DOs in general surgery

[Gatorman177]

Advertisement - Members don't see this ad

Can anyone attest to why this specialty seems to be difficult for DOs to get an ACMGE residency in? Anyone want to share how they feel the merger will change this over the next 2-3 years?

Thanks!

 

[meliora27]

I think it's program specific. University of Kansas (which I think is a decent program, they have an active transplant program, cardiothoracics, etc) is quite DO friendly. Gen Surg C/O 2018 4 out of the 5 residents are DO's. There's usually a couple per year, last year seemed to be an exception though with the majority being DO's. I know the intern class (C/O 2019) has 2 KCUMB alums in it, not sure if there are any other DO's.

Sidenote: Kansas also has a PGY-4 KCUMB grad who's in their integrated plastics residency program. I think he may have been the only DO that year to match MD Plastics.

 

[DrEnderW]

Agreed that it's program specific.

There's a relatively decent amount of DOs that land ACGME GS residencies. This is especially true compared to the surgical sub specialties. Plan to take USMLE from day one.

 

[Gatorman177]

Is it a specialty that prefers research? I know that is true for some of them. Also, are there any good AOA gs residencies?

 

[Gatorman177]

Also, what kind of USMLE score will it take

 

[Petypet]

ACGME GS is DO friendly with the right scores, research, and ECs. Further, there are many quality AOA and are easily researched on these forums.

 

[meliora27]

I think you would probably be able to match MD Gen Surg with a 230+ on Step 1

 

[Postictal Raiden]

I think you would probably be able to match MD Gen Surg with a 230+ on Step 1

Is it doable without research?

 

[meliora27]

Is it doable without research?

No clue. Why risk it though? Research always makes you a better applicant. It's not that hard to do.

 

[Petypet]

Sounds like, what are the minimum things required to match GS. You certainly do not need research to match AOA gen surg, but you would be handicapping yourself by not maximize your application for ACGME gen surg.

 

[Gatorman177]

I think you would probably be able to match MD Gen Surg with a 230+ on Step 1

Wow I would've thought we needed a higher score as DOs. 230+ seems achievable.

 

[gators21]

Wow I would've thought we needed a higher score as DOs. 230+ seems achievable.

Wait until you start step 1 studying before you say its easy

 

[schwasted589]

would ACGME programs look at someone with just a COMLEX score?

 

[Petypet]

would ACGME programs look at someone with just a COMLEX score?

Probably not. Most programs I have contacted require step 1 and step 2 for matching. Some even require both just for an interview.

 

[meliora27]

The cost of two exams sucks, no one is denying that. But, if you want to apply to a competitive allopathic program as a DO, why would you NOT take both exams? You're already most likely facing an uphill battle at some places as a DO, don't make it any harder on yourself by not taking the same exams as those you're competing against. This goes for surgery, medicine, whatever.

 

[Gatorman177]

Wait until you start step 1 studying before you say its easy

I thought I was pretty careful with my word choice when saying achievable. Easy was never said.

 

[darklabel]

44 DO students matched into Surgery (Categorical) for 2014 in the ACGME match. Sadly it won't say how many applied, or I couldn't find it, but it seems doable for a DO applicant.

http://www.nrmp.org/wp-content/uploads/2014/04/Main-Match-Results-and-Data-2014.pdf

Also this document clearly illustrates how its better to be a DO graduate in the match than it is to be an IMG.

 

[Gatorman177]

So 44 graduates out of the 4,500+ total osteopathic graduates... Jeez. idk if id call that doable.

(Or is 4500 not accurate?)

 

[Gatorman177]

.

 

[Petypet]

So 44 graduates out of the 4,500+ total osteopathic graduates... Jeez. idk if id call that doable.

(Or is 4500 not accurate?)

Most don't bother going ACGME, since most of the AOA training programs are decent. Some of the AOA programs are apprenticeship-like and I would be wary of those programs, but in general it is MUCH safer to go AOA.

 

[hallowmann]

So 44 graduates out of the 4,500+ total osteopathic graduates... Jeez. idk if id call that doable.

(Or is 4500 not accurate?)

Definitely not accurate. That is only in the ACGME match. About 2700 DOs applied ACGME last year. The AOA match filled 129 GS spots and had 10 unfilled (who knows what happened after the scramble). The real problem with both of these numbers that makes them kinds of meaningless is that we have no real idea how many applied general surgery in the first place.

 

[Gatorman177]

Most don't bother going ACGME, since most of the AOA training programs are decent. Some of the AOA programs are apprenticeship-like and I would be wary of those programs, but in general it is MUCH safer to go AOA.

I won't be applying for residency until 2017 since I'm just starting. Won't any AOA program people go into at that time technically be ACGME by the time they complete the residency? Since that would be like 2022/2023?

 

[hallowmann]

I won't be applying for residency until 2017 since I'm just starting. Won't any AOA program people go into at that time technically be ACGME by the time they complete the residency? Since that would be like 2022/2023?

Yeah, that's true. If the program gets accredited by the ACGME before they finish, they should be able to sit for both MD and/or DO boards, according to the merger FAQs.

 

[Petypet]

I won't be applying for residency until 2017 since I'm just starting. Won't any AOA program people go into at that time technically be ACGME by the time they complete the residency? Since that would be like 2022/2023?

In theory yes, in practicality who knows. No one knows what is going to happen to the smaller programs, but it seems unlikely that in 3-4 years small AOA programs, 1 hour from a major metropolitan area, are somehow going to increase in work load and pathology. Those programs may get better, may close; but I don't think the bottom of the barrel AOA will become the equivalent of the bottom ACGME programs.

 

[Gatorman177]

In theory yes, in practicality who knows. No one knows what is going to happen to the smaller programs, but it seems unlikely that in 3-4 years small AOA programs, 1 hour from a major metropolitan area, are somehow going to increase in work load and pathology. Those programs may get better, may close; but I don't think the bottom of the barrel AOA will become the equivalent of the bottom ACGME programs.

Even if I do a 3 year program for residency I shouldn't finish until 2021. Doesn't the merger state that all AOA programs must be approved by July 2020?

 

[hallowmann]

Even if I do a 3 year program for residency I shouldn't finish until 2021. Doesn't the merger state that all AOA programs must be approved by July 2020?

This is true, for now, but with big changes, usually comes rescheduling (e.g. they may delay the requirement, nothing is absolutely set in stone).

Like Petypet said, although in theory it should work out that way, nobody knows what will really happen. Its a risk to bank on something like that. That said you can reduce your risk by applying only to AOA programs in big academic hospitals known to have more pathology and maybe even to have a parallel ACGME surgery program (not sure how many of those there are).

 

[Gatorman177]

That said you can reduce your risk by applying only to AOA programs in big academic hospitals known to have more pathology and maybe even to have a parallel ACGME surgery program (not sure how many of those there are).

That sounds like the way to go if ACGME is unrealistic. Can anyone she some light on what programs these might be?

 

[DrEnderW]

So 44 graduates out of the 4,500+ total osteopathic graduates... Jeez. idk if id call that doable.

(Or is 4500 not accurate?)

That's not how you should look at match stats.

There aren't 4500 people that want to match GS, are remotely interested in GS, or who have the app for GS. You have to look at how many applied, not the total number of DO graduates. For example, if only 65 applied that wouldn't be so bad. There were 300 something independent applicants (non-US senior MDs) for first choice GS in 2014, which are mostly IMGS/FMGs. Even if those students were all DOs, which they overwhelmingly are not, that would be 44 out of 300ish not 4500. The overall match rate is 80% so it's likely somewhere slightly lower than that.

That's like saying there are ~25,000 MD grads and ~850 ortho spots so it's not doable to be an MD orthopod. Of course, that's completely false because there are way less people applying #1 for that specialty making it completely feasible if your app is tailored that way.

 

[demayette]

44 DO students matched into Surgery (Categorical) for 2014 in the ACGME match. Sadly it won't say how many applied, or I couldn't find it, but it seems doable for a DO applicant.

http://www.nrmp.org/wp-content/uploads/2014/04/Main-Match-Results-and-Data-2014.pdf

Also this document clearly illustrates how its better to be a DO graduate in the match than it is to be an IMG.

44 and you said it is doable! Seriously... even if we assume only there were 200 DO applicants (a conservative estimate), 44 matched would be a freaking low outcome... ACGME general surgery is not competitive for a MD applicant with average step1...

 

[darklabel]

44 and you said it is doable! Seriously... even if we assume only there were 200 DO applicants (a conservative estimate), 44 matched would be a freaking low outcome... ACGME general surgery is not competitive for a MD applicant with average step1...

We don't know how many applied so it's pretty meaningless. I'm sure most competitive DO applicants stayed AOA to avoid not matching.

And i'm not sure I understand the last part. Are you saying an average MD student isn't competitive for Gen Surg?


Sent from my iPhone using Tapatalk

 

[DrEnderW]

44 and you said it is doable! Seriously... even if we assume only there were 200 DO applicants (a conservative estimate), 44 matched would be a freaking low outcome... ACGME general surgery is not competitive for a MD applicant with average step1...

I don't think 200 is a conservative estimate... I think it's probably 2x or more the #1 of first choice applicants. Hopefully someone actually knows the exact numbers.

Only like 300-350 or something applied - those are mostly IMGs/FMGs, not DOs.

There were less than 200 DOs that applied to AOA GS first choice in 2013 so there is absolutely no way ACGME applicants are anywhere near that number.

 

[demayette]

We don't know how many applied so it's pretty meaningless. I'm sure most competitive DO applicants stayed AOA to avoid not matching.

And i'm not sure I understand the last part. Are you saying an average MD student isn't competitive for Gen Surg?


Sent from my iPhone using Tapatalk

Poorly phrased... I meant that AMG (MD) with an average step1 (225+) might have no problem matching into gen surg...

 

[DrEnderW]

Poorly phrased... I meant that AMG (MD) with an average step1 (225+) might have no problem matching into gen surg...

That's true, it's not terribly competitive. As always, top/desirable programs will be.

The same is true for DOs going AOA GS. The average COMLEX was 502, which is 44th percentile.

 

[Gatorman177]

I don't think 200 is a conservative estimate... I think it's probably 2x or more the #1 of first choice applicants. Hopefully someone actually knows the exact numbers.

Only like 300-350 or something applied - those are mostly IMGs/FMGs, not DOs.

There were less than 200 DOs that applied to AOA GS first choice in 2013 so there is absolutely no way ACGME applicants are anywhere near that number.

I don't know how it is among all DO grads but I know my school sends more people into ACGME residencies than it does AOA. Of course this is a generalization not just GS, but still. So it's not unreasonable to assume that half of the independent applicants are DO. But even if only 100 applied, that's still less than half of them land a spot. Scary business. I'm still pretty unfamiliar with the match process but why does applying to ACGME programs keep you from applying AOA? Timeline?

 

[demayette]

That's true, it's not terribly competitive. As always, top/desirable programs will be.

The same is true for DOs going AOA GS. The average COMLEX was 502, which is 44th percentile.

I am not sure why you are making that AOA comparison... My point was that ACGME Gen Surg programs should not be out of reach for an average DO student... GAS which probably has a higher step1 is not out reach for a middle of the road DO student; thus, I don't understand why Gen Surg is more competitive for DO than GAS...

 

[DrEnderW]

I don't know how it is among all DO grads but I know my school sends more people into ACGME residencies than it does AOA. Of course this is a generalization not just GS, but still. So it's not unreasonable to assume that half of the independent applicants are DO. But even if only 100 applied, that's still less than half of them land a spot. Scary business.

In general, lots of people apply to ACGME programs but it's mostly comprised of FM, IM, peds, and EM. I really don't know exact numbers, I am making the assumption that GS is applied to similar to other more competitive specialties. Even though GS isn't that competitive for MDs or DOs going AOA, it is decently competitive for DOs going ACGME so less apply. It's an instant filter for less to apply. There are thousands and thousands more IMGS than DOs that's why I'm assuming there is a small percentage of DOs.

I agree it's scary business if you don't have a strong app - another reason not many apply, in my opinion. AOA is a strong and viable option, even for competitive students.

I'm still pretty unfamiliar with the match process but why does applying to ACGME programs keep you from applying AOA? Timeline?

Good question and you're correct. The AOA match is before the ACGME match and if you match AOA you are bound to that spot and removed from ACGME match.

 

[DrEnderW]

I am not sure why you are making that AOA comparison... My point was that ACGME Gen Surg programs should not be out of reach for an average DO student... GAS which probably has a higher step1 is not out reach for a middle of the road DO student; thus, I don't understand why Gen Surg is more competitive for DO than GAS...

My bad - I absolutely agree with the point you were making.

I misread and I was just adding to the conversation by saying that a DO with an avg score wouldn't have a problem matching at least to AOA either.

 

[Gatorman177]

In general, lots of people apply to ACGME programs but it's mostly comprised of FM, IM, peds, and EM. I really don't know exact numbers, I am making the assumption that GS is applied to similar to other more competitive specialties. Even though GS isn't that competitive for MDs or DOs going AOA, it is decently competitive for DOs going ACGME so less apply. It's an instant filter for less to apply. There are thousands and thousands more IMGS than DOs that's why I'm assuming there is a small percentage of DOs.

I agree it's scary business if you don't have a strong app - another reason not many apply, in my opinion. AOA is a strong and viable option, even for competitive students.



Good question and you're correct. The AOA match is before the ACGME match and if you match AOA you are bound to that spot and removed from ACGME match.

Thank you for educating me on this! How do you think this process will be affected by the merger come 3 years from now when I'm applying to residency? If some of the AOA programs have received ACGME status, how would I apply to those programs?

 

[demayette]

My bad - I absolutely agree with the point you were making.

I misread and I was just adding to the conversation by saying that a DO with an avg score wouldn't have a problem matching at least to AOA either.

I guess most ACGME PDs think that DO are good enough to put patients to sleep, but not good enough to cut them open..😛

 

[hallowmann]

Thank you for educating me on this! How do you think this process will be affected by the merger come 3 years from now when I'm applying to residency? If some of the AOA programs have received ACGME status, how would I apply to those programs?

No one really knows this. It's possible though that programs that get ACGME accreditation before 2020 will either all be in the NRMP match or they will act the way dual-accredited programs act now, have specified DO spots in the AOA match and others in the NRMP match, etc. No one knows for sure how it will go though.

I don't know how it is among all DO grads but I know my school sends more people into ACGME residencies than it does AOA. Of course this is a generalization not just GS, but still. So it's not unreasonable to assume that half of the independent applicants are DO. But even if only 100 applied, that's still less than half of them land a spot. Scary business. I'm still pretty unfamiliar with the match process but why does applying to ACGME programs keep you from applying AOA? Timeline?

To put things in perspective, 146 US-IMGs and non-US IMGs matched GS in 2014. If we are assuming 350 applied with GS as their #1, and that all IMGs had matched (a very unlikely assumption), at MOST the DO applicant pool would be ~200.

Now if we assume IMGs and DOs had equivalent match rates in GS (a less unlikely, but still unlikely assumption), then the number of DO applicants would be closer to ~80.

Now if we assume that for IMGs, GS match rate is probably not significantly different than overall IMG match rate of ~50% (a reasonable assumption - but still an assumption because we lack the necessary data), then the number of DO applicants for GS was ~58 (DO GS match rate of ~76%, very close to the 2014 overall DO match rate of 77.7%).

The truth is probably somewhere between the last two sets of assumptions (i.e. DO applicants for GS were probably somewhere between 58 and 80), but probably closer to the latter.

 

[DrEnderW]

That is exactly my train of thought @hallowmann.

Well said.

 

[Gatorman177]

See those odds aren't nearly as daunting. It's too bad we don't have access to the exact numbers somewhere so we wouldn't have to assume! I appreciate your input

 

[Petypet]

Thank you for educating me on this! How do you think this process will be affected by the merger come 3 years from now when I'm applying to residency? If some of the AOA programs have received ACGME status, how would I apply to those programs?

You will know once you need to apply.

See those odds aren't nearly as daunting. It's too bad we don't have access to the exact numbers somewhere so we wouldn't have to assume! I appreciate your input

It would be nice from a conversation point of view, but how would that change where you go. If you got the grades and experiences, go ACGME. If you are border-line, go AOA and have a good shot at matching as numerous spots go unfilled every year.

 

[Mad Jack]

I'd be careful about some AOA GS programs with the merger. Since they're all falling under the ACGME soon, some of the weaker ones might end up closing due to being unable to meet the ACGME standards.

 

[cylondoctor]

I'd be careful about some AOA GS programs with the merger. Since they're all falling under the ACGME soon, some of the weaker ones might end up closing due to being unable to meet the ACGME standards.

not entirely sure on the veracity of this, but one of the assistant deans gave us a post-merger talk and I subsequently asked about lower tier AOA programs not making the cut and if they can close down while we're in the middle of a long 5-7 year residency. He said that is a possibility that they close down but those that are in the middle of a residency, "safe guards exist" for ppl to finish. Now he did not specify those "safe guards", but would like to know if anyone has heard of these.

 

[Mad Jack]

not entirely sure on the veracity of this, but one of the assistant deans gave us a post-merger talk and I subsequently asked about lower tier AOA programs not making the cut and if they can close down while we're in the middle of a long 5-7 year residency. He said that is a possibility that they close down but those that are in the middle of a residency, "safe guards exist" for ppl to finish. Now he did not specify those "safe guards", but would like to know if anyone has heard of these.

Programs have been closed in the past. Given that the ACGME will be running things, I'm not sure if the rule of your GME funding moving with you will apply to closed programs. The AOA had basically no safeguards with regard to program closures, basically you just had to scramble to find a place that would take you at that juncture in your training. Until you've got it in writing, trust no one. AOA program directors obviously will say to the deans that everything will be fine- if they didn't they'd risk a serious drop in applications.

 

[meliora27]

Let's say you match GS, which is a 5 year program. The way it works is that when you match, you come with 5 years of funding attached to you. So now let's say the program closes after your second year. You still have 3 years of GME funding attached to your name.

This is very attractive to a lot of programs. A new program can take you, and because you still have the funding stream, it costs them nothing.

This is how it was explained by an AOA DME who talked about an incident in the past where an AOA GS program was shut down and the residents had to find new training programs.

 

[Gatorman177]

So I guess a good plan would be sitting for USMLE and if I have the score and app for ACGME go that route, if not play it safe with AOA. I'm good with this.

 

[Elevencents]

So I guess a good plan would be sitting for USMLE and if I have the score and app for ACGME go that route, if not play it safe with AOA. I'm good with this.

I think it's foolish no matter what specialty you're interested in to not take the usmle.

 

[demayette]

I think that ACGME gen surgery bias toward MD is more pronounced than I thought... I had the chance to speak to a gen surg PD (new program) and he told me straight (off the record) that they favor MD applicants (AMG/IMG)... He also told me they have not taken a DO student since the program started (5 years ago), but they have taken a few IMG... This is crazy!