons of MDs have the same complaints and I met more that did less wards team-based rotations than I did and actually did more shadowing. They had more consistency across their class though.

Outpatient surgery for a core certainly is a joke, but again my surgery cores were 1.5 blocks of Gen Surg with surgery residents (scrubbed into a number of choles, appys, hernia repairs, and a few colon resections) followed by half a block of Ortho (with a rotating ortho resident) and still got to scrub into BKAs, SCFEs, knee replacements, and random pinning (mainly lower extremity stuff though). Again though, it was variable because I went to a medium sized hospital and I know some students that barely scrubbed because of low volume when they did their rotations.

I finished general surgery 1 (still have surgery 2 left in a few months) having scrubbed in on choles, appys, gastric sleeves, BKAs, open intestinal volvulus, colon resection, robotics, mastectomy, hernias, ex laps, liver transplant, kidney transplants, Roux-en-Y hepaticojejunostomy, hemorrhoidectomy, and more. My home hospital has residents I worked with, but I was also assigned to a primary surgeon who operated other places and I went with him there too, which I liked because I was first assist instead of being behind a resident.