DOs Residency Merger with ACGME

[Seth Joo]

My school encourages people to go into what specialty they are interested in and even has tracks for people who want to do certain fields. That being said the majority end up in Primary Care and when I ask people what they want to do it's almost always peds, medicine, or fm. I mean I honestly think I want to do a non GI or Cards IM fellowship or Psych. Nothing is going to make me want to do surgery, radiology, or derm tbh.

Many DO schools encourage their students to become primary care physicians, to the point that they "self select" for primary care by the time they finish their education. A good percent of my classmates were aiming to become MDs so it only natural we follow their career habits.

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[Drrrrrr. Celty]

Many DO schools encourage their students to become primary care physicians, to the point that they "self select" for primary care by the time they finish their education. A good percent of my classmates were aiming to become MDs so it only natural we follow their career habits.

Almost everyone at KCU wanted to go MD. The majority are still very strongly pulled towards FM and Peds tho.

 

[Seth Joo]

Almost everyone at KCU wanted to go MD. The majority are still very strongly pulled towards FM and Peds tho.

That would seem natural given your school is one of the best DO programs in the country and gets the best students, about 40 percent of my school wanted to become MDs but life had other plans. That being said I still appreciate the fact my school has given me an opportunity to become a physician.

 

[meliora27]

It would be interesting to see a study that looked at applicants to both MD and DO schools, were accepted to both, and then ultimately matriculated at a DO school.

I would guess it's a single digit percent.

 

[Drrrrrr. Celty]

It would be interesting to see a study that looked at applicants to both MD and DO schools, were accepted to both, and then ultimately matriculated at a DO school.

I would guess it's a single digit percent.

Eh, I mean it's not significantly important in my opinion. We're all medical school students being taught a very high caliber level of education that allows us to practice something that thousands of people would trade anything to be able to do.

I think generally what we should examine and which is more inherently interesting, is the changing attributes of older generation osteopaths and the new wave of students who are generally closer to being like their MD comrades and how it relates to a change in position in regard to the usefulness, modality, and eventual desire to use in practice OMM.

 

[DocVader1990]

i read this thread out of genuine curiosity. it was nothin but typical sdn fear mongering and useless information. please state facts and stop the speculation. makes reading threads useless

Worse than useless, this thread is boring, which for a de facto MD vs DO insecurity thread is almost unheard of.

 

[Drrrrrr. Celty]

Worse than useless, this thread is boring, which for a de facto MD vs DO insecurity thread is almost unheard of.

I mean whether we want to admit it or not, as DO students we're not the top dog. People are scared regardless of whether it's substantiated or not.

 

[user3]

Exactly, there are plenty of residencies that are very DO friendly. Neurology, Psych, PMR, Gas, EM, OB/Gyn, etc. It's not like people are choosing FM at the end of a spike, they're doing over a lot of other specialties that aren't anymore competitive than FM.

"DO friendly" really seems to just mean "less competitive"/desirable. It is not as if those specialties are specifically welcoming of DO students, they simply have fewer USMD students interested in them (whether due to pay, lifestyle, midlevels, etc).

I find the term misleading tbh.

 

[DocVader1990]

I mean whether we want to admit it or not, as DO students we're not the top dog. People are scared regardless of whether it's substantiated or not.

The letters behind your name don't define who you are as an applicant or as a person. Just because a few PDs don't understand that simple concept doesn't mean you cant. In fact those programs are already red flags for elitism and narrow mindedness and dare I say ignorance.

What if I told you that the problem is not with D.Os but with the perception of some PDs of the DOs?

Just focus on being the best Med student you can be and you will find yourself appreciated, leave the politics to "better" men.

 

[Seth Joo]

It would be interesting to see a study that looked at applicants to both MD and DO schools, were accepted to both, and then ultimately matriculated at a DO school.

I would guess it's a single digit percent.

There are applicants who have chosen a DO school over an MD, the reason for this is usually location.

 

[Drrrrrr. Celty]

"DO friendly" really seems to just mean "less competitive"/desirable. It is not as if those specialties are specifically welcoming of DO students, they simply have fewer USMD students interested in them (whether due to pay, lifestyle, midlevels, etc).

I find the term misleading tbh.

I think the term is appropriate and distinct from less competitive. There are top tier residencies in certain fields that are competitive and also accept DOs, ex Psych, Gas, Path, PMR, which also require Step 1 scores over 240. This is in distinction to certain university IM programs that only have an average of 227 which says no DOs.

 

[Drrrrrr. Celty]

The letters behind your name don't define who you are as an applicant or as a person. Just because a few PDs don't understand that simple concept doesn't mean you cant. In fact those programs are already red flags for elitism and narrow mindedness and dare I say ignorance.

What if I told you that the problem is not with D.Os but with the perception of some PDs of the DOs?

Just focus on being the best Med student you can be and you will find yourself appreciated, leave the politics to "better" men.

I never claimed that my degree defined more or that I dislike it. I'm proud of being a DO student and I think that being where I am now will make me a good physician. That being said I'm not diluted enough to believe that I live in a vacuum devoid of observing parties and judgement. We do have to be reasonable in acknowledging that some fear is reasonable.

 

[235009]

I wish you guys would stop making it out to be the 7th Circle of Hell. It's not.

As you all know @Goro and I rarely agree on anything but I feel like this is not emphasized enough on sdn. IM, the biggest "primary care" field is getting more competitive and more desirable. It basically opens the door to a multitude of opportunities in addition to subspecialty training. So stop acting like primary care is a repository for failed med students.

 

[Drrrrrr. Celty]

As you all know @Goro and I rarely agree on anything but I feel like this is not emphasized enough on sdn. IM, the biggest "primary care" field is getting more competitive and more desirable. It basically opens the door to a multitude of opportunities in addition to subspecialty training. So stop acting like primary care is a repository for failed med students.

Honestly, SDN birthed this absurdity. It's like if you're not a harvard trained cardiologist then you probably failed the boards twice or something. Why is it that someone is forced into PCP? Could it possibly be that they actually enjoyed it and liked the balance of life?

I mean when one of the former mods on preDO started a FM residency despite having high boards scores I was pretty confused. But then I realized, she probably liked the field and there's nothing wrong with that.

 

[Noomm]

Honestly, SDN birthed this absurdity. It's like if you're not a harvard trained cardiologist then you probably failed the boards twice or something. Why is it that someone is forced into PCP? Could it possibly be that they actually enjoyed it and liked the balance of life?

I mean when one of the former mods on preDO started a FM residency despite having high boards scores I was pretty confused. But then I realized, she probably liked the field and there's nothing wrong with that.

I think it has more to do with the fact that, IIRC, only 25-30% of FM/IM doctors would choose the same specialty if they could do it over again. That just tells me that it must be miserable.

 

[Drrrrrr. Celty]

I think it has more to do with the fact that, IIRC, only 25-30% of FM/IM doctors would choose the same specialty if they could do it over again. That just tells me that it must be miserable.

Source? Also what's the general percentage of doctors who would choose any specialty.... or medicine entirely over again?

 

[Noomm]

Source? Also what's the general percentage of doctors who would choose any specialty.... or medicine entirely over again?

http://www.medscape.com/features/slideshow/compensation/2015/public/overview#page=17

I guess you could say that the numbers aren't great for any specialty other than derm, but it's still amazing just how low family medicine and internal medicine are.

 

[Drrrrrr. Celty]

I find it funny that IM doctors are more satisfied with their income than cardiologists.

 

[NurWollen]

As you all know @Goro and I rarely agree on anything but I feel like this is not emphasized enough on sdn. IM, the biggest "primary care" field is getting more competitive and more desirable. It basically opens the door to a multitude of opportunities in addition to subspecialty training. So stop acting like primary care is a repository for failed med students.

Amen to that. It would be hard to find a specialty more at the core of medicine than.... medicine.

 

[Noomm]

I find it funny that IM doctors are more satisfied with their income than cardiologists.

LOL yeah but honestly I think the numbers are close enough that they probably fall under the same confidence interval. I would consider the numbers to be the same.

 

[NurWollen]

I find it funny that IM doctors are more satisfied with their income than cardiologists.

LOL yeah but honestly I think the numbers are close enough that they probably fall under the same confidence interval. I would consider the numbers to be the same.

Or that pediatricians are more likely to be satisfied with their income than orthopedic surgeons?

 

[Mjolner]

View attachment 196544
http://www.medscape.com/features/slideshow/compensation/2015/public/overview#page=17

I guess you could say that the numbers aren't great for any specialty other than derm, but it's still amazing just how low family medicine and internal medicine are.

I feel like pretty much all the specialties that would choose another specialty are are the lower paying specialty. I guessing, but that seems to me to speak of paycheck envy.

 

[Seth Joo]

As you all know @Goro and I rarely agree on anything but I feel like this is not emphasized enough on sdn. IM, the biggest "primary care" field is getting more competitive and more desirable. It basically opens the door to a multitude of opportunities in addition to subspecialty training. So stop acting like primary care is a repository for failed med students.

There seems to be different tiers of Internal Medicine residencies that vary in quality and prestige, an IM residency at MGH is not the same as one at an AOA hospital. The one at MGH is more likely to lead to that individual specializing or going into academic medicine.

 

[Drrrrrr. Celty]

There seems to be different tiers of Internal Medicine residencies that vary in quality and prestige, an IM residency at MGH is not the same as one at an AOA hospital. The one at MGH is more likely to lead to that individual specializing or going into academic medicine.

Way to miss the point.

 

[235009]

There seems to be different tiers of Internal Medicine residencies that vary in quality and prestige, an IM residency at MGH is not the same as one at an AOA hospital. The one at MGH is more likely to lead to that individual specializing or going into academic medicine.

While true that you have more opportunities coming from a certain program you'll still find a good percentage of residents at these top programs who elect to become career Hospitalists or do primary care. At my program, which while not MGH is MGH-adjacent...geographically ;-) ....(good reputation and competitive) approximately 50% of the class elects to forego further training (usually Hospitalist or primary care).

 

[Noomm]

a good percentage of residents at these top programs who elect to become career Hospitalists or do primary care.

LOL "elect"... as if it was their choice

 

[Postictal Raiden]

LOL "elect"... as if it was their choice

Why would you say that? Nowadays, becoming a hospitalist is a much more financially sound decision than becoming an IM sub specialist in nephro/ID/Endo/geriatrics/A&I/Rheum. Heck, in many markets, it's even better than being a cardiologist. Working the typical 7 on/7 off schedule plus adding few shifts here and there on your weeks off can net you 300k+ in many urbanized markets, let alone rural ones.

 

[DocVader1990]

I never claimed that my degree defined more or that I dislike it. I'm proud of being a DO student and I think that being where I am now will make me a good physician. That being said I'm not diluted enough to believe that I live in a vacuum devoid of observing parties and judgement. We do have to be reasonable in acknowledging that some fear is reasonable.

Your starting to activate my troll detector.

If you want to be afraid you should go ahead, tremble in terror, poo your panties, cry in the corner for your mommy, so many fear activities for you to choose.

 

[NurWollen]

LOL "elect"... as if it was their choice

That's exactly his point... they are electing to become hospitalists or do primary care. Do you really think someone from a solid university IM program wouldn't have the opportunity to do a fellowship somewhere if they wanted to? Not everyone wants to work 80 hrs a week for a pittance of income for 2-3 more years. Some people want to start a real job and settle down sooner rather than later.

 

[Drrrrrr. Celty]

Your starting to activate my troll detector.

If you want to be afraid you should go ahead, tremble in terror, poo your panties, cry in the corner for your mommy, so many fear activities for you to choose.

I imagine you're very unpleasant to be around....

 

[DocVader1990]

I imagine you're very unpleasant to be around....

To top things off you also have a poor imagination.

 

[jaguar33]

Pretty close. This AACOM survey study in 2012 showed that about 12% of people with both a DO and MD acceptance went to a DO school.

It would be interesting to see a study that looked at applicants to both MD and DO schools, were accepted to both, and then ultimately matriculated at a DO school.

I would guess it's a single digit percent.

 

[NontradCA]

That's happening now. About 2/3rds of DO grads go into Primary Care. Someone has to do it. My students actually self-select for this. I wish you guys would stop making it out to be the 7th Circle of Hell. It's not.

This is all part of an evolution where Osteopathic and Allopathic medicine will merge. Remember, at one time Surgeons were not considered Physicians, something still incorporated into the name of Columbia's med school. American medicine has come a long way from the days where AT Still (an MD, BTW) felt obligated to design a new doctrine on the practice of medicine.

We all know that it's not so bad. It's just easy to use it as a scapegoat for the stress during school. I think for the people that do not want to do FM, administrators cramming it down your throat gets old real quick. There's also the prestige factor. I think this profession lures in folks who need some kind of validation.

 

[Seth Joo]

Pretty close. This AACOM survey study in 2012 showed that about 12% of people with both a DO and MD acceptance went to a DO school.

I would wager most of those people who were accepted to an MD program picked the DO school for location.

 

[NurWollen]

We all know that it's not so bad. It's just easy to use it as a scapegoat for the stress during school. I think for the people that do not want to do FM, administrators cramming it down your throat gets old real quick. There's also the prestige factor. I think this profession lures in folks who need some kind of validation.

This is probably true. I'm very interested in primary care and even I catch myself saying things like, "be careful or you'll end up stuck in...."

 

[SnowDoggy44]

That requirement is quite vague and does not explicitly exclude the possibility of a one-week crash course in OMT to give a "sufficient" background" (whatever that means) to any applicant. Note that it does not even mention basic competency in palpation or other aspects of osteopathic diagnosis.

I have no idea how much influence the AAO will have on the OPC of the acgme, but they recently released a position statement on the recommended knowledge base for entering residences with osteopathic recognition. In it they recommend that online lecture learning and in person palpation and OMT training be utilized. They recommend periodic assessment during basic training and a final assessment. Also they envision that this training could be implemented during the fourth year of medical school or the fourth year and intern year. Finally they recommend that the OPC designate a minimum number of hands-on hours but do not make any recommendations themselves about the minimum number. Where an MD candidate finds the time to do all of this during a busy medical school curriculum and schedule, I have no idea but it would seem tough unless it could be made as an elective for the student/intern.
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[ninjaman22]

If you guys haven't seen this yet. CUSOM was recently approved for ACGME accreditation for all of its current 363 residency positions here in NC.

http://www.aacom.org/news-and-event.../sept-2015/cusom-receives-acgme-accreditation

 

[Drrrrrr. Celty]

If you guys haven't seen this yet. CUSOM was recently approved for ACGME accreditation for all of its current 363 residency positions here in NC.

http://www.aacom.org/news-and-event.../sept-2015/cusom-receives-acgme-accreditation

An impressive new school with a true willingness to put its money where it's mouth is.

 

[SnowDoggy44]

If you guys haven't seen this yet. CUSOM was recently approved for ACGME accreditation for all of its current 363 residency positions here in NC.

http://www.aacom.org/news-and-event.../sept-2015/cusom-receives-acgme-accreditation

It was only approved for initial accreditation as a sponsoring institution just like many other osteopathic organizations serving as sponsoring institutions have achieved (Still OPTI, Midwestern, MSUCOM, KCUMB, numerous osteopathic hospitals). Its 19 programs can now individually go on to seek ACGME accreditation, but they each still have to go through the steps of Application -> Pre-accreditation -> Site visit -> RRC Review and decision -> Initial accreditation. This will take several months before any of the programs can gain the designation of ACGME accreditation.

In the sense that they beat many other prominent institutions such as OSU, PCOM, and NYCOMEC to initial accreditation is impressive or promising.

 

[Allykat1850]

If you guys haven't seen this yet. CUSOM was recently approved for ACGME accreditation for all of its current 363 residency positions here in NC.

http://www.aacom.org/news-and-event.../sept-2015/cusom-receives-acgme-accreditation

I have contacted a few of these residencies. It seems that due to the initial ACGME accreditation, the next few years these programs will not allow any non-CUSOM students to complete audition rotations at the sites. The programs will also switch next cycle to the MD match, so I guess it will be an early trial of a single accreditation? Kind of sucks for the DO students still wanting to apply only in the AOA match. If more programs follow suit and drop out of the AOA match, the 2017/2018 classes will really need to consider applying to both matches. It will all even out once the single match rolls around (2020), but it seems to me every class that matches until then is getting screwed over. There's also no standardization when programs may switch over, so who knows what the AOA match may look like in a couple years.

 

[hallowmann]

I have contacted a few of these residencies. It seems that due to the initial ACGME accreditation, the next few years these programs will not allow any non-CUSOM students to complete audition rotations at the sites. The programs will also switch next cycle to the MD match, so I guess it will be an early trial of a single accreditation? Kind of sucks for the DO students still wanting to apply only in the AOA match. If more programs follow suit and drop out of the AOA match, the 2017/2018 classes will really need to consider applying to both matches. It will all even out once the single match rolls around (2020), but it seems to me every class that matches until then is getting screwed over. There's also no standardization when programs may switch over, so who knows what the AOA match may look like in a couple years.

Realistically 65-75% of all DO students were applying to ACGME programs to begin with. 55%+ match ACGME and many others apply, but get pulled out after matching AOA. It really only screws over that small subset of the sizeable minority of students that want to apply only AOA and to the AOA programs that are switching to the NRMP match.

It's certainly an annoyance for that subset of students, but I'm not sure I'd classify it as screwing over all the classes of DOs between now and 2020.

In any case, I'm not really sure how all these programs can say they will switch matches next year. It may be their intention, but a lot has to happen between now and then for that to materialize.

 

[GUH]

"DO friendly" really seems to just mean "less competitive"/desirable. It is not as if those specialties are specifically welcoming of DO students, they simply have fewer USMD students interested in them (whether due to pay, lifestyle, midlevels, etc).

I find the term misleading tbh.

PM&R programs sometimes specifically advertise that they like having DOs.

 

[IslandStyle808]

PM&R programs sometimes specifically advertise that they like having DOs.

PM&R seems to be getting more competitive also.

 

[Drrrrrr. Celty]

PM&R seems to be getting more competitive also.

I think it has to do with the culture of the current pool of med students. They want a balance of work and play. PM&R is the ultimate specialty for life and work balance.

Though if it's anything like OMM it seems like it'd be pretty boring for the majority of applicants.

 

[sia_simba]

To the OP and others with similar questions.

1. The total residency spots in the country is more than all the US allopathic students and US osteopathic students combined. If you are competitive, you will get a spot, likewise, if you are not competitive, you will NOT get a spot regardless.
(When I was associate program direction, I removed DO's applicant from my desk who were not competitive)

2. There are more US osteopathic students than there are osteopathic programs.

3. A good number of Osteopathic residency programs unfortunately may end up closing, despite what the AOA and its respected colleges say. Like-wise, CMS allows "X" number of spots. The closed osteopathic spots will be gobbled up by the existing ACMGE programs.

4. The ACGME programs on probation for whatever reason will also be revamped if not closed and its spots given to bigger institution.

5. You will basically be competing against US allopathic students and US osteopathic students, unfortunately, the IMGs will always have their stigma regardless. It is true that most IMGs fill residency spots where US allopathic and osteopathic students don't want to go.

6. Yes you can apply to MD or DO schools, I would hesitate on applying to off-shore schools.

7. Osteopathic-trained and osteopathic boarded physicians "WILL BE CONSIDERED" for PD in almost all the specialties except a few. However, note on the phrase "will be considered". That will be dependent on the Chair of the department and the other directors. Politics will play a lot into this portion. Of course, if you know people, then it wouldn't be a program.

8. All Osteopathic residents in a current AOA program with ACGME approval will be allowed to sit for the ACGME specialty board, if they are accepted into specialty field.
(i.e. If I graduated from an AOA OBGYN program, I can apply for an ACGME OBGYN sub-specialty fellowship program and be accepted. However, I will not be able to sit for the sub-specialty board exam)
(The governing college and the board examiners are TWO DIFFERENT entity)

9. All the stats and numbers that people quoted on this thread is pure garbage. Its irrelevant and does not help make any decision because unfortunately, NO ONE really knows what the outcome will be. People can only assume.

Good luck to the OP and all others stuck in his/her situation. Please take note of point#6.

 

[abolt18]

The letters behind your name don't define who you are as an applicant or as a person. Just because a few PDs don't understand that simple concept doesn't mean you cant. In fact those programs are already red flags for elitism and narrow mindedness and dare I say ignorance.

What if I told you that the problem is not with D.Os but with the perception of some PDs of the DOs?

Just focus on being the best Med student you can be and you will find yourself appreciated, leave the politics to "better" men.

This type of comment makes me think of aesop's fable, "the Fox and the grapes" every. single. time.

 

[GUH]

This type of comment makes me think of aesop's fable, "the Fox and the grapes" every. single. time.

Would you prefer to work in a place in which you are welcome, or one in which you are not welcome?

 

[Drrrrrr. Celty]

Would you prefer to work in a place in which you are welcome, or one in which you are not welcome?

The place that provides me the most room for professional development.

 

[abolt18]

Would you prefer to work in a place in which you are welcome, or one in which you are not welcome?

You don't even know their reason for not taking DO's. Maybe they just already receive so many high caliper applicants, they don't see a need to increase the pool of applicants or they're too lazy to add to their already huge list of applications to look at. Maybe they had some bad experiences with a couple DO's so they can't look past that. Or maybe they really are a sour grape and your assumption is correct that they are so "elitist" they wouldn't ever consider a lowly DO.

My point is solely that assumptions are being made about the character of people we know nothing about.

 

[DrEnderW]

Basically all DOs will have to practice FM in South Dakota on uninsured patients.

Fortunately, this is what I said my passion was in my PS and at every interview so I should be all set!!!