Does taking USMLE as a DO offset some discrimination?

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Suppose you take USMLE as a DO and do well. Will that offset some discrimination during matching? Because the way I look at it, you don't learn to be a true doctor till residency. So doing well on the USMLE means that you know what you are talking about, right?

 

[sliceofbread136]

Somewhat, but definitely not completely. Many residencies will still throw your app straight in the garbage.

 

[Psai]

When I was looking at resident lists, I specifically looked to see where current residents were from. It's not the only factor or the most important but it played a large role. A lot of top schools, I would say wow they are probably awesome. Anyone from a do school or caribbean or fmg I would think wow this guy is probably a superstar or has connections or did a few years of research so the program is still great. A substantial number of dos, caribbeans and fmgs make me think that it's a crappy program for whatever reason, maybe location, malignant, terrible schedule and the good applicants either didn't apply or chose to go elsewhere so I shouldn't even bother. Few programs publish step scores on their websites. Pds know we think like this and tend to act accordingly

 

[235009]

There is no discrimination. DO is not a protected class it's your educational credentials which a portion of residency programs deem to be insufficient for consideration of your candidacy.


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[terra330]

Doesn't have to be a protected class to be considered discrimination. No one is saying it's illegal to discriminate against DOs

 

[sinombre]

Because the way I look at it, you don't learn to be a true doctor till residency.

This is true. In med school we mostly just sit around and hang out all day. I did try on a stethoscope at the beginning of third year, but it turns out I was wearing it the wrong way. I'm hoping I can figure it out at the beginning of residency because I've heard they're kind of important, although I'm not really sure that that's true because we haven't gone over it in school.

 

[sinombre]

And the answer to the original question: maybe.

Residency programs have filters they use to screen, which they can set up however they want.

 

[ortnakas]

It absolutely helps but it doesn't "fix everything."

 

[mimelim]

Suppose you take USMLE as a DO and do well. Will that offset some discrimination during matching? Because the way I look at it, you don't learn to be a true doctor till residency. So doing well on the USMLE means that you know what you are talking about, right?

Three sets of programs:
Set 1: Takes DOs and FMGs with somewhat regularity, maybe at least once every couple of years. They are less competitive and do not attract a ton of stellar US MDs. Doing average on your Step 1 will give you a reasonable shot at matching.
Set 2: Open to the possibility of a DO or FMG, has taken one or two historically. These can range from mid-tier to extremely competitive. Most of them expect to see a good step 1 score from all of their applicants and many will have step 1 floors (set at 220, 230, 240, etc) and regularly get plenty of applicants with very good scores. A stronger score, lets say >20 points above the typical for a program will turn heads. But, as it is for every applicant, then the other factors come in. And when it comes to those other factors, DOs and IMGs tend to suffer. Worse LOR, less research, etc. It isn't the DO that gets in the way, but the tendency for a lower quality applicant. FMGs tend not to suffer from this as much. They tend to have stronger LOR, research, etc. But they may have other issues (not for this thread).
Set 3: Never takes DOs, always has plenty of US MDs to fill their spots and chucks DO applications regardless of score. Reviewing applications and interviewing candidates is time and energy consuming. Every program employs some sort of filters. Some choose to simply not interview DOs because they know it won't hurt the quality of their class. They also tend to be the larger programs that already have a nightmare of time organizing their recruitment.

Doesn't have to be a protected class to be considered discrimination. No one is saying it's illegal to discriminate against DOs

Is it discrimination to use grades or test scores to select applicants? At some point they are simply selection criteria. A fair argument can be made that DOs do not get the same education that MDs do, thus they are less qualified. Is it a gross over simplification? Of course. Is it something I ascribe to? Not particularly, but it is pretty hard to argue against, especially when a lot of the education has to be subjectively evaluated in the clinical years.

 

[terra330]

Three sets of programs:
Set 1: Takes DOs and FMGs with somewhat regularity, maybe at least once every couple of years. They are less competitive and do not attract a ton of stellar US MDs. Doing average on your Step 1 will give you a reasonable shot at matching.
Set 2: Open to the possibility of a DO or FMG, has taken one or two historically. These can range from mid-tier to extremely competitive. Most of them expect to see a good step 1 score from all of their applicants and many will have step 1 floors (set at 220, 230, 240, etc) and regularly get plenty of applicants with very good scores. A stronger score, lets say >20 points above the typical for a program will turn heads. But, as it is for every applicant, then the other factors come in. And when it comes to those other factors, DOs and IMGs tend to suffer. Worse LOR, less research, etc. It isn't the DO that gets in the way, but the tendency for a lower quality applicant. FMGs tend not to suffer from this as much. They tend to have stronger LOR, research, etc. But they may have other issues (not for this thread).
Set 3: Never takes DOs, always has plenty of US MDs to fill their spots and chucks DO applications regardless of score. Reviewing applications and interviewing candidates is time and energy consuming. Every program employs some sort of filters. Some choose to simply not interview DOs because they know it won't hurt the quality of their class. They also tend to be the larger programs that already have a nightmare of time organizing their recruitment.



Is it discrimination to use grades or test scores to select applicants? At some point they are simply selection criteria. A fair argument can be made that DOs do not get the same education that MDs do, thus they are less qualified. Is it a gross over simplification? Of course. Is it something I ascribe to? Not particularly, but it is pretty hard to argue against, especially when a lot of the education has to be subjectively evaluated in the clinical years.

I would consider the 3rd set to be discrimination, along with the issues DOs sometimes face after residency.

 

[mimelim]

I would consider the 3rd set to be discrimination, along with the issues DOs sometimes face after residency.

Why? Is it discrimination to not consider people under a certain Step score? DOs have a different degree. Why should a program be obligated to spend time and other resources on applicants that have virtually zero chance of ending up at that residency?

 

[terra330]

Why? Is it discrimination to not consider people under a certain Step score? DOs have a different degree. Why should a program be obligated to spend time and other resources on applicants that have virtually zero chance of ending up at that residency?

They only have a virtually zero chance of ending up there because said program chooses to ignore said students. If someone has step scores, letters of recommendation, and research on par with the MD students applying there, I don't see how it is not discrimination to still reject without any consideration.

 

[DNC127]

They only have a virtually zero chance of ending up there because said program chooses to ignore said students. If someone has step scores, letters of recommendation, and research on par with the MD students applying there, I don't see how it is not discrimination to still reject without any consideration.

Because the school doesn't need to consider you. They can do whatever they want. ITS THEIR SYSTEM. I hate this politically correct world we live in where everybody looks for excuses to pull the "This is unfair and it offends me card". Even if you could call it discrimination who cares? They have a right to pick who they want. As an incoming DO student I know there will be certain challenges however, I feel comfortable in my ability to work through those challenges to the best of my ability and thats what it takes. If we keep whining about the "unfair" system we will gain ZERO respect. Study/Work hard, put the best application together you can and hope you match as good as physically possible for yourself.

 

[mimelim]

They only have a virtually zero chance of ending up there because said program chooses to ignore said students. If someone has step scores, letters of recommendation, and research on par with the MD students applying there, I don't see how it is not discrimination to still reject without any consideration.

They aren't ignored. Their application is reviewed and considered. They don't meet what the program is looking for in it's applicants and their application is chucked. It is like a job application requiring 5 years of prior work experience. You may have great LOR and maybe even fit the job really well. That doesn't mean that the job is discriminating against an applicant. Again, they have a different degree. What you are arguing again is the same as crying discrimination against HMS not accepting you or even bothering to look at your PS or LOR because you have a 2.7 GPA and a 24 MCAT.

 

[EmergDoc2B]

I think the most correct response is it depends on the specialty. I took both to ensure that no matter what I chose to do I was covered. I didnt choose to take the USMLE to decrease discrimination. I actually avoided visiting / applying to residencies with very very poor D.O. percentages in Freida.

 

[terra330]

Because the school doesn't need to consider you. They can do whatever they want. ITS THEIR SYSTEM. I hate this politically correct world we live in where everybody looks for excuses to pull the "This is unfair and it offends me card". Even if you could call it discrimination who cares? They have a right to pick who they want. As an incoming DO student I know there will be certain challenges however, I feel comfortable in my ability to work through those challenges to the best of my ability and thats what it takes. If we keep whining about the "unfair" system we will gain ZERO respect. Study/Work hard, put the best application together you can and hope you match as good as physically possible for yourself.

I never said they should have to consider DOs, nor did I ever state I find it offensive (hell, I'm going to be at an MD school, so I don't even have a personal stake in the matter). I do find it discriminatory to pass over a DO simply by virtue of being a DO. I don't think there's anything objectionable to pointing out a practice as unfair.

They aren't ignored. Their application is reviewed and considered. They don't meet what the program is looking for in it's applicants and their application is chucked. It is like a job application requiring 5 years of prior work experience. You may have great LOR and maybe even fit the job really well. That doesn't mean that the job is discriminating against an applicant. Again, they have a different degree. What you are arguing again is the same as crying discrimination against HMS not accepting you or even bothering to look at your PS or LOR because you have a 2.7 GPA and a 24 MCAT.

If the program filters out all DOs automatically (remember it's only your "set 3" I have some issue with), that isn't really reviewing and considering the application. I don't think it's the same as being mad that HMS chucked my app for having a 2.7 and 24 (or even a 3.7/34 since it's HMS). It's more akin to being upset that they reject all BAs over BSs regardless of course load, test scores, research, etc.

I realize that at the end of the day the residency program is entitled to do what they want, but that doesn't make the practice any less discriminatory.

 

[The Knife & Gun Club]

I feel like a big wrench in the gears here is also that not all DO schools are created equal. They're way less regulated than MD. Some DO schools could have markedly clinical worse training than MD. So who cares if you blow up the STEP if you have sub-standard clinical training during years 3 and 4?

Seems like a reasonable decision on the part of any PD to avoid (or at least look skeptically at) people who didn't go to a school that abides by the stringent regulations in which they trained.


*Also @terra330 , as an aside, literally every DO residency in existence has been operating as "Set 3" from above. If you have an MD, no one cares if you have a perfect COMLEX, rec's from a bunch of DO's, research in OMM, etc, no MD's allowed. Don't throw stones if you live in a glass house lol.

 

[terra330]

*Also @terra330 , as an aside, literally every DO residency in existence has been operating as "Set 3" from above. If you have an MD, no one cares if you have a perfect COMLEX, rec's from a bunch of DO's, research in OMM, etc, no MD's allowed. Don't throw stones if you live in a glass house lol.

Fair enough, I do agree that's discriminatory in a similar manner (Though I do think it's better to disallow applications rather than taking applications and then rejecting them if you're not going to give any consideration). Those residencies will all be under the ACGME by the time we're interviewing anyway.

Edit: Apparently they can choose to take either or not consider any scores

 

[Dr. Death]

Oh this thread again.

Someone close it before it ends up 5 pages long.

As @DNC127 said, DOs know they are facing an uphill battle. If they don't know that they were too stupid to get into a competitive residency anyway. This isn't a cute little socialist game where everybody wins and goes home happy with the residency of their choice. Yes taking USMLE will help offset some discrimination but you are going to have to work harder than MD students and even in best case circumstances there are going to be locked doors that you can't break down. Such is life. If everybody wins, everybody loses. /rant

 

[ortnakas]

Oh this thread again.

Someone close it before it ends up 5 pages long.

Agreed. Maybe, just maybe, we could keep this focused on the pros and cons of DO students taking the USMLE? Because that might actually be a worthwhile discussion (albeit one more appropriate for Osteo than Pre-Allo).

 

[Lawpy]

*Also @terra330 , as an aside, literally every DO residency in existence has been operating as "Set 3" from above. If you have an MD, no one cares if you have a perfect COMLEX, rec's from a bunch of DO's, research in OMM, etc, no MD's allowed. Don't throw stones if you live in a glass house lol.

Well with the upcoming merger, the DO residencies will open up for MD students without the need for COMLEX (correct me if I'm wrong). So that's a plus.

Of course, if that's the case, it makes COMLEX completely useless...

 

[terra330]

Well with the upcoming merger, the DO residencies will open up for MD students without the need for COMLEX (correct me if I'm wrong). So that's a plus.

Of course, if that's the case, it makes COMLEX completely useless...

I believe that is correct. I think for now DO students will still have to take the COMLEX, but I guess they can treat it as more of a pass/fail thing since the USMLE will be what matters.

DO residencies do have the option of having an "osteopathic distinction" which would require MD applicants to get some training in OMM, but from what I understand, pretty much none of the formerly DO residencies bothered with applying for the distinction.

 

[DoctorSynthesis]

Suppose you take USMLE as a DO and do well. Will that offset some discrimination during matching? Because the way I look at it, you don't learn to be a true doctor till residency. So doing well on the USMLE means that you know what you are talking about, right?

I'm a DO student.

It's not discrimination because DO schools and MD schools aren't equal. DO is part of your academic resume. Taking the USLME would get your application looked at by programs who wouldn't have otherwise if that answers your questions. As an aside the difficulty of matching in the ACGME as a DO is vastly overplayed. The differences you see are actually more to do with the overall competitiveness of the application pools, however, yes you do need higher scores as a DO compared to an MD.

 

[DoctorSynthesis]

I believe that is correct. I think for now DO students will still have to take the COMLEX, but I guess they can treat it as more of a pass/fail thing since the USMLE will be what matters.

DO residencies do have the option of having an "osteopathic distinction" which would require MD applicants to get some training in OMM, but from what I understand, pretty much none of the formerly DO residencies bothered with applying for the distinction.

If you're only taking the COMLEX your score still matters. For DO programs your score will still matter.

 

[terra330]

If your only taking the COMLEX your score still matters. For DO programs your score will still matter.

If programs aren't bothering to apply for an "osteopathic distinction", would they still take COMLEX?

 

[DoctorSynthesis]

If programs aren't bothering to apply for an "osteopathic distinction", would they still take COMLEX?

If a program is dually accredited they will take the COMLEX. If they are only accredited by the ACGME it depends on the program.

 

[AnatomyGrey12]

If everybody wins, everybody loses.

Gotta love that game theory. It's like how everyone these days has a bachelors degree, basically making it so diluted that to get a competative job it is essentially a necessity to have a Masters or higher.

 

[AlteredScale]

If programs aren't bothering to apply for an "osteopathic distinction", would they still take COMLEX?

That osteopathic recognition application is to "protect" the residency by making requirements of having preceding OMM training. It has nothing to do with accepting the COMLEX or not. Any previous AOA-gone-ACGME program will consider the COMLEX, but not all ACGME programs will consider it.


Taking the usmle gets you considered at more programs and allows a PD to have a standard comparisons with you and other students (as they should since the AOA wants to be called equal amongst their peers), but it's not going to offset the intrinsic bias that comes along with a plethora of academic residency programs that simply don't need to look at DO apps or simply don't trust those apps no matter how stellar their step score is. The elephant in the room is the horrendously variable clinical training amongst DO programs.

The fact that a student can rotate with a house-call doctor and call that an internal medicine rotation, or have a nurse practitioner as a preceptor for a soon-to-be physician, is appalling. Now yes, this are the extreme cases and not the norm...but the fact that it is even allowed and flown right under COCA's radar as acceptable justifies why many hesitate to accept DO's into programs.

 

[Scumione]

This is true. In med school we mostly just sit around and hang out all day. I did try on a stethoscope at the beginning of third year, but it turns out I was wearing it the wrong way. I'm hoping I can figure it out at the beginning of residency because I've heard they're kind of important, although I'm not really sure that that's true because we haven't gone over it in school.

This is literally what I think when people say residents "aren't real doctors yet".

 

[libertyyne]

This is literally what I think when people say residents "aren't real doctors yet".

I am sorry, I forgot to read the portion where they have privileges to practice without supervision. I suppose advanced practice providers "aren't real doctors yet" by that logic.

 

[Scumione]

I am sorry, I forgot to read the portion where they have privileges to practice without supervision. I suppose advanced practice providers "aren't real doctors yet" by that logic.

Okay, if thats how you want to see it 🙂

 

[Instatewaiter]

I would consider the 3rd set to be discrimination, along with the issues DOs sometimes face after residency.

When a place literally gets a thousand applications, they have to use arbitrary cutoffs like boards scores, degree etc to screen out applicants that are exceptionally unlikely to be ranked to match. DOs often fit within this mold. If you don't like it, don't go to a DO school and don't do poorly on step 1.