markboonya said:
for those of you preferring to match into MD residencies, can u tell me ur personal opinions on why? is there some sort of advantage of being in an MD residency(besides location)? and what are the advantages of a DO residency (espcially for specialized residencies where OMM is not used)? from the above posts, there seems to be no differences at all. i'm a pre-do so this might seem like a newbie question, but i am just curious about the basic differences. Do u work with attendings/residents/interns who are exclusively DOs in a DO residency?
I do not claim to be an expert on the differences b/t osteopathic(AOA) and allopathic(ACGME) programs but I have had experience training at both (as a student) and after spending all my rotations on the road feel fairly well qualified to comment on the difference in training in these two realms.
First, two disclaimers: As stated above, there is a spectrum in quality in both realms. And, for any given individual they will get out of a program what they put in.
The major differences I have noticed are as follows:
1) The major factor in training at a major teaching hospital is having attendings who are PAID to teach you, rather than depending on the kindness of a private attending to sit down with you once and awhile. Of note, most major teaching centers have ACGME programs. The rotations I had at big teaching hospitals were ALWAYS of high quality, whereas the rotations at small community places were frequently country club-esque.
2) Major teaching hospitals not only have a greater amount of pathology, but also technology and facilities that most small community hospitals only dream of.
3) The leaders in a given field, those who publish and /or define the cutting edge of a field tend to migrate to major teaching hospitals/medical centers.
4) As mentioned above, a possible disadvantage of a large medical center is that you often wait behind residents and fellows when it comes to procedures. This being said, if you do not know the reason behind a procedure, knowing how is less important. While you may have to watch instead of do, you are more likely to get a lecture on the various options for that procedure and what the literature says about the effectiveness/safety of that procedure. After all we are training to be physicians, not technicians. There is a legitamate difference of opinion on this issue and it depends on your goals.
5) as stated in above posts, didactics are on average better at acgme programs. This has been my consistent experience and it relates very much to issue #1, that attending involvement is higher and the schedule actually happens. My rotations at a prominent osteopathic hospital was rife with cancelled lectures, most of which were given by interns, or lower level residents. Attendings rarely attended.
6) The last point I'd like to make that really sticks in my craw is that AOA programs have yet to really set themselves apart when it comes to OMT training. I think most of us would love it if these programs aggessively incorporated OMT into the training and published more on the effectiveness of OMT in both the inpt./outpt. areas. I know there are a few small studies here and there, but the burden of proof with OMM is high and tough to study and as of yet I have not seen a really high quality study from a AOA program.
7) the post I quote is from a pre-DO, so let me say to them that I am exteremely proud to be a DO, use OMT at every chance (weekly in an inpt. teaching hospital), and would not trade in my DO degree for anything. I feel my medical school training was great.
I think the fill rates of AOA programs speaks volumes and its time the AOA steps up to the plate and improves quality and quantity of programs. Unfortunately, there is a difference in quality (on average) and its a shame.
I am trying to get my acgme internship approved by the AOA and hope to be involved with teaching at an AOA program when I am an attending (and hopefully get paid to do so!)
