DO Urology Competitiveness

[amccague]

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Im a 3rd year and just got my COMLEX scores back.
Im curious if i have any chances with Uro.
Can anyone make any generalizations about good COMLEX, what sort of extra curricular get peoples attention etc.
Thanks alot.

 

[Dr JPH]

There are only 7 Osteopathic Urology residencies in the country. I believe there are fewer than 20 spots total...perhaps less.

 

[amccague]

Any word on average COMLEX or GPA of accepted students?

 

[Kannen1979]

I was told by several programs directors/residents that a score of around 85 is what they're looking for. A good step II or other strong portions to your file can still get you an interview if you're not quite there, although there are fewer programs, they seem to be a little less hard core about the scores than the allopathic folks.

If you apply to allopathic programs, ask around to find out which ones have taken DO's in the past, there are only a few that are DO friendly, U of I is one, don't know about any others.

--A fellow future DO urologist

 

[Richie Truxillo]

Right there with ya Amccague. I am planning on taking Step II early and doing well. I also recently finished a urology rotation and did well with it. It pretty much solidified my interest in the field over other specialties. I am not quite sure about which allopathic programs are DO friendly. I imagine you won't know until you interview and speak to the staff at each hospital.

From what I have been told so far, urology programs really use your urology rotation comments and grade as a benchmark for performance. So do well in your urology rotations. I am setting up a sub-I in urology in the beginning of my 4th year to continue my pursuit of a residency slot somewhere.

I don't have any statistics of average GPA or COMLEX scores but if I come across any numbers I will post them.

Anyway, my best to all of ya 😉 See you out there on the interview trail this fall!

-Richie

 

[Yosh]

I think you guys are right...DO urology is really comeptitive....but with the right determination...and more importantly....CONNECTIONS...the best thing you can do is rotate at programs and get to know the residents and PD's..

It worked for me..and now 1 month shy of finishing my Gen Sx year...and start Urology July 1

Can't wait!!!!!!!!!

 

[Richie Truxillo]

Glad to hear it Yosh! 🙂 I'm going for the DO slots this year. Going to be doing some urology rotations starting in august-november. For now it's studying for boards so I can shine. My step I COMLEX wasn't stellar so I'm hoping to lay the smack down on Step II.

 

[Ratch]

there are very few programs, it is competitive. if you have plans to attempt allo urology then you need to be sure to go to a large program early in the cycle (july or august would be best) and get a letter from the chairperson. that was my experience with allo uro. i ended up getting a very good letter but it wasn't until october or so which was far too late to make a difference in getting more allo interviews. you also need to research the DO uro programs, as not every program takes someone every year, some have delayed acceptances (only take you as a pgy-2 after you have 2 years of general under your belt), some programs are a consortium of hospitals where each takes a resident a different year, some expect you to find your own general surgery training, etc. its a lot of work to figure it all out (at least here in michigan). call the programs and find the coordinator or a resident or anyone who can point you in the right direction. alot of this only applies to the MSU programs, but i know the philly program was hard to get ahold of for information as well. good luck!

 

[Yosh]

The best thing you can do is rotate early at the programs, like Ratch said...I spent my MSIII year at Botsford in MI and then my 1st six months of MS IV spent doing urology auditions,the 1st two being at an academic allopathic university doing research in Urology/sub-I which was intense..
I went to and did Sub-I's at CCOM, PCOM, (MSU durning 3rd year)...sadly was never able to get in touch with anyone from UMDNJ for two years..so just wrote them off...

In the end...I was published in two Lippencott books, and happily matched into urology.

The one thing to be VERY aware and conscious of regarding Allopathic urology, aside from the DO stigma and ultra-competitiveness...is that most MD Urology programs literally have one spot...some have two..and for the schools to A)bypass their own MS IV's who have been gunning for urology, B) by pass other MD candidates is sadly unlikely to happen...reason being is most programs petition for an extra spot..and if they offer their one spot to a DO...they will unlikely be given a second slot by the AUA...politics...but it sucks.

I had an excellent rwo months at my MD urology program..and really loved the program..the residents and attendings were excellent..and I still keep in touch with them...but being they have only one spot a year...and they have alum applying for a spot, and have been working with these attendings for potentially all four years of med school...my two month audition earned me an AMAZING LOR..and the PD actually went to bat and spoke to DO urology program PD's and really took care of me...along with the publications..

Bottom line is shoot for the stars...but have solid back up and work like hell..

I did it..and am glad I did...

Hope this was helpful....

 

[Richie Truxillo]

Thanks for the advice 🙂 I am currently trying to setup another urology rotation for september at one of my top choices. I figured I'd drive up there and try to speak with the program director face to face. Might have a better shot at getting a rotation slot that way.

Gotta run, back to work I go!

 

[beastmaster]

Thanks for the advice 🙂 I am currently trying to setup another urology rotation for september at one of my top choices. I figured I'd drive up there and try to speak with the program director face to face. Might have a better shot at getting a rotation slot that way.

Speaking of this. If there is a surplus of students applying for a competitive 4th year audition rotation during prime season, how do they decide who gets to rotate? Do they ask for CVs to help make that decision? An interview for a rotation seems a bit much.

 

[Richie Truxillo]

It's not a formal interview. The hospital is associated with a university system and I do not know anyone there. Alot of my friends are rotating at the institution and I have heard that there are many people wanting to do a urology rotation there. Preference usually goes to students already affiliated with the hospital. Since I imagine that most phone calls are screened out, I figured asking in person would be the way to go. Assertive? Yes, but that way I can get a yes or no answer up front. Worse case scenario? I get to see my friends and help them study for their OB/GYN shelf exam (while getting a refresher for step II myself). Best case scenario, I get a urology rotation setup at a place I am considering to do residency at while becoming a smidgen more familiar with the staff and inner workings of the hospital. Nothing is worse than that first day of not knowing where anything is at or how the system works.

As for screening out candidates...I don't really have an answer for you there. I would imagine that would have to be answered by a site coordinator.

Ok off I go! Good luck

 

[misery]

What about DO's going to MD programs. What kind of USMLE does that take. Etc.

 

[Richie Truxillo]

Sorry for the late reply. Doing my audition urology rotations right now so been getting up at 4:30am for rounds everyday to shine.

For Allo Urology, you are going to need a USMLE above 220+ to stay competitive as there are alot of applicants for a handful of spots. Apply very early in the cycle too and get a strong letter from your urology faculty.

Best of luck out there.

Ok need to go back and study so I can live my pee soaked urology dream.

 

[Yosh]

Now with DO GU residency being reduced to 5 years, instead of 6, and having a linkage straight through....its going to be interesting to see what happens application-wise...

Gonna be interesting.....

 

[Doc34]

IM a 3rd yeat at NSUCOM. We do not have a urology program down here, in fact there are only 2 DO urologists that I know of in south florida. I don't have the budget to do so many urolgy away rotations, so i have to pick one away and the only thing local I have is University of Miami and I am not sure they will take DOs.

Should I go to ST. James, Cook County, PCOM, or UMDNJ?

I have no connections anywhere, no research because I just got interested in the field last week, and 85 comlex with a 85.8 GPA.(USMLE 204/84)

Any shot at allopathic or osteopathic?

 

[Richie Truxillo]

Just finished all of my urology rotations (4 to be exact) and have decided I'd rather go into another specialty. My best to all of you urology applicants.

My advice? Rotate in urology somewhere and involve yourself in some research at that place. Be as visible as possible without being annoying! Be assertive in showing your interest at a program.

I got to do some neat stuff on my uro rotations. I loved endoscopic procedures but didn't really enjoy some of the longer uro procedures like ileal loop urinary diversions and slings. I managed to get a published article on a renal trauma case study during my time so it was not time wasted.

Score as high as you can on your boards and remember, never lose hope 🙂 For you DO applicants for 2008 match, I've freed up 4 spots for ya since I have not ranked any programs! My best to everyone!

-Richie

 

[beastmaster]

well don't keep us in suspense, Rich, why did did you change your mind, and what's the "other specialty" ????

 

[Richie Truxillo]

Well a number of reasons:

#1: Getting married: As malignant as a surgical residency can be, I was prepared to plow through it on my own. Now that I am getting married on March 29th, I've learned I have to consider someone else other than myself in my career plans. I know that urology will have some long hours associated with it.

#2: My sewing ability: I have good hand-eye coordination and a steady hand. I can drive a scope like it was an xbox controller. I can blast a stone with a laser fiber. However, I suck at tying knots in tight spaces. I realize this is something that would get better with practice but the realization came to me when trying to throw some stitches during a pyeloplasty. I just have issues when tying surgical knots, especially the one handed ones.

#3: My draw towards medicine: I've been reprimanded more than once for writing Internal Medicine length notes on a handful of surgical patients. I know, my bad, but that's what it is all about...finding what drives me more. Don't get me wrong, I love procedures but I think I like the thought process behind patient care more. Thinking IM with a fellowship in either GI, Endocrine, ID, or Oncology.

#4: About 3 weeks ago, when I was feeling unsure about my career choice, I prayed that a door would open wide or God would slam it shut on urology. I became increasingly disinterested over the next week. I flat out asked the PD if I had a shot and was told that I was one of 3 candidates to interview and was told I was ranked #2 for a 1 slot program. That was the final decision maker for me.

#5: After making this decision, I can actually sleep easy at night again! I would toss and turn wondering if I made the right decision but I feel more at peace now. I realize I decided to go into urology originally based on the fact that all of my previous medical experience was working with urologists. Kind of a comfort thing.

Now my advice to you all future colleagues and urologists. Figure out that you want to do urology ASAP in your 3rd year...heck even your 2nd. Score high on USMLE/COMLEX Step I/II. Find as many urologists as possible as connections to one particular program you want to goto. Spend as much time as possible there in 3rd/4th year doing research projects and getting in face time. Do research at that program (and don't let others steal it 😱). Express interest to the PD!

Above all though, I believe it comes down to face time. At least that was what was explained to me at my #1 pick.

It's a shame we can't have more time to pick a specialty in our clinical years. However, be swift and strike fast 😉 . You future urologists have my utmost respect!

See you on the flip side and rest assured that if you get a consult request from me, I know what I'm doing and I promise it won't be something that wastes your time.

Much love,
Richie

 

[Yosh]

Wow...I have been curious to see what program you would have ended up in, but your post was really well done...

I respect your reasons, and wish you the best....It takes a strong person to realize what they really want and need, and to make that decision is tough...

Congrats on the wedding, eh?

 

[drivesmecraazee]

Well a number of reasons:

#1: Getting married: As malignant as a surgical residency can be, I was prepared to plow through it on my own. Now that I am getting married on March 29th, I've learned I have to consider someone else other than myself in my career plans. I know that urology will have some long hours associated with it.

#2: My sewing ability: I have good hand-eye coordination and a steady hand. I can drive a scope like it was an xbox controller. I can blast a stone with a laser fiber. However, I suck at tying knots in tight spaces. I realize this is something that would get better with practice but the realization came to me when trying to throw some stitches during a pyeloplasty. I just have issues when tying surgical knots, especially the one handed ones.

#3: My draw towards medicine: I've been reprimanded more than once for writing Internal Medicine length notes on a handful of surgical patients. I know, my bad, but that's what it is all about...finding what drives me more. Don't get me wrong, I love procedures but I think I like the thought process behind patient care more. Thinking IM with a fellowship in either GI, Endocrine, ID, or Oncology.

#4: About 3 weeks ago, when I was feeling unsure about my career choice, I prayed that a door would open wide or God would slam it shut on urology. I became increasingly disinterested over the next week. I flat out asked the PD if I had a shot and was told that I was one of 3 candidates to interview and was told I was ranked #2 for a 1 slot program. That was the final decision maker for me.

#5: After making this decision, I can actually sleep easy at night again! I would toss and turn wondering if I made the right decision but I feel more at peace now. I realize I decided to go into urology originally based on the fact that all of my previous medical experience was working with urologists. Kind of a comfort thing.

Now my advice to you all future colleagues and urologists. Figure out that you want to do urology ASAP in your 3rd year...heck even your 2nd. Score high on USMLE/COMLEX Step I/II. Find as many urologists as possible as connections to one particular program you want to goto. Spend as much time as possible there in 3rd/4th year doing research projects and getting in face time. Do research at that program (and don't let others steal it 😱). Express interest to the PD!

Above all though, I believe it comes down to face time. At least that was what was explained to me at my #1 pick.

It's a shame we can't have more time to pick a specialty in our clinical years. However, be swift and strike fast 😉 . You future urologists have my utmost respect!

See you on the flip side and rest assured that if you get a consult request from me, I know what I'm doing and I promise it won't be something that wastes your time.

Much love,
Richie

a stone? like the ones you find in the blatter?
lol...just kidding?

 

[Richie Truxillo]

a stone? like the ones you find in the blatter?
lol...just kidding?

*shoots you a confused look*

Read this one 3 times and don't get it. If you are poking fun at me, explain so I can play too! Was speaking of ureteral stones and bladder stones but still racking my brain on this one. A lil' help here 😛

 

[drivesmecraazee]

*shoots you a confused look*

Read this one 3 times and don't get it. If you are poking fun at me, explain so I can play too! Was speaking of ureteral stones and bladder stones but still racking my brain on this one. A lil' help here 😛

Nooo dude, Im not trying to make fun at you. It's just that when you said that you could "blast a stone with a laser fiber" sounded like super hero skills, you know, I just pictured you in my head in a space suit blasting lasers all over the place and destroying huge rocks, like the X Men cartoon. That's why I asked you such an obvious question, cuz if the answer was something else, it sould be something completly crazy, out of this world.

Im sorry, my sense of humor's kinda weird...but hey, fine with me, I laugh a lot at my own toughts.

P.d: Excuse my spelling mistakes, english isn't my mother tongue.

 

[drivesmecraazee]

like I tryied to indulge you into a sarcastic answer...I guess that would be the joke...🙂

 

[felipe5]

.... blasting lasers all over the place and destroying huge rocks, .

basically when you're doing stone stuff (endoscopically) these things really do look like huge-@ss boulders man....and nothing is cooler than the argon laser, straight out of star wars mang....seriously urology is the ****


sorry we lost you there richie, best of luck w/ your career in medicine!

<shudders at thinking of 8 hour rounds>

 

[Richie Truxillo]

yeah they do look like boulders and then you back your ureteroscope out and there is just a tiny piece of gravel. As a past kidney stone sufferer, the first time I saw this I was like WTF!?!?! 😱

However, "TURP Gravy" (My special name for chunks of prostate) always looks like it does on the screen though 😛

Part of me will miss it, don't get me wrong, but I just think I was just wasn't meant for a surgical specialty now. Still though, I will always agree with ya, urology is the ****! You get the best toys to play with and you are the reason you get the Da Vinci robots and shiny new HD monitors for scoping!

like I tryied to indulge you into a sarcastic answer...I guess that would be the joke...

Not a problem, I just kept reading it and going "Did I misspell something" but looking back it does seem a little silly. Reminds me of that "Sharks with fricken laser beams" comment from Dr. Evil in Austin Powers

Ok, gotta pack for another residency interview, flight leaves in 4 hours

-Richie

 

[drivesmecraazee]

Man those procedures seem frickin' awesome!!
Im not sure what I like the most between ENT and Urology, I think both have a nice balance between medicine and surgery, but the clinical part seems cooler in urology...the only thing that makes me thing twice about choosing urology is the obligation to do prostates exams and seeing/touching other dude's privates, I know this sounds a little bit imature but I guess we all feel a little bit uncomftable about this in a certain time of our carrer ¿right? How do you guys manage that?? Just curious.

Congrats to the future residents.

 

[drivesmecraazee]

hope my last post didn't offend anyone, I am aware of how childish it is, I was just being honest

 

[Natsam]

I have found most students who give up on pursuing a given residency is that they realize that their chances are slim and do not wish to wait for rejection. I think all your (Richie) other reasons for choosing a so-called 'cerebral' specialty is rationalizing. If you think for one second that an IM or FP does more thinking than a surgeon you obviously have no idea! I know for certain that most surgeons did not graduate at the bottom of their classes and if you think taking care of critically ill post-operative patients is done by internists you have less a clue than i thought. If you want to care for chronic conditions/pts. then go ahead with your cerebral specialty, i went into urology because i enjoy instant gratification, cool procedures,and the ability to make a difference.
Also, I am curious what residents/residency program/hospital allowed a MS4 to perform UScope and tie an anastomosis for a pyeloplasty, unless you were tying on the closure which I can then understand. Most times the students retract and help close the wound. I just find it very amusing the comments left here and the presumptive tone taken by some of the posting members.

 

[rubberducky24]

What sort of percentile do you think as a baseline one should have to be "competitive" for urology. I realize there aren't many spots and that i have to do well on rotations, and be friendly etc. etc....but as a guideline does anyone have a suggestion as to what comlex i should have?

Also do you know if programs look at the USMLE?

 

[DOCTORSAIB]

I just find it very amusing the comments left here and the presumptive tone taken by some of the posting members.

Really? I didn't notice any presumptive tone on here. Could Richie be rationalizing? Sure. But who cares as long as he's happy.

Why are you getting your panties in a bunch?

What sort of percentile do you think as a baseline one should have to be "competitive" for urology. I realize there aren't many spots and that i have to do well on rotations, and be friendly etc. etc....but as a guideline does anyone have a suggestion as to what comlex i should have?

Also do you know if programs look at the USMLE?

I'm not a urologist but I've heard 600+ thrown around a lot. Clearly, audition rotations are key to matching.

No, DO programs do not look at the USMLE. Why would they? Common sense man!

G'luck.

 

[tejada234]

I've got a 591 on step 1....am I SOL??? I have no research background or anything like that. top 1/3 of class

 

[Osteopathology]

591, your not SOL. Just take step II early, do well. Showcase at some of the places you want to go.

Shouldnt be too killer -- people want people they can work with a lot more than they want 9 more pts on the COMLEX.

 

[exmike]

Sorry for the late reply. Doing my audition urology rotations right now so been getting up at 4:30am for rounds everyday to shine.

For Allo Urology, you are going to need a USMLE above 220+ to stay competitive as there are alot of applicants for a handful of spots. Apply very early in the cycle too and get a strong letter from your urology faculty.

Best of luck out there.

Ok need to go back and study so I can live my pee soaked urology dream.

The median Step 1 for allopathic urology is mid to upper 230's. 220 is not 'competitive'

 

[Richie Truxillo]

Just some general stuff first:

DO programs don't look at USMLE scores just COMLEX scores, so do well on COMLEX if you can. Don't forget to study sacral/cranial OMT for that thing. Savarese (the big OMT Review green book) is the book of choice for that section.

As for board score competitiveness, just do the best you can on USMLE and shoot for above whatever number is considered "above average" this year.

I believe audition rotations are *THE* key to matching uro regardless of board scores. Set them up early and go for it! 👍

As for rectal/genital exams: You get used to it. You do them in medicine also. If I don't do a rectal on someone who hasn't had one in awhile or is anemic, I'm not doing my job.
====================================================
As an aside.

Wow didn't realize this would start a mini flame war, of course I've gotten some correspondence from some friends I used to see at AUA meetings baffled by my decision. To each their own I guess.

As for the comment regarding the pyeloplasty, I didn't get the chance to reanastamose the ureter to the renal pelvis because I lacked the manual dexterity to do the fine suturing required. The senior resident ended up doing that and did a darn good job of doing so. Kinda shocked and scared the heck out of me also, but maybe they were rattling my cage to see if I had nerve. Who knows.

Let's get this straight now. Holy smokes, I'm not belittling surgical fields at all. It takes a hell of a lot of personal sacrifice to survive a 5 year surgical residency and if you have the motive and drive to go for it, I say go for it. Looking back at everything the past few months, I am definitely happy with my decision. My life is different now than it was in my 3rd year when I was single and driven to do whatever it took no matter the cost. Starting a family changed things for me personally, which may or may not for you.

Medicine and surgery are definitely two different worlds. But what it comes down to is what you are exposed to on a regular basis and how much you read about things you aren't exposed to. I could tell stories about a urology PD who didn't know how to work up a GI bleed or medicine attendings who couldn't work up an acute abdomen, but it just doesn't matter. I realize I could be in one of those situations myself someday due to getting academic "tunnel vision" but all I can do is try my best to read daily and continue lifelong learning. All that matters in the long run is that we work together as a team for the good of our patients.

So regardless, you can write me off as just a "bottom-feeding unintelligent Family Medicine doc" or understand why I pulled the plug on all surgical programs (not just uro) the day before the DO match. What is done is done. All I want to do is encourage people who want to do urology to keep on going. I've got nothing to hide, hence why I use my real name on the forums. Re-reading my post, I don't know how I could have been more honest and down-to-earth about things. I guess you can read into everything on the ole internet. 😉

Urology is a fun field with lots of procedures, good money and a decent lifestyle once you get past residency. You also get to work with urological colleagues with alot of personality who are generally fun individuals. If you want it bad enough, go for it I say.

To all of the urologists I met during my years traveling to AUA meetings while developing vascenter.com and urostonecenter.com, thanks for your friendship and support. I'm truly glad I went to medical school. Hope you continue to receive patient referrals thru my previous efforts.

Blast a bladder stone for me, mmmkay? 🙂

 

[drivesmecraazee]

Just some general stuff first:

DO programs don't look at USMLE scores just COMLEX scores, so do well on COMLEX if you can. Don't forget to study sacral/cranial OMT for that thing. Savarese (the big OMT Review green book) is the book of choice for that section.

As for board score competitiveness, just do the best you can on USMLE and shoot for above whatever number is considered "above average" this year.

I believe audition rotations are *THE* key to matching uro regardless of board scores. Set them up early and go for it! 👍

As for rectal/genital exams: You get used to it. You do them in medicine also. If I don't do a rectal on someone who hasn't had one in awhile or is anemic, I'm not doing my job.
====================================================
As an aside.

Wow didn't realize this would start a mini flame war, of course I've gotten some correspondence from some friends I used to see at AUA meetings baffled by my decision. To each their own I guess.

As for the comment regarding the pyeloplasty, I didn't get the chance to reanastamose the ureter to the renal pelvis because I lacked the manual dexterity to do the fine suturing required. The senior resident ended up doing that and did a darn good job of doing so. Kinda shocked and scared the heck out of me also, but maybe they were rattling my cage to see if I had nerve. Who knows.

Let's get this straight now. Holy smokes, I'm not belittling surgical fields at all. It takes a hell of a lot of personal sacrifice to survive a 5 year surgical residency and if you have the motive and drive to go for it, I say go for it. Looking back at everything the past few months, I am definitely happy with my decision. My life is different now than it was in my 3rd year when I was single and driven to do whatever it took no matter the cost. Starting a family changed things for me personally, which may or may not for you.

Medicine and surgery are definitely two different worlds. But what it comes down to is what you are exposed to on a regular basis and how much you read about things you aren't exposed to. I could tell stories about a urology PD who didn't know how to work up a GI bleed or medicine attendings who couldn't work up an acute abdomen, but it just doesn't matter. I realize I could be in one of those situations myself someday due to getting academic "tunnel vision" but all I can do is try my best to read daily and continue lifelong learning. All that matters in the long run is that we work together as a team for the good of our patients.

So regardless, you can write me off as just a "bottom-feeding unintelligent Family Medicine doc" or understand why I pulled the plug on all surgical programs (not just uro) the day before the DO match. What is done is done. All I want to do is encourage people who want to do urology to keep on going. I've got nothing to hide, hence why I use my real name on the forums. Re-reading my post, I don't know how I could have been more honest and down-to-earth about things. I guess you can read into everything on the ole internet. 😉

Urology is a fun field with lots of procedures, good money and a decent lifestyle once you get past residency. You also get to work with urological colleagues with alot of personality who are generally fun individuals. If you want it bad enough, go for it I say.

To all of the urologists I met during my years traveling to AUA meetings while developing vascenter.com and urostonecenter.com, thanks for your friendship and support. I'm truly glad I went to medical school. Hope you continue to receive patient referrals thru my previous efforts.

Blast a bladder stone for me, mmmkay? 🙂

Well said 🙂. Wish you the best in your future, good luck!! 👍👍👍