DO Stigma in residency/fellowship

[EastSide]

1st year DO student.

I was well aware that DO students are at a disadvantage but I did not realize how profound the stigma against DO was in competitive IM residencies and fellowship.
I've seen post where DO students scored 240-260 USMLE Step1, but still had trouble matching into MD residencies, hence made attaining desired fellowship even more difficult. These students are scoring crazy board scores, even more competitive than their MD counterparts.

I know talking about it here won't change the fact, but I'd like to know why that is?
Is it simply traditional bias?
If DO docs are in a program, does the program look less attractive, less intelligent, to the eyes of the public and even future applicants?


(who knows what the merger will do; hopefully it will add some sense to selective ACGME programs)

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[Angus Avagadro]

Doubtful. This has been talked to death on SDN. Some of what you post is probably true. Our local univeristy IM program has never taken a DO and never will, according to my internist. Pedigree bigotry does exist in the MD world. As I have said in other posts, they do it to each other too. Focus less on what you think might be fair and more on what programs will enhance your career. There are many DO friendly IM programs. Find them and move on.

 

[AnatomyGrey12]

If DO docs are in a program, does the program look less attractive, less intelligent, to the eyes of the public and even future applicants?

The brutal truth is yes.

IM is one of the most prestige driven fields in medicine. It’s only natural even the most qualified DOs have a hard time getting into the most competitive programs. Someone with the stats you mention will have zero problems matching a quality program though.

 

[Dr.Bruh]

The brutal truth is yes.

IM is one of the most prestige driven fields in medicine. It’s only natural even the most qualified DOs have a hard time getting into the most competitive programs. Someone with the stats you mention will have zero problems matching a quality program though.

It’s important we get out of our med school bubble here. Does a program with DOs look less attractive to the public (like OP asked) Of course not. 99% of people don’t even know their NP from their doctor. True, your top MD applicants and PDs will see DOs as a negative thing but this is far from the majority. The top programs and applicants who think like this make up a small percentage of the massive amount of IM applicants and lM programs. Most MDs going IM are like the rest of us. Not really prestige driven. They just want to match in a place they wouldn’t mind living and in the specialty of their choice and don’t give a damn if it has DOs.

 

[FutureDoctor5000]

1st year DO student.

I was well aware that DO students are at a disadvantage but I did not realize how profound the stigma against DO was in competitive IM residencies and fellowship.
I've seen post where DO students scored 240-260 USMLE Step1, but still had trouble matching into MD residencies, hence made attaining desired fellowship even more difficult. These students are scoring crazy board scores, even more competitive than their MD counterparts.

I know talking about it here won't change the fact, but I'd like to know why that is?
Is it simply traditional bias?
If DO docs are in a program, does the program look less attractive, less intelligent, to the eyes of the public and even future applicants?


(who knows what the merger will do; hopefully it will add some sense to selective ACGME programs)

Well you see if you want a top 15-20 IM program then even going to a low tier MD/state MD will make things difficult due to pedigree blah blah blah... but theres plenty and I mean plenty of very good IM programs with fellowship opportunities both academic and community programs with in house fellowships, many of them are DO friendly, and a DO with 240+ should have no problem getting into them and matching the fellowship of his choice, there is really no bias against DO/even IMG when it comes to fellowships. For example the state MD school in my state takes plenty of DO's from my school and others as do the ones from the surrounding states, they are all good programs and have in house fellowships that our grads have matched into, their also community programs with in house fellowships that take DO's. If your a DO/IMG and even low tier MD and hellbent on matching at MGH/stanford or some crazy top tier IM program to match into their cards or GI fellowship then your gonna be in the situation that poster was and will be in world of hurt, prestige honestly is a SDN/blowhard premed issue, go to a program you fit in that has in house fellowships and work hard and you will a cardiologist/gi/heme onc/whatever you wanna be still get $$ and respect as some dude that went to Harvard for IM and fellowship. If you want to be in academic medicine then things might be tougher but it can still be done for DO's. Don't get caught up in the bulls**it on this site, just put your head down and work hard and you can get what you want regardless of your school. Couple dudes in our last class matched Derm, ENT and Neurosurg...

 

[calvinhobbes]

No, no one cares. Know your medicine. If you’re dumb or incompetent or a jerk it’s going to show regardless if you’re an MD or a DO. Be respectful and impress your peers, and people will quickly forget what school you went to and instead remember you as the best resident, fellow, etc.

 

[Dr. Death]

1st year DO student.

I was well aware that DO students are at a disadvantage but I did not realize how profound the stigma against DO was in competitive IM residencies and fellowship.
I've seen post where DO students scored 240-260 USMLE Step1, but still had trouble matching into MD residencies, hence made attaining desired fellowship even more difficult. These students are scoring crazy board scores, even more competitive than their MD counterparts.

I know talking about it here won't change the fact, but I'd like to know why that is?
Is it simply traditional bias?
If DO docs are in a program, does the program look less attractive, less intelligent, to the eyes of the public and even future applicants?


(who knows what the merger will do; hopefully it will add some sense to selective ACGME programs)

I'm going to go point by point here.
I've seen post where DO students scored 240-260 USMLE Step1, but still had trouble matching into MD residencies, hence made attaining desired fellowship even more difficult. These students are scoring crazy board scores, even more competitive than their MD counterparts.

DO students with 240-260 will comfortably match university IM. Not top 25 programs, but any other respectable program is attainable, particularly if you have some research. Fellowships are almost all about where you did your residency and what your research profile looks like.

I know talking about it here won't change the fact, but I'd like to know why that is?
That's the way it's always been. In the past (and present), osteopathic clinical training and research has lagged behind allopathic. Furthermore, most DO students were academically weaker than their MD counterparts in the first place, which is why they are at an osteopathic school in the first place.

If DO docs are in a program, does the program look less attractive, less intelligent, to the eyes of the public and even future applicants?
Eyes of the public, no. Nobody knows the difference. Future applicants, maybe. Which is why those top tier residencies don't consider DOs.

(who knows what the merger will do; hopefully it will add some sense to selective ACGME programs)
Doubtful

 

[DrStephenStrange]

Well you see if you want a top 15-20 IM program then even going to a low tier MD/state MD will make things difficult due to pedigree blah blah blah... but theres plenty and I mean plenty of very good IM programs with fellowship opportunities both academic and community programs with in house fellowships, many of them are DO friendly, and a DO with 240+ should have no problem getting into them and matching the fellowship of his choice, there is really no bias against DO/even IMG when it comes to fellowships. For example the state MD school in my state takes plenty of DO's from my school and others as do the ones from the surrounding states, they are all good programs and have in house fellowships that our grads have matched into, their also community programs with in house fellowships that take DO's. If your a DO/IMG and even low tier MD and hellbent on matching at MGH/stanford or some crazy top tier IM program to match into their cards or GI fellowship then your gonna be in the situation that poster was and will be in world of hurt, prestige honestly is a SDN/blowhard premed issue, go to a program you fit in that has in house fellowships and work hard and you will a cardiologist/gi/heme onc/whatever you wanna be still get $$ and respect as some dude that went to Harvard for IM and fellowship. If you want to be in academic medicine then things might be tougher but it can still be done for DO's. Don't get caught up in the bulls**it on this site, just put your head down and work hard and you can get what you want regardless of your school. Couple dudes in our last class matched Derm, ENT and Neurosurg...

OP this ^ right here.

Also, I wanted to add that just because a IM program is hard to get into doesn't mean that it offers the best training and/or the best opportunities for matching into the fellowship that you want. There are plenty of IM programs that are competitive only because they are located in a desirable area. Also, some programs are just associated with a big school/hospital name, and that attract applicants too. Just do more research and you'll find that there are plenty of great IM DO friendly programs out there that will give a good training and offer you lots of opportunities.

Here's an old thread I found very informative: DO friendly internal medicine university programs

 

[AnatomyGrey12]

It’s important we get out of our med school bubble here. Does a program with DOs look less attractive to the public (like OP asked) Of course not. 99% of people don’t even know their NP from their doctor. True, your top MD applicants and PDs will see DOs as a negative thing but this is far from the majority. The top programs and applicants who think like this make up a small percentage of the massive amount of IM applicants and lM programs. Most MDs going IM are like the rest of us. Not really prestige driven. They just want to match in a place they wouldn’t mind living and in the specialty of their choice and don’t give a damn if it has DOs.

You’re right, the public won’t give a crap. Future applicants do however look at programs and programs with lots of DOs are given a bit of a sideways glance. This isn’t necessarily isolated to applicants from top schools either.

Now of course there absolutely are many high quality residencies that consider DOs, I dare say most programs outside the top 25 probably will if the fit is right, and these programs are in reach for most DO students.

 

[FutureDoctor5000]

You’re right, the public won’t give a crap. Future applicants do however look at programs and programs with lots of DOs are given a bit of a sideways glance. This isn’t necessarily isolated to applicants from top schools either.

Now of course there absolutely are many high quality residencies that consider DOs, I dare say most programs outside the top 25 probably will if the fit is right, and these programs are in reach for most DO students.

Those “top tier” applicants will be in a world of hurt once some of these top tier residencies start taking DO’s, it’s just a numbers thing and there’s gonna be a higher number of DO’s applying and few will get into these top programs, you see this already, some very good top tier matches from many DO schools. There will also be low tier MD applicants in former DO programs that will be trained by DO’s, these prestige blowhards will be humbled soon I think, this is one thing that the merger is good for I think.

 

[Angus Avagadro]

Those “top tier” applicants will be in a world of hurt once some of these top tier residencies start taking DO’s, it’s just a numbers thing and there’s gonna be a higher number of DO’s applying and few will get into these top programs, you see this already, some very good top tier matches from many DO schools. There will also be low tier MD applicants in former DO programs that will be trained by DO’s, these prestige blowhards will be humbled soon I think, this is one thing that the merger is good for I think.

I dont necessarily think the merger will change much of the above. Programs take who they think is a good match for them. They can discriminate as they please. Snobbery exists as I have said. That wont change for a long time ,if ever. Best advice, run your own race, stay in your lane, strive for excellence. You can be an excellent physician without training in a top 20 program. To think so is naive and an SDN fallacy.

 

[NecFasc92]

Those “top tier” applicants will be in a world of hurt once some of these top tier residencies start taking DO’s, it’s just a numbers thing and there’s gonna be a higher number of DO’s applying and few will get into these top programs, you see this already, some very good top tier matches from many DO schools. There will also be low tier MD applicants in former DO programs that will be trained by DO’s, these prestige blowhards will be humbled soon I think, this is one thing that the merger is good for I think.

You live in an interesting fantasy world

 

[AnatomyGrey12]

Those “top tier” applicants will be in a world of hurt once some of these top tier residencies start taking DO’s

Lol... no. To think anything changes for them is borderline delusional.

be a higher number of DO’s applying and few will get into these top programs, you see this already, some very good top tier matches from many DO schools.

Not in IM..... the best IM match we have seen to date is probably UT Southwestern, and that person's app was completely impeccable, there are less than 5 DOs in the country in any given year with that ability. So no, higher numbers of DOs aren't going to start matching top tier IM. The merger isn't going to change any of this.

 

[FourniersGreenGang]

If I see a roster with a DO or two on it at a competitive program/specialty I gain respect for them. I know they chose the best applicants they could and that school name had little impact, if any. They cared about performance when making that selection.

 

[BorderlineQueen]

I think the stigma for DOs has lessened over the years. In my area about 5-10 years ago local hospitals would ask patients if they were okay seeing a DO doctor in the ER or while admitted. The hospitals in my area have stopped doing this. Just a note this is an area where the average income is 140k so it's understanding that some wealthy people would have qualms about seeing a DO.

 

[Osminog]

If I see a roster with a DO or two on it at a competitive program/specialty I gain respect for them. I know they chose the best applicants they could and that school name had little impact, if any. They cared about performance when making that selection.

If only the process were that meritocratic.

A lot of DO students have physicians in the family, and some of those physicians have powerful affiliations. Without the influence of string-pulling, very, very few super-elite residency programs would ever rank a strong DO applicant over a half-decent MD applicant. The harsh reality is that having a DO on your roster looks bad and can have an adverse effect on your program’s future match outcomes; top MD applicants don’t want to have colleagues from no-name osteopathic schools, just like DOs don’t want to find themselves at an IMG mill.

I can’t offer you an elaborate data set or official memo to support what I said above, because it happens under the radar, behind closed doors. Also, DOs who are beneficiaries of this sort of string-pulling wouldn’t ever admit it in most cases, since they want to be thought of as self-made success stories. I’m just here to say that it happens.

 

[AnatomyGrey12]

A lot of DO students have physicians in the family, and some of those physicians have powerful affiliations. Without the influence of string-pulling, very, very few super-elite residency programs would ever rank a strong DO applicant over a half-decent MD applicant.

I am very familiar with the apps of about 8-10 superstar DO matches. Not a single one of them had the kinds of connections you are insinuating. Does it happen? Probably. Is it behind most of the amazing DO matches we’ve seen recently? Nope not even close.

The rest of your post is correct however.

 

[Goro]

1st year DO student.

I was well aware that DO students are at a disadvantage but I did not realize how profound the stigma against DO was in competitive IM residencies and fellowship.
I've seen post where DO students scored 240-260 USMLE Step1, but still had trouble matching into MD residencies, hence made attaining desired fellowship even more difficult. These students are scoring crazy board scores, even more competitive than their MD counterparts.

I know talking about it here won't change the fact, but I'd like to know why that is?
Is it simply traditional bias?
If DO docs are in a program, does the program look less attractive, less intelligent, to the eyes of the public and even future applicants?


(who knows what the merger will do; hopefully it will add some sense to selective ACGME programs)

There are three causes of the stigma
1) Snobbery and the worry of PDs that elitist resident candidates will look at a program with DOs as somehow inferior.
2) Poor clinical training at a fair number of DO schools
3) For much older PDs, memories of the cult of Still

 

[Sardonix]

There are three causes of the stigma
1) Snobbery and the worry of PDs that elitist resident candidates will look at a program with DOs as somehow inferior.
2) Poor clinical training at a fair number of DO schools
3) For much older PDs, memories of the cult of Still

/thread.

Maybe add a fact that, while not yet ideal, things are slowly changing. Each year well established DO schools get a dozen more competitive surgical matches and a handful of extremely competitive residency programs that had never taken DOs before (ex: various derm matches. Or that one guy that got into UMich Urology that SDNers on this forum basically wanted to make out with).

 

[Hippocrates II]

If only the process were that meritocratic.

A lot of DO students have physicians in the family, and some of those physicians have powerful affiliations. Without the influence of string-pulling, very, very few super-elite residency programs would ever rank a strong DO applicant over a half-decent MD applicant. The harsh reality is that having a DO on your roster looks bad and can have an adverse effect on your program’s future match outcomes; top MD applicants don’t want to have colleagues from no-name osteopathic schools, just like DOs don’t want to find themselves at an IMG mill.

I can’t offer you an elaborate data set or official memo to support what I said above, because it happens under the radar, behind closed doors. Also, DOs who are beneficiaries of this sort of string-pulling wouldn’t ever admit it in most cases, since they want to be thought of as self-made success stories. I’m just here to say that it happens.

Personally, I think you're minimizing the accomplishments of many DOs who have attained strong residencies without connections.

Also, I disagree that seeing a DO on the roster of a super-elite program makes other applicants hesitant to apply there. If I'm looking at the residency roster of SMKCC or some other highly-praised institution and I see a DO on their roster, my first thought isn't that this extremely well-respected cancer institute couldn't gain the attention of MDs, it's that that particular DO must have been very impressive. I have to imagine most people would have a similar thought process because everyone knows that competitive programs will have their pick of applicants, and there surely isn't going to be a shortage of solid MDs applying.

For a "low-tier" or what have you residency, sure, I could see having an abundance of DOs making it appear that you couldn't get the attention of MDs, and that might look bad. I'm a DO student and even I would be guilty of thinking the same. I don't think that would ever be the case at a 'super-elite' residency, though. My 2 cents.

 

[FourniersGreenGang]

Personally, I think you're minimizing the accomplishments of many DOs who have attained strong residencies without connections.

Also, I disagree that seeing a DO on the roster of a super-elite program makes other applicants hesitant to apply there. If I'm looking at the residency roster of SMKCC or some other highly-praised institution and I see a DO on their roster, my first thought isn't that this extremely well-respected cancer institute couldn't gain the attention of MDs, it's that that particular DO must have been very impressive. I have to imagine most people would have a similar thought process because everyone knows that competitive programs will have their pick of applicants, and there surely isn't going to be a shortage of solid MDs applying.

For a "low-tier" or what have you residency, sure, I could see having an abundance of DOs making it appear that you couldn't get the attention of MDs, and that might look bad. I'm a DO student and even I would be guilty of thinking the same. I don't think that would ever be the case at a 'super-elite' residency, though. My 2 cents.

Yeah this is pretty much what I was trying to say. Who looks at UPenn ENT, UW ortho, uw plastics, etc. and goes oh they have a DO, those programs have gone to s**t. The answer is nobody. Those programs are still top tier and highly respected. It only makes ME respect THEM more because they took that superstar DO. I know those programs care about performance, and that also contributes to why they're at the top of the heap. Could you imagine a similar situation in sports? Professional sports teams care about performance. If you are faster, stronger, better team player, etc. than the next guy, you've got a spot on the team. To take someone because of pedigree over performance, you're diluting the potential of your team.

 

[Goro]

Who looks at UPenn ENT, UW ortho, uw plastics, etc. and goes oh they have a DO, those programs have one to s**t

Actually, a PD posted in these fora exactly that sentiment as to why his program doesn't take Dos.

As Angus has pointed out, elitism is real.

But I also agree that the glass doors sure seem like they're cracking open more frequently lately. My kids int he Class of '19 had some astounding matches that left us slacked-jawed with amazement.

 

[Instatewaiter]

Those “top tier” applicants will be in a world of hurt once some of these top tier residencies start taking DO’s, it’s just a numbers thing and there’s gonna be a higher number of DO’s applying and few will get into these top programs, you see this already, some very good top tier matches from many DO schools. There will also be low tier MD applicants in former DO programs that will be trained by DO’s, these prestige blowhards will be humbled soon I think, this is one thing that the merger is good for I think.

Hmmm...so these top tier programs always had the option of taking DO applicants. Why is the merger going to make them start considering DO applicants?

 

[Instatewaiter]

Well you see if you want a top 15-20 IM program then even going to a low tier MD/state MD will make things difficult due to pedigree blah blah blah... If your a DO/IMG and even low tier MD and hellbent on matching at MGH/stanford or some crazy top tier IM program to match into their cards or GI fellowship then your gonna be in the situation that poster was and will be in world of hurt,

This sentiment is very commonly posted and then reposted because people assume it is true. To prove a point, I looked up my old schools match list this last year (an unranked state school) to see where they matched.

This year, there were 4 matches to the top 5 IM programs in the country- including 2 to the #1 program. There were a few more in the top 10 and 2-3 more in the top 20.

So out of 30 matches in IM, about 30% were to top 20 programs and more than 10% were to the most selective programs.

Yeah it's not all that hard to match to a top tier medicine program coming from an unranked state school.

 

[EastSide]

Wow thank you all for your great response!

 

[PA_dud3]

Is there a general list of "competitive" IM Subspecialties? Cardiology would be the only one I'd really think of.

 

[Angus Avagadro]

Is there a general list of "competitive" IM Subspecialties? Cardiology would be the only one I'd really think of.

GI and Heme Onc come to mind

 

[libertyyne]

Is there a general list of "competitive" IM Subspecialties? Cardiology would be the only one I'd really think of.

GI , cards, heme onc, being the most and adult congenital heart, nephrogeriatric being some of the least.

 

[PA_dud3]

View attachment 278689
GI , cards, heme onc, being the most and adult congenital heart, nephrogeriatric being some of the least.

Cool beans, I appreciate you looking that up.

 

[dfib slim]

I've seen post where DO students scored 240-260 USMLE Step1, but still had trouble matching into MD residencies, hence made attaining desired fellowship even more difficult. These students are scoring crazy board scores, even more competitive than their MD counterparts.

I scored 260s on both steps and had to apply to double the amount of residency and fellowship programs to get the same number of interviews as MD applicants.

 

[Schwifty]

I scored 260s on both steps and had to apply to double the amount of residency and fellowship programs to get the same number of interviews as MD applicants.

What specialty?

 

[dfib slim]

What specialty?

Rheumatology

 

[KeikoTanaka]

The reason so many more DO schools are opening compared to MD schools is because, If I'm not mistaken, it is because the cost to open DO schools is less because there aren't as many regulations regarding research output/lab space.

This causes DO students to get a great education, but falter when it comes to access to good research experience. Score a 260, that's good and all as a DO, but theres 100 other MDs who also scored a 260 or 255 who have been doing research for the last 4 years. This is where a lot of the disconnect comes from. You don't need to go to the most prestigious residency anyways to get a good fellowship, just make sure whichever residency you go to has a lot of access to specialists and has fellowships in house. Good luck.

 

[Sardonix]

The reason so many more DO schools are opening compared to MD schools is because, If I'm not mistaken, it is because the cost to open DO schools is less because there aren't as many regulations regarding research output/lab space.

This causes DO students to get a great education, but falter when it comes to access to good research experience. Score a 260, that's good and all as a DO, but theres 100 other MDs who also scored a 260 or 255 who have been doing research for the last 4 years. This is where a lot of the disconnect comes from. You don't need to go to the most prestigious residency anyways to get a good fellowship, just make sure whichever residency you go to has a lot of access to specialists and has fellowships in house. Good luck.

That and, ya know, terrible rotations in the middle of nowhere/not actually learning anything useful for 3rd/4th year.

 

[AnatomyGrey12]

This causes DO students to get a great education, but falter when it comes to access to good research experience.

It also causes a lot of DO students to have trash rotations, which is a huge problem. New DO schools are allowed to start accepting applications without having their clinical rotations set up. They only need a plan to have them set up....

 

[KeikoTanaka]

It also causes a lot of DO students to have trash rotations, which is a huge problem. New DO schools are allowed to start accepting applications without having their clinical rotations set up. They only need a plan to have them set up....

That's scary. I'm glad I'm where I am XD

 

[BorntobeDO?]

Rheumatology

I thought rhuem was not that hard to match? You make me worried man, you've been a rockstar for years.

 

[dfib slim]

I thought rhuem was not that hard to match? You make me worried man, you've been a rockstar for years.

The overall applicant pool isn't as competitive as cards, GI, or heme/onc, but increasing popularity and relatively smaller number of program spots has lead it to become one of the lowest overall match rate in recent years. 33% applying rheum went unmatched compared to 27% for cards, 35% for GI, and 21% for heme/onc.

 

[Kalam]

That and, ya know, terrible rotations in the middle of nowhere/not actually learning anything useful for 3rd/4th year.

IDK if it's just my school (newer DO school), but our rotations kick absolute ass. Some big cities, some rurals. You got to pick (for the most part) which location you wanted out of a list of 30+. Always 1 on 1 with preceptors. There are some drawbacks, like most locations don't have residency programs at the hospital, but that is also a benefit in that the preceptors treat you like a resident instead of 3rd year being glorified observing. Our school is requiring one month of the year to be at a preceptorship with residents, at least.

My class universally agrees we are learning a ton. We may miss out on some of the Zebra's at huge academic centers, but I think it's a fair tradeoff for the awesome hands-on training we are receiving.

Of course, there's stupid stuff from the school, too. Like making us do one month of hospice and one month of rural med (glorified OMM rotation, basically).

 

[NecFasc92]

IDK if it's just my school (newer DO school), but our rotations kick absolute ass. Some big cities, some rurals. You got to pick (for the most part) which location you wanted out of a list of 30+. Always 1 on 1 with preceptors. There are some drawbacks, like most locations don't have residency programs at the hospital, but that is also a benefit in that the preceptors treat you like a resident instead of 3rd year being glorified observing. Our school is requiring one month of the year to be at a preceptorship with residents, at least.

My class universally agrees we are learning a ton. We may miss out on some of the Zebra's at huge academic centers, but I think it's a fair tradeoff for the awesome hands-on training we are receiving.

Of course, there's stupid stuff from the school, too. Like making us do one month of hospice and one month of rural med (glorified OMM rotation, basically).

You literally just described the definition of run-of-the-mill subpar DO clinical education. Lmao. Absolutely nothing about what you wrote is “kick ass”.

 

[AnatomyGrey12]

but our rotations kick absolute ass

Always 1 on 1 with preceptors. There are some drawbacks, like most locations don't have residency programs at the hospital

I hate to break it to you but rotations where only 4 weeks are on a preceptorship at a hospital that also happens to have residents isn't really the definition of "kicking ass."

It's not zebras you're missing out on. It's learning how to function as an intern as part of a medical team.

 

[DrStephenStrange]

ARCOM rotations are pretty good IMO. Most of them are at decent sized 300-400+ bed Hospitals (including Baptist health in Little Rock 800+ beds/biggest Hospital in AR), with a good fair share of outpatient and inpatient education. A lot of them are at UAMS residency programs and rotation sites (so we rotate with MD students at some sites). Unity health in Searcy also just recently became one of our main GME partners with well-established residency spots in IM, FM, EM and Psych protected for our school.

 

[Chibucks15]

There's a fine line. I have a good rotation year where I'm essentially an intern, but I've been assisting/observing on all sorts of procedures that I would've been the one performing them if there was less of us. I'm usually at least 4th to 5th in line behind fellows/residents/auditioning students.

1 on 1 time you learn a bunch on how to actually do things, and unless you're socially inept or your residents suck it isn't that hard to fit into a team within a day or so. I don't understand where this idea where everyone needs a ton of experience is this came from. Be a decent human and it isn't difficult.

Everything about this always gets blown out of proportion, there are positives and negatives to both. Ideally you get mostly ward based with some preceptorships in FM, etc. Obviously it depends on what you're planning on pursuing. Being part of a resident team isn't super useful if all you want is a small community program, actually learning how to do things is. Being completely outpatient is not good, but if you have a mix of stuff that isn't bad.

To each their own, but the absolutism is a little stale

 

[Schwifty]

I hate to break it to you but rotations where only 4 weeks are on a preceptorship at a hospital that also happens to have residents isn't really the definition of "kicking ass."

It's not zebras you're missing out on. It's learning how to function as an intern as part of a medical team.

What exactly makes a rotation site good vs bad? I know i’ll have to ask 3rd and 4th year’s at my school about our sites specifically, but what are like the general characteristics of a good site?

 

[NecFasc92]

I hate to break it to you but rotations where only 4 weeks are on a preceptorship at a hospital that also happens to have residents isn't really the definition of "kicking ass."

It's not zebras you're missing out on. It's learning how to function as an intern as part of a medical team.

Ya but how many does someone really need? I learned how to function as an intern after a couple of weeks during third year at the big house. Weeks 6...10... etc didn’t change that. I think, personally, a mix of resident/ no resident is the best, as I 100% learned more last year without residents

 

[AnatomyGrey12]

What exactly makes a rotation site good vs bad? I know i’ll have to ask 3rd and 4th year’s at my school about our sites specifically, but what are like the general characteristics of a good site?

This will vary a lot depending on the rotation but I think a good rotation is one where you present on all your patients, get pimped (in an educational way), get to be involved (or at least they pretend to let you) with the decision making and are an active part of the team. If you get to physically do some stuff great, but honestly that is a secondary consideration.

Now this isn't to say that just because a rotation is a preceptorship it's a bad one, but I think a good clinical education needs a healthy mix of resident teams with some preceptorship 1 on 1.

Ya but how many does someone really need? I learned how to function as an intern after a couple of weeks during third year at the big house. Weeks 6...10... etc didn’t change that. I think, personally, a mix of resident/ no resident is the best, as I 100% learned more last year without residents

I agree, I think a mix is the best as well. However someone definitely needs more than "one preceptorship at a hospital with residents." I honestly think it's embarrassing that there are DO schools where a lot of their students don't have a wards/resident based IM rotation, or at least have the option for it. In an ideal world I think medical students would have a wards based surgery and IM rotations, and then stuff like FM/Peds/Psych would be a mix of both.

 

[Sardonix]

IDK if it's just my school (newer DO school), but our rotations kick absolute ass. Some big cities, some rurals. You got to pick (for the most part) which location you wanted out of a list of 30+. Always 1 on 1 with preceptors. There are some drawbacks, like most locations don't have residency programs at the hospital, but that is also a benefit in that the preceptors treat you like a resident instead of 3rd year being glorified observing. Our school is requiring one month of the year to be at a preceptorship with residents, at least.

My class universally agrees we are learning a ton. We may miss out on some of the Zebra's at huge academic centers, but I think it's a fair tradeoff for the awesome hands-on training we are receiving.

Of course, there's stupid stuff from the school, too. Like making us do one month of hospice and one month of rural med (glorified OMM rotation, basically).

While I agree with some of the criticisms mentioned by commenters above, I will say you will go far with your attitude and keep looking on the bright side.

 

[Toxin066]

Unity health in Searcy also just recently became one of our main GME partners with well-established residency spots in IM, FM, EM and Psych protected for our school.

This is news to me, because the last 2 years Unity Health has taken fewer and fewer DOs. Only 1 DO in the 2018-19 class, and I don't think there's any in the 19-20 class (spits in the face of the "former DO programs are going to continue to take DOs...). But if they JUST became your partners, hopefully this'll change!

 

[DrStephenStrange]

This is news to me, because the last 2 years Unity Health has taken fewer and fewer DOs. Only 1 DO in the 2018-19 class, and I don't think there's any in the 19-20 class (spits in the face of the "former DO programs are going to continue to take DOs...). But if they JUST became your partners, hopefully this'll change!

Yeah, this happened in February, and the contract became effective July 1st. They were already a clinical rotation site for us, but the new contract added the protected residency spots part.

Osteopathic College partners with Searcy’s Unity Health on residency program - Talk Business & Politics

A new partnership between the Arkansas College of Osteopathic Medicine (ARCOM) and Searcy-based Unity Health will allow medical school graduates residency programs as well as offer training opportunities for the...

talkbusiness.net

 

[Dr. Death]

I'm on my 15th rotation of medical school. 14 at your typical or above average DO sites. My school has it's own hospital with residents. I've also done several preceptor based rotations. My current rotation is a sub-i at a large academic center out of state affiliated with an MD school. It is night and day. The teaching, learning and pathology are a complete 180 from everything I've seen at my school. I have no interest in going back for my final 7 rotations.