DO vs FMG for Gen Surgery Residency

rafman

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    First of all, I want to apologize for the misleading title, this isn't a pointless "which is better: DO or Carribean" Thread

    I just wanted to know who has a better chance of getting an ACGME General Surgery Residency, a DO applicant or an FMG from a legitimate foreign medical school (eg. from Europe or India, not the Carribeans)? I was looking at some of the residents at mid to low tier ACGME general surgery residencies, and there seems to be many FMGs (from Poland, England, Germany, India, etc.), but I couldn't find that many DO's. Again, I hope this is a legitimate question!
     

    Oxer45

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      First of all, I want to apologize for the misleading title, this isn't a pointless "which is better: DO or Carribean" Thread

      I just wanted to know who has a better chance of getting an ACGME General Surgery Residency, a DO applicant or an FMG from a legitimate foreign medical school (eg. from Europe or India, not the Carribeans)? I was looking at some of the residents at mid to low tier ACGME general surgery residencies, and there seems to be many FMGs (from Poland, England, Germany, India, etc.), but I couldn't find that many DO's. Again, I hope this is a legitimate question!

      I'm a DO going into gen surg. First DO's have their own osteopathic gen surg residency. So majority of DO's go into osteopathic residency for the following reasons: (1) You can get most surg fellowships (except for peds) with a DO residency. DO's also have their own fellowships as well in areas like Plastics (2) you dont have to worry about getting your intern yr approved by AOA. (3) DO match occurs before MD match, so to go for MD residency, you have to give up DO match. A risk most people don't want to take, unless you're sure you will match into a good place in MD match. So you wont see a lot of DOs in MD (ACGEM) surgery residency. In my school out of ~10 going into gen surg, 8 went DO, 2 went to MD.

      Now is getting into a ACGEM residency easier as a DO vs FMG/IMG? Yes, for a verity of reasons, but most importantly DO students are seen as similar to other US medical students. Our preclinical education, clinical rotations, are same as any MD school, and many of us take usmle as well.

      Btw, FMG's have a harder time getting a surg res than Crib students.
       

      Whiskeypunch

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        The access to DO only general surgery residencies is a hugely important factor.

        Assuming nothing increases the number of ACGME residency slots in the next 3-4 years, the competition is going to be absolutely brutal given the increase in medical school matriculants.
         
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        Oxer45

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          The access to DO only general surgery residencies is a hugely important factor.

          Assuming nothing increases the number of ACGME residency slots in the next 3-4 years, the competition is going to be absolutely brutal given the increase in medical school matriculants.

          Although at this point its pure speculation, I think residency slots will increase. It doesnt make sense to have less slots when there's apparently a doctor shortage. Obviously fields like derm have an interest in controlling # of residents per year. But when you have medical students (US MD's) who cant get residency, then govt will fund more slots. But then again medicine may become like law is today. This is why I'm a big supporter of DO's having their own residency and fellowships. Ideally DO world should have enough residency slots for all its graduates.
           

          rafman

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            Thanks for the insight! I was asking because I would like to return to TX for my residency and there's only 1 Gen Surgery OPTI in the entire state. I guess beggars can't be choosers.
             

            Instatewaiter

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              First of all, I want to apologize for the misleading title, this isn't a pointless "which is better: DO or Carribean" Thread

              I just wanted to know who has a better chance of getting an ACGME General Surgery Residency, a DO applicant or an FMG from a legitimate foreign medical school (eg. from Europe or India, not the Carribeans)? I was looking at some of the residents at mid to low tier ACGME general surgery residencies, and there seems to be many FMGs (from Poland, England, Germany, India, etc.), but I couldn't find that many DO's. Again, I hope this is a legitimate question!

              Depends on where the FMG is from:
              FMG from western europe (UK, Germany, france) > DO > FMG from india/Carribean/non-western european countries

              A risk most people don't want to take, unless you're sure you will match into a good place in MD match. So you wont see a lot of DOs in MD (ACGEM) surgery residency. In my school out of ~10 going into gen surg, 8 went DO, 2 went to MD.

              Now is getting into a ACGEM residency easier as a DO vs FMG/IMG? Yes, for a verity of reasons, but most importantly DO students are seen as similar to other US medical students. Our preclinical education, clinical rotations, are same as any MD school, and many of us take usmle as well.

              Btw, FMG's have a harder time getting a surg res than Crib students.

              *ACGME. If you can't spell it, you probably don't know what you are talking about... Just sayin'

              Although at this point its pure speculation, I think residency slots will increase. It doesnt make sense to have less slots when there's apparently a doctor shortage. Obviously fields like derm have an interest in controlling # of residents per year. But when you have medical students (US MD's) who cant get residency, then govt will fund more slots. But then again medicine may become like law is today. This is why I'm a big supporter of DO's having their own residency and fellowships. Ideally DO world should have enough residency slots for all its graduates.

              Since there has been a looming "doctor shortage" for decades and the gov't hasn't increased residency funding, don't expect them to add residency slots- at least for a while. Funding hasn't changed since 1997. It's tied to medicare and given the ****-show that is gov't funded healthcare at this point, they're not going to put more money into residency slots when they're tryihng to cut costs.
               

              jumpmanv15

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                I'm a DO going into gen surg. First DO's have their own osteopathic gen surg residency. So majority of DO's go into osteopathic residency for the following reasons: (1) You can get most surg fellowships (except for peds) with a DO residency. DO's also have their own fellowships as well in areas like Plastics (2) you dont have to worry about getting your intern yr approved by AOA. (3) DO match occurs before MD match, so to go for MD residency, you have to give up DO match. A risk most people don't want to take, unless you're sure you will match into a good place in MD match. So you wont see a lot of DOs in MD (ACGEM) surgery residency. In my school out of ~10 going into gen surg, 8 went DO, 2 went to MD.

                Now is getting into a ACGEM residency easier as a DO vs FMG/IMG? Yes, for a verity of reasons, but most importantly DO students are seen as similar to other US medical students. Our preclinical education, clinical rotations, are same as any MD school, and many of us take usmle as well.

                Btw, FMG's have a harder time getting a surg res than Crib students.

                You can only apply thru one match as a DO student?
                 

                donkeykong1

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                  Depends on where the FMG is from:
                  FMG from western europe (UK, Germany, france) > DO > FMG from india/Carribean/non-western european countries



                  *ACGME. If you can't spell it, you probably don't know what you are talking about... Just sayin'



                  Since there has been a looming "doctor shortage" for decades and the gov't hasn't increased residency funding, don't expect them to add residency slots- at least for a while. Funding hasn't changed since 1997. It's tied to medicare and given the ****-show that is gov't funded healthcare at this point, they're not going to put more money into residency slots when they're tryihng to cut costs.

                  got stats?
                   

                  rafman

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                    I presumed DOs might have an advantage over the western European FMGs, if USMLE scores, gpa, and research are the same between the two candidates. I mean the DO students would be more proficient in English and the hospital won't have to go through the hassle of acquiring work visas and such.
                     
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                    Oxer45

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                      You can only apply thru one match as a DO student?

                      No, you can apply to both matches (AOA (DO) and NRMP (MD)). The results of DO match occur before MD match, so if you match into a DO residency, you are automatically taken out of the MD match. So if you want to match into an allopathic (MD) residency, you'd have to sit out for the DO match.

                      *ACGEM is a typo.
                       

                      Oxer45

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                        Did someone just say they expect an increase in residency slots? They're gonna build Newt's moon base too!

                        Yes. Soon the number of US MD grads will equal total residency spots (I think by 2016). When you have students who went to 4 yrs of med school not being able to find residency, all hell will break loose. (see law students suing their own schools + writing op eds, etc).
                         

                        Dharma

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                          Yes. Soon the number of US MD grads will equal total residency spots (I think by 2016). When you have students who went to 4 yrs of med school not being able to find residency, all hell will break loose. (see law students suing their own schools + writing op eds, etc).

                          If I remember correctly the number of US MD/DO grades will be coming close to total residency spots, not MD alone. They get into it a bit here:

                          http://forums.studentdoctor.net/showthread.php?t=880154

                          I think there are a few more threads were they get into the numbers. Regardless, in today's political climate, I am very skeptical that there will be a significant increase in GME positions without major changes in funding (e.g. salaries that already low, dropping lower, and/or hospitals covering more). That said, the current talk has been geared towards funding cuts. Who knows what will happen.

                          sorry for the thread derail there.
                           

                          donkeykong1

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                            Yes. Soon the number of US MD grads will equal total residency spots (I think by 2016). When you have students who went to 4 yrs of med school not being able to find residency, all hell will break loose. (see law students suing their own schools + writing op eds, etc).

                            Its the number of US MD+DO grads will equal the number of ACGME positions by 2016 at the current rate of expansion of schools. this is not counting the expansion of AOA residencies.
                             

                            docnotsopc

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                              I presumed DOs might have an advantage over the western European FMGs, if USMLE scores, gpa, and research are the same between the two candidates. I mean the DO students would be more proficient in English and the hospital won't have to go through the hassle of acquiring work visas and such.

                              You do know that in the UK they speak English right? And their english is actually more accurate and not butchered like it is in North America. Also many educated people in Germany and France can speak English surprisingly well

                              The visa thing is a HUGE hassle believe me, but not really on the end of the employer. Its more of a problem for the potential employee. It used to be tough for employers but the paper work has significantly decreased over the years
                               

                              DocEspana

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                                You do know that in the UK they speak English right? And their english is actually more accurate and not butchered like it is in North America. Also many educated people in Germany and France can speak English surprisingly well

                                The visa thing is a HUGE hassle believe me, but not really on the end of the employer. Its more of a problem for the potential employee. It used to be tough for employers but the paper work has significantly decreased over the years

                                Well that's like saying in a DocEspana look alike competition, I'd always finish first (unlike charlie chaplain, who finished third). I'd have an unfair advantage of actually *being* DocE. They only don't butcher the language because they actively create it. If the language is named after your country, you sort of can do any butchering you want to the language and it will, by definition, still be the pinnacle of the english langauge. :laugh:
                                 
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                                docnotsopc

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                                  Well of course it didn't sound right to you, you are american lol. Most other english speaking countries use phrases/slang that are more common in England than in the US though.

                                  Yes I have spent months and months surrounded by English people and many of my good friends are from there. I know what you mean haha depending where they are from at times they can sound like a rambling drunk! But this is no different than listening to people from the South :p

                                  Back the original topic, I do feel that graduating from an English medical school for example (or maybe Irish?) would be "better" than going to a Caribbean school (even top 4). There is less stigma attached to UK schools, so when someone quickly reads your application that split unconscious bias is less obvious. Honestly at times if I had to do it over, I would probably go to an English/ Australian MD/MBBS school. I loved the idea of DO schools when I started but it turned out I hate OMM and I get sick of explaining to people what a DO does as the term osteopath throws people off all the time. Maybe im just lazy? Also even my MD professors take jabs at DOs unintentionally, this gets annoying. I didnt think any of this would bug me when I started, hopefully it will go away when rotations start :)

                                  IF you are willing to do an AOA surgery than DO >>>> FMG. If you want to do ACGME surg, FMG slightly > DO. As an FMG you will have no OMM, wont have to write TWO board exams (no comlex) so you can focus on doing really well on the USMLE in my opinion. Thoughts?
                                   
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                                  DocEspana

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                                    Well of course it didn't sound right to you, you are american lol. Most other english speaking countries use phrases/slang that are more common in England than in the US though.

                                    Yes I have spent months and months surrounded by English people and many of my good friends are from there. I know what you mean haha depending where they are from at times they can sound like a rambling drunk! But this is no different than listening to people from the South :p

                                    Back the original topic, I do feel that graduating from an English medical school for example (or maybe Irish?) would be "better" than going to a Caribbean school (even top 4). There is less stigma attached to UK schools, so when someone quickly reads your application that split unconscious bias is less obvious. Honestly at times if I had to do it over, I would probably go to an English/ Australian MD/MBBS school. I loved the idea of DO schools when I started but it turned out I hate OMM and I get sick of explaining to people what a DO does as the term osteopath throws people off all the time. Maybe im just lazy? Also even my MD professors take jabs at DOs unintentionally, this gets annoying. I didnt think any of this would bug me when I started, hopefully it will go away when rotations start :)

                                    IF you are willing to do an AOA surgery than DO >>>> FMG. If you want to do ACGME surg, FMG slightly > DO. As an FMG you will have no OMM, wont have to write TWO board exams (no comlex) so you can focus on doing really well on the USMLE in my opinion. Thoughts?

                                    Well the first issue (actually only issue) that I have is that people pretty much seem to be misunderstanding the dynamics of western european schools (and australian). Ever wonder why US students don't just go to England? Or if they spoke spanish, Spain.This goes back to the 60's and 70's when the place to go if you couldnt go to an american school was Spain, Portugal, or France. These nations have since closed their doors to all but national students. AKA if you don't have a citizenship or a good claim to potential citizenship you can't go there. England, from what I understand, has a nearly identical rule but its slightly more forgiving. Ireland is pretty wide open IIRC.

                                    So why aren't people abusing England's loopholes and Irelands wide-open stance? Because British/Irish trained (and western european trained for that matter) graduates do not match into residencies. They don't. European trained *attendings* come over here. People with a few years of experience under their belt. There is no reason why european schools don't match here, as best as I can tell, but it's simply the trend. I'm sure there are some periods of obligated work or regulations I'm unaware of that absolutely prevent applying for US residency right out of UK/Ireland medical school, otherwise it would be very common.

                                    Generally speaking, you should always think of schools as "national" or "offshore". Offshore schools explicitly train you to return to the US. They are in Mexico, the Caribbean, Poland, and a few isolated Asian schools. If you are in a "national" medical school, as 99% of them in the world are, you stand the lowest chance of anyone to get a residency right out of graduation. I dont care how westernized and amazing the country is, it appears to be a regulation/obligation issue.

                                    All I know about Australia is I'm dating a girl who almost went there for med school and was told point blank by the australian schools that it is *absolutely not* a route back to the US and she has a long period of required practice in Australia after graduation before she can even consider a US residency.

                                    So with the functional elimination of all european and australian schools (because no one is arguing the chances of a tenured attending wishing to relocate to america), its DO > Top 4 >> any other IMG for ACGME spots. Someone has done the math on another thread (hockydoc?) and when you're measuring for categorical matches in ACGME we win narrowly (oh and then we also have AOA spots additionally)
                                     

                                    Instatewaiter

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                                      got stats?

                                      There are no data that compare Western European FMGs to DOs. There are no data that even talk about western europeans.


                                      So why aren't people abusing England's loopholes and Irelands wide-open stance? Because British/Irish trained (and western european trained for that matter) graduates do not match into residencies. They don't. European trained *attendings* come over here. People with a few years of experience under their belt. There is no reason why european schools don't match here, as best as I can tell, but it's simply the trend. I'm sure there are some periods of obligated work or regulations I'm unaware of that absolutely prevent applying for US residency right out of UK/Ireland medical school, otherwise it would be very common.

                                      You should tell that to our 2 current Irish residents...Also, we have had 3 residents in the last 4 years from Ireland/UK. There are western european residents in the surgical programs at my hospital, in Gen Surg at MGH and ortho at MGH (the only ones I looked into). There are a lot of irish and UK residents that come to this country but they are generally held in high enough regard that they go to good hospitals not crappy community programs. Those who think DO> European FMGs are waaaay off base.

                                      The problem (for US students) is that these schools are generally closed to foreigners, although where I went to med school, we did have a medicine resident who was American and did her training in England...
                                       

                                      donkeykong1

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                                        There are no data that compare Western European FMGs to DOs. There are no data that even talk about western europeans.




                                        You should tell that to our 2 current Irish residents...Also, we have had 3 residents in the last 4 years from Ireland/UK. There are western european residents in the surgical programs at my hospital, in Gen Surg at MGH and ortho at MGH (the only ones I looked into). There are a lot of irish and UK residents that come to this country but they are generally held in high enough regard that they go to good hospitals not crappy community programs. Those who think DO> European FMGs are waaaay off base.

                                        The problem (for US students) is that these schools are generally closed to foreigners, although where I went to med school, we did have a medicine resident who was American and did her training in England...

                                        Did these residents have any post-graduate training in their home countries before they gobbled up US pgy spots?
                                         

                                        Whiskeypunch

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                                          Trained FMG's seem like a real winner for academic powerhouse institutions. You get free labor that doesn't need to be supervised as closely, you don't have to teach them much, plus they probably have more experience doing research. Win, win, win?
                                           

                                          DocEspana

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                                            There are no data that compare Western European FMGs to DOs. There are no data that even talk about western europeans.




                                            You should tell that to our 2 current Irish residents...Also, we have had 3 residents in the last 4 years from Ireland/UK. There are western european residents in the surgical programs at my hospital, in Gen Surg at MGH and ortho at MGH (the only ones I looked into). There are a lot of irish and UK residents that come to this country but they are generally held in high enough regard that they go to good hospitals not crappy community programs. Those who think DO> European FMGs are waaaay off base.

                                            The problem (for US students) is that these schools are generally closed to foreigners, although where I went to med school, we did have a medicine resident who was American and did her training in England...

                                            Well the one thing I should have made more clear, though I thought you would have caught the distinction (my error on that) Western Europe is a referral to the continental western european countries. They don't match here in any appreciable numbers. I addressed UK/Ireland and admitted that they do match here, after some required training and that makes it a bit odd to compare a fresh out of school american grad with these two groups as 1) they cannot return to the US immediately if they are from there and 2) they do come with 2+ years of physician experience.

                                            2 of them finished their foundation years. One did specialty training. They all started back at intern year

                                            Yea. I think you sort of back up my point, not contradict it, that UK/Irish training doesn't represent a legitimate way into the US. You admit that there is one who pulled it off as a from-US-to-UK-and-back, but s/he would have required to be a pre-existing citizen of the other country and spent an additional two years after graduating training in that country just to return to the US. It does eliminate the equivalence to US grads since the hurdles to returning to the US are much more extensive and restrictive than any true "offshore" school, as well as the fact that a PGY1 US Grad =/= PGY1 European grad... since the latter is effectively, by experience, a PGY3 at their admission to the program. They simply have to play the part of the intern in America because our system doesn't recognize their foundation year training for credit in our system, but it is absolutely required of them as a UK graduate.

                                            I dont think its fair to say DO > Western European grad, but it is equally incorrect to say Western European grad > DO. They are simply not compatible due to the required difference in training prior to entering the US residency system (And the intangible that "difficulty in returning to the US" represents if a discussion is made only for viability of going to europe, rather comparing the two in totality). Sure you can say that you don't see any DOs in Hopkins IM, but you see a few UK MDs. That's fine, but those graduates represent students of merit outside of the scope of the OPs question, likely among the best their country has. Also, a more legitimate comparison would be judging the training of DO physicians who decide to re-enter the residency pool after a few years of practice to be boarded in a new field... not comparing it to fresh out of the gate students.
                                             

                                            DOWay

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                                              It really depends on the program - why dont you check what programs there are in the demographic that you're considering and then see how many DOs and/or FMGs they have in those programs? It's so hard to generalize to every program in the US.
                                               
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                                              DocEspana

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                                                It really depends on the program - why dont you check what programs there are in the demographic that you're considering and then see how many DOs and/or FMGs they have in those programs? It's so hard to generalize to every program in the US.

                                                not as hard as you'd think in surgery. Its pretty homogeneous on their stance here, with only a few outliers from everything I've researched.
                                                 

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                                                  Not to hijack this thread but does anyone know 100% yet if they are going to allow AOA residencies to do ACGME fellowships? I have heard so many different things (its almost 100% versus others saying there is almost no way it can happen to others being 50/50 on it). Last I heard from some credible sources is that it seems like it will be inevitable in 2013/2014. I think this issue really effects those wanting to do general surgery the most as most of us planning on doing some sort of fellowship and there really aren't too many consistent fellowships offered. Thank!
                                                   

                                                  SpecterGT260

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                                                    First of all, I want to apologize for the misleading title, this isn't a pointless "which is better: DO or Carribean" Thread

                                                    I just wanted to know who has a better chance of getting an ACGME General Surgery Residency, a DO applicant or an FMG from a legitimate foreign medical school (eg. from Europe or India, not the Carribeans)? I was looking at some of the residents at mid to low tier ACGME general surgery residencies, and there seems to be many FMGs (from Poland, England, Germany, India, etc.), but I couldn't find that many DO's. Again, I hope this is a legitimate question!

                                                    I'm a DO going into gen surg. First DO's have their own osteopathic gen surg residency. So majority of DO's go into osteopathic residency for the following reasons: (1) You can get most surg fellowships (except for peds) with a DO residency. DO's also have their own fellowships as well in areas like Plastics (2) you dont have to worry about getting your intern yr approved by AOA. (3) DO match occurs before MD match, so to go for MD residency, you have to give up DO match. A risk most people don't want to take, unless you're sure you will match into a good place in MD match. So you wont see a lot of DOs in MD (ACGEM) surgery residency. In my school out of ~10 going into gen surg, 8 went DO, 2 went to MD.

                                                    Now is getting into a ACGEM residency easier as a DO vs FMG/IMG? Yes, for a verity of reasons, but most importantly DO students are seen as similar to other US medical students. Our preclinical education, clinical rotations, are same as any MD school, and many of us take usmle as well.

                                                    Btw, FMG's have a harder time getting a surg res than Crib students.

                                                    I dont think you really addressed anything the OP wanted. Question was not about carib students, it is ACGME, and well, rationale for going with AOA has nothing to do about difficulty for DO vs FMG in ACGME residencies. Have you matched? Im just slightly suspicious that you are either pre-med still with a life plan or otherwise just bullsh***ing due to some errors in information and some interesting spellings of words.

                                                    OP, if I were you I would look at NRMP data. They do have a breakdown for DO and FMG students on one of their stats papers. It isnt perfect, but I would look at acceptance/applied to get a vague idea of how likely people from the respective pools are to get in.
                                                     

                                                    SoulinNeed

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                                                      I dont think you really addressed anything the OP wanted. Question was not about carib students, it is ACGME, and well, rationale for going with AOA has nothing to do about difficulty for DO vs FMG in ACGME residencies. Have you matched? Im just slightly suspicious that you are either pre-med still with a life plan or otherwise just bullsh***ing due to some errors in information and some interesting spellings of words.

                                                      OP, if I were you I would look at NRMP data. They do have a breakdown for DO and FMG students on one of their stats papers. It isnt perfect, but I would look at acceptance/applied to get a vague idea of how likely people from the respective pools are to get in.
                                                      I don't think that's a fair way to look at it. Most DO's who want to go into surgery apply to both DO and MD surgical residencies, they match into DO, and thus, get automatically pulled out of the ACGME match.
                                                       

                                                      SpecterGT260

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                                                        Doesn't matter. The nrmp comparison only considers those who attempt and complete the match. There is other data for people who withdraw. To be honest I actually can't find a valid reason why entry into the AOA match would affect this point at all. Remember... the topic is about difficulty matching ACGME.
                                                         

                                                        SoulinNeed

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                                                          Doesn't matter. The nrmp comparison only considers those who attempt and complete the match. There is other data for people who withdraw. To be honest I actually can't find a valid reason why entry into the AOA match would affect this point at all. Remember... the topic is about difficulty matching ACGME.
                                                          Because it under represents the number of DO's who could have matched into ACGME residencies, because they first matched into the AOA match. Those tend to be the strongest applicants, as well.
                                                           

                                                          MedPR

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                                                            You do know that in the UK they speak English right? And their english is actually more accurate and not butchered like it is in North America. Also many educated people in Germany and France can speak English surprisingly well

                                                            The visa thing is a HUGE hassle believe me, but not really on the end of the employer. Its more of a problem for the potential employee. It used to be tough for employers but the paper work has significantly decreased over the years


                                                            Your opinion of butchered, accurate or not, is irrelevant. In the United States people understand the "butchered" version of english, therefore it is still better (in the US) than your "proper" UK english.
                                                             

                                                            SpecterGT260

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                                                              Because it under represents the number of DO's who could have matched into ACGME residencies, because they first matched into the AOA match. Those tend to be the strongest applicants, as well.

                                                              I haven't seen good evidence of this. ACGME residencies are usually at larger hospitals with more resources and opportunities. It stands to reason that the better applicants forgo the AOA all together. There are also some interesting papers (that tend to cause a shiz storm here on sdn) that when cross compared indicate a fairly weak average applicant to the AOA slots.


                                                              Either way I think it is unreasonable to just assume that
                                                              1. those few who apply and match AOA are a higher caliber applicant
                                                              2. That use of these few applicants would significantly alter the data
                                                              3. That in a thread about "who has a harder time matching ACGME?" that discussing AOA match is relevant at all.


                                                              That said, the DO sub analysis has a higher match rate than the overall "independent applicant" analysis (I believe) which to me means DOs have an easier time. But as has already been mentioned, there does not exist an analysis which separates western Europeans from Caribs or whatever
                                                               

                                                              SoulinNeed

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                                                                I haven't seen good evidence of this. ACGME residencies are usually at larger hospitals with more resources and opportunities. It stands to reason that the better applicants forgo the AOA all together. There are also some interesting papers (that tend to cause a shiz storm here on sdn) that when cross compared indicate a fairly weak average applicant to the AOA slots.


                                                                Either way I think it is unreasonable to just assume that
                                                                1. those few who apply and match AOA are a higher caliber applicant
                                                                2. That use of these few applicants would significantly alter the data
                                                                3. That in a thread about "who has a harder time matching ACGME?" that discussing AOA match is relevant at all.


                                                                That said, the DO sub analysis has a higher match rate than the overall "independent applicant" analysis (I believe) which to me means DOs have an easier time. But as has already been mentioned, there does not exist an analysis which separates western Europeans from Caribs or whatever
                                                                Well, it just seems to me that any DO who wants to do surgery would apply to both AOA and ACGME. While some DO residencies are considered subpar (mainly Anes, I believe), I've heard very little bad statements about DO surgery residencies. Just to play it safe, I would think they would apply to both DO and ACGME residencies, and clearly the best (you would think) of the bunch that applies to both would match AOA first, and get withdrawn out of the ACGME residency. I would think it is significant, since such a HUGE amount DO's end up getting withdrawn out of the ACGME match, and I would just naturally think that only a few DO's looking to go into Surgery would apply just to ACGME, for whatever reason.

                                                                You're right, though, that no one is going to have information that specifically compares Western European graduates to DO's. Firstly, because I would think that very few Western European grads even come to the US to practice. All we have is anecdotal evidence, so I'll give my take. I'm the son of a FMG who tries to match surgery in the US 10 years ago, and couldn't (even with years of urological surgery experience). I have many relatives who are FMG, recently arrived and a few who try to go into surgery, and even with top scores (99% percentile), they have a lot of trouble getting any surgery at all. Of course, since many FMG's tend to spend a lot of time studying for USMLE, getting a high score as a FMG is not all that uncommon. I would still recommend the applicant to go DO, simply because like you said, the little data we have does suggest that DO's have an easier time, and in the end, there is really no shame in doing an AOA surgery residency (yes, I know that's not what the OP asked).
                                                                 

                                                                SoulinNeed

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                                                                  I had trouble reading beyond right here. Not trying to pick on you too much but the above does not stand as evidence
                                                                  Well, maybe if you did read beyond, you would understand that I conceded that it was lame evidence. However, my point is that there is no real concrete evidence for who does better (Western Europe or DO), and thus, we'll just have to rely on lame and anecdotal evidence.
                                                                   

                                                                  Oxer45

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                                                                    MD: For 2011, there were 1108 gen surg spots offered. 897 were taken by US MD grads. Remaining 211 were taken by 1003 other applicants (only 21% of non US MD applicants got spots)

                                                                    DO: There were 111 gen surg spots offered, 108 were taken, 3 still unfilled (meaning any DO student who did not match in DO and MD match could take it)
                                                                    http://www.natmatch.com/aoairp/summpos.htm

                                                                    If you want to become a gen surgeon and dont care about DO or MD residency, go to a DO school where you have a pretty good shot at becoming a surgeon. If you decide to go to European MD school, you have a 20% chance of matching in a ACGME program.
                                                                     
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