DOs Residency Merger with ACGME

[GUH]

This is what I mean by ACGME standardizing the quality of care coming from different residencies. It will trickle down to DOs at some point. So, what does it mean? If you're a quality candidate as a DO, your options will obviously expand bc more doors will be opened for you.

Please provide some evidence of the last sentence. I am not aware of any increase in the number of opportunities for DOs to become surgeons due to the ACGME takeover of osteopathic GME.

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[AlbinoHawk DO]

Why dont DO schools receive NIH funding/funding for research?

It's not the school that receives or doesn't. It's the researchers at the institution that apply for NIH funding. At WesternU, we have a few research faculty and they all have grants, but of course, because the school is small, no PhD students and the researchers are generally no-name folks, the funding is limited and their publications too. If you're planning on making a research career, going to work for one of the non-public-osteopathic-associated schools is a very bad career move. So now you're wondering what kind of PhDs go to work for these schools. These tend to be folks that see research as secondary and prefer either teaching or administrative jobs, or they come from a foreign country and don't have the CV to be hired by a real university.

 

[GUH]

Ppl like to bring up this notion that the matching abilities of DOs to get into competitive specialties will be damaged. I'm saying that not many DOs want surgery so we're really overblowing this.

Nor should we throw them under the bus for nebulous goals such as standardization in the absence of evidence showing that it is necessary.

 

[IslandStyle808]

Isn't the whole point of OPTI's so that you have DO schools helping to organize hospital-based residencies? Does anyone know if the residency in this case belongs to the hospital or to the school?

From what I recall, either a school can be an OPTI sponsor or a hospital can be an OPTI sponsor. I believe a school can join the OPTI network of a hospital. Would be interesting to know all the different set ups though.

EDIT made

 

[68PGunner]

Please prvude some evidence of the last sentence. I am not aware of any increase in the number of opportunities for DOs to become surgeons due to the ACGME takeover of osteopathic GME.

There's no evidence available at this time. It's all just speculation from both aisles of the conversation.

 

[Mjolner]

Ppl like to bring up this notion that the matching abilities of DOs to get into competitive specialties will be damaged. I'm saying that not many DOs want surgery so we're really overblowing this.

There are competitive specialties that aren't considered surgery even if they have procedures. And I think lots of DOs do want surgery and other competitive specialities, just they know that isn't going to happen so they temper their expectations.
I mean I want to be stranded on a deserted island with a bunch of Victoria's Secret models, but that isn't going to happen so I shoot for more obtainable goals, like you know, developing superpowers.

 

[IslandStyle808]

There are competitive specialties that aren't considered surgery even if they have procedures. And I think lots of DOs do want surgery and other competitive specialities, just they know that isn't going to happen so they temper their expectations.
I mean I want to be stranded on a deserted island with a bunch of Victoria's Secret models, but that isn't going to happen so I shoot for more obtainable goals, like you know, developing superpowers.

I believe this to be the truth. It is an opting out phenomenon among DO students. For instance, my state MD school is a primary care school. However, nearly half the matches are in specialties. The last match list I checked there were 3 people who matched into derm from a class of 60.

 

[scoKraz4]

Ppl like to bring up this notion that the matching abilities of DOs to get into competitive specialties will be damaged. I'm saying that not many DOs want surgery so we're really overblowing this.

How do you know this?? I know at least a third or more of my DO class wants to go into something in the surgical field. My friend in another DO school said it seemed like half of his class wanted some sort of surgical specialty as well. Is there some sort of statistic you are referring to?

 

[Drrrrrr. Celty]

How do you know this?? I know at least a third or more of my DO class wants to go into something in the surgical field. My friend in another DO school said it seemed like half of his class wanted some sort of surgical specialty as well. Is there some sort of statistic you are referring to?

Well, how many DOs applied to surgery in general both acgme and AOA last year? The number from what I remember is less than 5% of DOs.

 

[Seth Joo]

This is what I mean by ACGME standardizing the quality of care coming from different residencies. It will trickle down to DOs at some point. So, what does it mean? If you're a quality candidate as a DO, your options will obviously expand bc more doors will be opened for you. However, if you can't meet the cut for a surgery residency, it means that you either are poorly prepared by your school in term of clinical education or you're not suitable for the specialty.

No one can predict the future but the COCA has been opening up new schools left and right, I am not sure how well the newer schools will perform in terms of them training their students in terms of clinical schools, even schools that have been around nearly 20 years have issues with their clinical education, so this merger could wind up hurting DO students.

The main benefit here is that people who go to dual accredited programs can apply for fellowships, but I do not like the idea of AOA programs shutting their doors, it does not give a me a good feeling.

I would not recommend the newer DO schools to someone that is applying these days who wants to get into a competitive specialty, their interests would be best served at the older more well established schools. For those who want to become PCPs any DO school will get you from point A to B.

 

[Drrrrrr. Celty]

No one can predict the future but the COCA has been opening up new schools left and right, I am not sure how well the newer schools will perform in terms of them training their students in terms of clinical schools, even schools that have been around nearly 20 years have issues with their clinical education, so this merger could wind up hurting DO students.

The main benefit here is that people who go to dual accredited programs can apply for fellowships, but I do not like the idea of AOA programs shutting their doors, it does not give a me a good feeling.

I would not recommend the newer DO schools to someone that is applying these days who wants to get into a competitive specialty, their interests would be best served at the older more well established schools. For those who want to become PCPs any DO school will get you from point A to B.

I'm pretty sure 80% of graduates from newer DO schools will not be competitive for anything but low tier FM due to the fact that they will be bottom of the barrel applicants.

We have enough DO schools for the applying body to be competitive enough to score well on boards and etc. Any on top of that will mostly just be getting a class that will do poorly, ex. LUCOM & WCUCOM.

 

[Ipper91]

I'm pretty sure 80% of graduates from newer DO schools will not be competitive for anything but low tier FM due to the fact that they will be bottom of the barrel applicants.

We have enough DO schools for the applying body to be competitive enough to score well on boards and etc. Any on top of that will mostly just be getting a class that will do poorly, ex. LUCOM & WCUCOM.

I don't see logic behind your statement of "80% of newer DO school graduates not being competitive..." There are plenty amazing students who just didn't do well early in their undergraduate career and had to come back from behind. Once you're in medical school, it's a whole different ball game, you shape up or get toasted in the oven. I go to a newer school and not only is our class highly competitive nationally to other DO schools in terms of grades, but we've gotten great feedback from our 3rd years going to clinical rotations for the first time (our first class is 3rd years now). How can I make such a statement? Well I go to ACOM where they've had rotation sites for the past 10 years established in Alabama. They have had students from KCUMB, GA-PCOM, NOVA, and many others who have already rotated in those sites as a comparison. Our class has even been told that they're more professional and has on occasion stood out better in terms of performance than UAB, the top MD school in our state. (I said on occasion...don't twist that as me making extreme statements)
^^ That was in reply to your statement about the 80%

Back on topic about the merger...no one knows what is going to happen. We have faculty who have served on the board for AOA and they said the leadership wasn't expecting this many DO programs to close when they first started (back in like 2011-2012 time). Now that it's actually happening, they're seeing that the situation for DO's is seeming worse because there are more programs closing than initially anticipated. Based on the past and current situations, I don't think anyone can expect to predict the future.


EDIT: To add on to the topic...what really concerns me is...does anyone know what the fate of the neuromuscular/omm residencies will be?

 

[Drrrrrr. Celty]

I don't see logic behind your statement of "80% of newer DO school graduates not being competitive..." There are plenty amazing students who just didn't do well early in their undergraduate career and had to come back from behind. Once you're in medical school, it's a whole different ball game, you shape up or get toasted in the oven. I go to a newer school and not only is our class highly competitive nationally to other DO schools in terms of grades, but we've gotten great feedback from our 3rd years going to clinical rotations for the first time (our first class is 3rd years now). How can I make such a statement? Well I go to ACOM where they've had rotation sites for the past 10 years established in Alabama. They have had students from KCUMB, GA-PCOM, NOVA, and many others who have already rotated in those sites as a comparison. Our class has even been told that they're more professional and has on occasion stood out better in terms of performance than UAB, the top MD school in our state. (I said on occasion...don't twist that as me making extreme statements)
^^ That was in reply to your statement about the 80%

Back on topic about the merger...no one knows what is going to happen. We have faculty who have served on the board for AOA and they said the leadership wasn't expecting this many DO programs to close when they first started (back in like 2011-2012 time). Now that it's actually happening, they're seeing that the situation for DO's is seeming worse because there are more programs closing than initially anticipated. Based on the past and current situations, I don't think anyone can expect to predict the future.


EDIT: To add on to the topic...what really concerns me is...does anyone know what the fate of the neuromuscular/omm residencies will be?

Being entirely honest and frank there is a relationship between mcat scores, grades, etc and how you do in medical school. Someone who has a set of lower scores and enters medical school has a statistically likely chance for an incident that reduces their competitiveness for residency i.e class failure, year retake, board retake, etc than someone who is average or above.

So yes, it's observable that someone with low scores will do poorly. And when it comes down to it, most new schools are opening up in places that will not attract high tier applicants. Not many will be applying to Bozmann in the middle of MN and so it'll be a last choice school for applicants who are doing very very poorly.

ACOM isn't really what I was talking about. ACOM is a good school with a good average. Many other new DO schools that are coming out are not.

 

[68PGunner]

I don't see logic behind your statement of "80% of newer DO school graduates not being competitive..." There are plenty amazing students who just didn't do well early in their undergraduate career and had to come back from behind. Once you're in medical school, it's a whole different ball game, you shape up or get toasted in the oven. I go to a newer school and not only is our class highly competitive nationally to other DO schools in terms of grades, but we've gotten great feedback from our 3rd years going to clinical rotations for the first time (our first class is 3rd years now). How can I make such a statement? Well I go to ACOM where they've had rotation sites for the past 10 years established in Alabama. They have had students from KCUMB, GA-PCOM, NOVA, and many others who have already rotated in those sites as a comparison. Our class has even been told that they're more professional and has on occasion stood out better in terms of performance than UAB, the top MD school in our state. (I said on occasion...don't twist that as me making extreme statements)
^^ That was in reply to your statement about the 80%

Back on topic about the merger...no one knows what is going to happen. We have faculty who have served on the board for AOA and they said the leadership wasn't expecting this many DO programs to close when they first started (back in like 2011-2012 time). Now that it's actually happening, they're seeing that the situation for DO's is seeming worse because there are more programs closing than initially anticipated. Based on the past and current situations, I don't think anyone can expect to predict the future.


EDIT: To add on to the topic...what really concerns me is...does anyone know what the fate of the neuromuscular/omm residencies will be?

We're talking about WCU and LUCOM here, and future Caribbean schools that are disguised as DOs. ACOM is actually decent.

 

[Mjolner]

Being entirely honest and frank there is a relationship between mcat scores, grades, etc and how you do in medical school. Someone who has a set of lower scores and enters medical school has a statistically likely chance for an incident that reduces their competitiveness for residency i.e class failure, year retake, board retake, etc than someone who is average or above.

So yes, it's observable that someone with low scores will do poorly. And when it comes down to it, most new schools are opening up in places that will not attract high tier applicants. Not many will be applying to Bozmann in the middle of MN and so it'll be a last choice school for applicants who are doing very very poorly.

ACOM isn't really what I was talking about. ACOM is a good school with a good average. Many other new DO schools that are coming out are not.

What you're discounting is the student (and while this is not the majority, this is not uncommon among DO students) who did abysmally (2.something) 10 years ago in undergrad, returned and did stellar (3.8+) but still doesn't have MD GPA when combined so they go DO and perform stellar there too. These people go on to do well on boards and rotations.

DO student populations are exceedingly diverse in academic backgrounds. Some never got it together all the way, and some got it together too late.

What schools were you referencing? There are few schools newer than ACOM.

 

[Ipper91]

Being entirely honest and frank there is a relationship between mcat scores, grades, etc and how you do in medical school. Someone who has a set of lower scores and enters medical school has a statistically likely chance for an incident that reduces their competitiveness for residency i.e class failure, year retake, board retake, etc than someone who is average or above.

So yes, it's observable that someone with low scores will do poorly. And when it comes down to it, most new schools are opening up in places that will not attract high tier applicants. Not many will be applying to Bozmann in the middle of MN and so it'll be a last choice school for applicants who are doing very very poorly.

ACOM isn't really what I was talking about. ACOM is a good school with a good average. Many other new DO schools that are coming out are not.

We're talking about WCU and LUCOM here, and future Caribbean schools that are disguised as DOs. ACOM is actually decent.

I kind of get what you guys are saying, but it just sounded harsh to the students who are still making an effort. I am also unaware of those schools and their quality, but can't knock down all the new schools . And even so..I do feel for some people because they just get the bad end of things. I am a true example because I was on the lower side of those scores..average on MCAT, but that didn't reflect my abilities because of an upward trend. Some people just need a foot in the door wherever possible.

 

[AlteredScale]

Research wasn't a focus before. However, older DOs are catching up to the research landscape.

I dont think thats true 68PGunner. Even the "top DO schools" research wise (MSU, OU, OSU, Rowan) pale in comparison when it comes to NIH funding (and that is what matters, not professors getting intramural pick-me-up seed grants because they cant win anything coming from a small DO inst).

Go search Loma Linda or UC Davis (less prestiged MD schools compared to the HYPS) and count how man R01s they have. Do the same for any DO school and youll be happy to see one or two.

There is no push or drive to do research. Touro Harlem doesnt have anything to offer to make a professor with a few active grants jump ship from Icahn SOM or NYU SOM. I am only aware that my school just got its FIRST PI who has NIH grant funding because they provided her with essentially every resource she needed to continue forth and keep publishing (that meant buying state of the art confocal microscopy machines worth hundreds of thousands of dollars.

 

[AlteredScale]

More and more of these aoa programs are closing and imo its for the better. These were programs that at this point in time, admit that they couldnt afford hiring the proper staff for clinical departments for the residents, and also they cant or dont have the manpower of attending physicians who can teach at the GME level.

Additionally these were programs with a resident to faculty ratio of 4 to 1. Which means as a resident in gen surgery, you had perhaps 12 attendings to consult and train from. None of them sub specialized, none of them having participated in research ever so as a resident, youve been gloriously pigeon-holed and locked out of getting into fellowships or doing anything outside of a community hospital. If you are fine with that and knew that coming in great. But for those who suddenly have an interest are SOL.

 

[Drrrrrr. Celty]

I dont think thats true 68PGunner. Even the "top DO schools" research wise (MSU, OU, OSU, Rowan) pale in comparison when it comes to NIH funding (and that is what matters, not professors getting intramural pick-me-up seed grants because they cant win anything coming from a small DO inst).

Go search Loma Linda or UC Davis (less prestiged MD schools compared to the HYPS) and count how man R01s they have. Do the same for any DO school and youll be happy to see one or two.

There is no push or drive to do research. Touro Harlem doesnt have anything to offer to make a professor with a few active grants jump ship from Ichan SOM or NYU SOM. I am only aware that my school just got its FIRST PI who has NIH grant funding because they provided her with essentially every resource she needed to continue forth and keep publishing (that meant buying state of the art confocal microscopy machines worth hundreds of thousands of dollars.

You've got to start somewhere man. KCU hopefully will by the end of the decade have a few PhD programs and some decent level of research going. But honestly, as I've said before, DO schools will not likely ever be research orientated or even big on it as the paradigm is still focused on physician production, not research. I think it's a bit of a disadvantage, but there are worst things to skimp on, namely rotations.

 

[Drrrrrr. Celty]

More and more of these aoa programs are closing and imo its for the better. These were programs that at this point in time, admit that they couldnt afford hiring the proper staff for clinical departments for the residents, and also they cant or dont have the manpower of attending physicians who can teach at the GME level.

Additionally these were programs with a resident to faculty ratio of 4 to 1. Which means as a resident in gen surgery, you had perhaps 12 attendings to consult and train from. None of them sub specialized, none of them having participated in research ever so as a resident, youve been gloriously pigeon-holed and locked out of getting into fellowships or doing anything outside of a community hospital. If you are fine with that and knew that coming in great. But for those who suddenly have an interest are SOL.

I agree. Closing poor programs is quality control. And thankfully we're dealing with those closes by opening up GME that will survive the merger.

 

[AlteredScale]

You've got to start somewhere man. KCU hopefully will by the end of the decade have a few PhD programs and some decent level of research going. But honestly, as I've said before, DO schools will not likely ever be research orientated or even big on it as the paradigm is still focused on physician production, not research. I think it's a bit of a disadvantage, but there are worst things to skimp on, namely rotations.

I agree, KCU has made the right steps with regards to research. And i def agree with regards to the fact that a DO schooll will never leap and bound over its barriers to resources to become a research intensive medical school or simply provide research opps that even a "bottom of the barrel" MD school would offer.

Rotations need to get fixed otherwise, I can see lcme taking over this aspect when they realize the fourth year DO doesnt know how to function with a resident team because they spent 3rd year following around a physician (BUT second assist in everything though #sarcasm),.

 

[SouthernSurgeon]

It's not the school that receives or doesn't. It's the researchers at the institution that apply for NIH funding. At WesternU, we have a few research faculty and they all have grants, but of course, because the school is small, no PhD students and the researchers are generally no-name folks, the funding is limited and their publications too. If you're planning on making a research career, going to work for one of the non-public-osteopathic-associated schools is a very bad career move. So now you're wondering what kind of PhDs go to work for these schools. These tend to be folks that see research as secondary and prefer either teaching or administrative jobs, or they come from a foreign country and don't have the CV to be hired by a real university.

And NIH does look at institutional support (and mentorship for K awards), so even if a Bona fide researcher is trying to apply with a good proposal, they are already at a disadvantage.

More and more of these aoa programs are closing and imo its for the better. These were programs that at this point in time, admit that they couldnt afford hiring the proper staff for clinical departments for the residents, and also they cant or dont have the manpower of attending physicians who can teach at the GME level.

Additionally these were programs with a resident to faculty ratio of 4 to 1. Which means as a resident in gen surgery, you had perhaps 12 attendings to consult and train from. None of them sub specialized, none of them having participated in research ever so as a resident, youve been gloriously pigeon-holed and locked out of getting into fellowships or doing anything outside of a community hospital. If you are fine with that and knew that coming in great. But for those who suddenly have an interest are SOL.

And to give a comparison point, the faculty resident ratio for my program is nearly 20 to 1

 

[Drrrrrr. Celty]

I agree, KCU has made the right steps with regards to research. And i def agree with regards to the fact that a DO schooll will never leap and bound over its barriers to resources to become a research intensive medical school or simply provide research opps that even a "bottom of the barrel" MD school would offer.

Rotations need to get fixed otherwise, I can see lcme taking over this aspect when they realize the fourth year DO doesnt know how to function with a resident team because they spent 3rd year following around a physician (BUT second assist in everything though #sarcasm),.

For what it is worth it seems like most DO residents enter ACGME residencies are do fine honestly. So I think that's a bit much.

 

[235009]

I'm just going to say this. But, even at MDs, a good portion of the students go to primary care.

As someone who was counted in that "primary care" statistic at my med school I can tell you that it's total BS. The majority of those going into IM will either subspecialize or go into hospital medicine (hospitalist) which is the exact opposite of primary care.

He's referring to the quality level of the programs including primary care.

You should honestly follow up your comment with at least the understanding that match lists at DO schools are getting better even beyond the 2-4 matchs in Derm/ Rad Onc/ Plastics that schools obtain. The caliber of residencies and matching to established programs is improving in many schools and there is familiarity with the graduates of DO students at programs in their states/ local.

Likewise it's worth mentioning that newer DO GME programs are still being founded and still keeping the door to specialization for DOs open.

I'm not some pre-med who counts up the number of derm and neurosurgery matches on a school's match list to try and determine how good it is. I look at where people are matching, primarily in IM and I haven't seen much improvement. At most only 15-20% are matching at university programs (almost all lower tier or in undesirable locations) and there are some schools that have next to none.

We'll see if these new DO GME spots survive the "merger" and what they'll look like if they do

I still don't understand where people got this idea that the majority or even a sizable minority of IM residents or any resident from MD schools actually go on to do fellowships. Hell, I say I want to do a fellowship but I'm pretty sure once I'm done with my residency I'll be wanting to stay the hell away from anything related to training for a lifetime.

Likewise I don't understand why people think that IM subspecialties outside of Cards or GI are actually competitive. And mind you that I'd gut myself before doing either even if I was given the option.

You don't understand it because you haven't experienced anything yet. First of all as I said above the majority of US MD IM residents who don't subspecialize go on to be hospitalists rather than primary care doctors. A sizable portion do subspecialize, particularly at more academic/prestigious programs, less so at community programs. The degree to which IM subspecialities are competitive depends on who you are and where you're coming from. US MD at a university program - no problem. US MD at community program - tough. DO or IMG at university program - even tougher. DO or IMG at community program - toughest. In terms of competitiveness: GI, Cardiology, Pulm/CC, heme/onc and to a lesser extent rheum and endocrine are competitive. ID, renal, geriatrics - just apply and you'll be fine.

As a first year med student I'd recommend you do more listening than talking regarding these topics. Try not to be defensive. No one is attacking you, we're just giving you a sense of the reality that lies ahead from our experiences.

 

[IslandStyle808]

As someone who was counted in that "primary care" statistic at my med school I can tell you that it's total BS. The majority of those going into IM will either subspecialize or go into hospital medicine (hospitalist) which is the exact opposite of primary care.





I'm not some pre-med who counts up the number of derm and neurosurgery matches on a school's match list to try and determine how good it is. I look at where people are matching, primarily in IM and I haven't seen much improvement. At most only 15-20% are matching at university programs (almost all lower tier or in undesirable locations) and there are some schools that have next to none.

We'll see if these new DO GME spots survive the "merger" and what they'll look like if they do



You don't understand it because you haven't experienced anything yet. First of all as I said above the majority of US MD IM residents who don't subspecialize go on to be hospitalists rather than primary care doctors. A sizable portion do subspecialize, particularly at more academic/prestigious programs, less so at community programs. The degree to which IM subspecialities are competitive depends on who you are and where you're coming from. US MD at a university program - no problem. US MD at community program - tough. DO or IMG at university program - even tougher. DO or IMG at community program - toughest. In terms of competitiveness: GI, Cardiology, Pulm/CC, heme/onc and to a lesser extent rheum and endocrine are competitive. ID, renal, geriatrics - just apply and you'll be fine.

As a first year med student I'd recommend you do more listening than talking regarding these topics. Try not to be defensive. No one is attacking you, we're just giving you a sense of the reality that lies ahead from our experiences.

I have a question about DO/IMGs at university programs. Why is there a difference in treatment between a US MD at a university program versus a DO/IMG at one? Considering that when they come out, they have equivalent training. This is assuming both are at mid-tier programs (no difference in tiers).

 

[68PGunner]

I have a question about DO/IMGs at university programs. Why is there a difference in treatment between a US MD at a university program versus a DO/IMG at one? Considering that when they come out, they have equivalent training. This is assuming both are at mid-tier programs (no difference in tiers).

There is definitely a bias. However, MeatTornado has a history of branding DOs as second class citizens in comparison to MDs.

He seems to take pleasure in it.

 

[IslandStyle808]

There is definitely a bias. However, MeatTornado has a history of branding DOs as second class citizens in comparison to MDs.

He seems to take pleasure in it.

I don't understand why would there would be a strong bias, because if the exact same training is done then the quality of resident would be the same. There are still DO that are able to match into competitive fellowships as long as they are in mid-tier programs. I am wondering if there is really is a legitimate reason or should I chop it up to DO bias?

 

[68PGunner]

As someone who was counted in that "primary care" statistic at my med school I can tell you that it's total BS. The majority of those going into IM will either subspecialize or go into hospital medicine (hospitalist) which is the exact opposite of primary care.

I have no doubt that 90% of all internists from both DO and MD schools have plans to specialize in the future. However, I find it comical that you try to separate the role of a hospitalist being different from primary care, when the only noticeable difference is the patient population -- inpatient vs outpatient. I guess that DOs can't be hospitalists since they're inferior to MDs in every way and are equivalent to Caribbean caliber med students disguised as US medical students.

Excuse me but I don't buy what you're selling. I'm not some clown on this board who's easily impressed or intimidated by your credentials. What I don't appreciate is the way you try to project your insecurity and misery on others by over-exaggerating the gloom and doom scenario.

My general advice to everyone is to chill out, try your best, and live life with no regrets. Good things will come to good, hardworking people.

 

[68PGunner]

I don't understand why would there would be a strong bias, because if the exact same training is done then the quality of resident would be the same. There are still DO that are able to match into competitive fellowships as long as they are in mid-tier programs. I am wondering if there is really is a legitimate reason or should I chop it up to DO bias?

This guy is a Stony Brook MD with a god complex. It's ok. He works hard to get where he is after being rejected by the Ivy League med schools. But, he will never be happy in life bc he will always compare himself to others instead of focusing on himself. Everyone has an agenda around here. He probably doesn't believe 50-60% of his bs, but he just says it in order to laugh at the gloom and doom spewed by DOs premeds/students.

 

[68PGunner]

I don't understand why would there would be a strong bias, because if the exact same training is done then the quality of resident would be the same. There are still DO that are able to match into competitive fellowships as long as they are in mid-tier programs. I am wondering if there is really is a legitimate reason or should I chop it up to DO bias?

I personally don't believe MeatPotato bs about DOs and MDs from the same IM caliber of programs being branded differently by PDs. It's pure horse manure. Nobody gives a damn about my top five undergraduate degree when I apply for medical schools as a nontrad.

 

[235009]

I have a question about DO/IMGs at university programs. Why is there a difference in treatment between a US MD at a university program versus a DO/IMG at one? Considering that when they come out, they have equivalent training. This is assuming both are at mid-tier programs (no difference in tiers).

I don't understand why would there would be a strong bias, because if the exact same training is done then the quality of resident would be the same. There are still DO that are able to match into competitive fellowships as long as they are in mid-tier programs. I am wondering if there is really is a legitimate reason or should I chop it up to DO bias?

I actually don't know if fellowship PDs would prefer the US MD over the DO if they went to the same residency program. Maybe not. That's not what I was trying to say. The subtext of what I was saying accounts for the caliber of university program I've seen most commonly represented on DO and IMG match lists. I can see that definitely wasn't clear.

I find it comical that you try to separate the role of a hospitalist being different from primary care, when the only noticeable difference is the patient population -- inpatient vs outpatient.

The only thing comical here is this ridiculously stupid and misinformed statement. I'm so glad I was able to immortalize it with a quote before you deleted it because it's a perfect example of the fact that you have no f'n idea what you're talking about.

Please explain to me how a Hospitalist is the same as a primary care doctor?

I guess that DOs can't be hospitalists since they're inferior to MDs in every way

Huh? No one said that. A good portion of DOs who do IM become Hospitalists too.

I'm not some clown on this board

You most certainly are. Getting this riled up when we're trying to have an adult discussion and saying ridiculous things like Hospitalist = primary care. Classic clownin'.

Nobody gives a damn about my top five undergraduate degree when I apply for medical schools as a nontrad.

Actually they do. An adcom member at my school told me specifically that they prefer students from ivy league schools....and it showed. I undoubtedly had an advantage because I graduated from an ivy league undergrad.


Sent from my iPhone using SDN mobile app

 

[AlteredScale]

Alright please keep the name calling down.

Imo, a hospitalist at an academic med center such as tufts has a much different role than an IM trained primary care physician.

I do not think MT is trying to down DOs, he's never said DOs are lower class MDs and I'm sure he'd agree with me to say that we are both physicians down the road. The issue he brings to light is that as a DO and just by choosing the path you've locked yourself out of a whole multitude of top tier and mid tier academic specialties. Now you can go on and say "who cares about stuff like that I'll get the same training at Podunk hospital in Topeka, MO in internal med" and find out that 1) you don't see a variety of pathology that you would working in an inner city academic hospital 2) you can't access research since the program you're in doesn't have any research going for it and you live too far away to go to another inst and 3) you've essentially forced yourself to be a hospitalist because you will not have a competitive resume and additionally, you're a DO.

You can kick and scream and say that's not true but come 4th year you'll realize just how hard it is to get into these academic programs . And instead of accepting it and really pushing to prevent yourself from having a subpar application come residency time because the only research your school offered was OMM and evolutionary anatomy of non human primates you go in and get hit with a huge dose of reality.

 

[jordansetron]

Alright please keep the name calling down.

Imo, a hospitalist at an academic med center such as tufts has a much different role than an IM trained primary care physician.

I do not think MT is trying to down DOs, he's never said DOs are lower class MDs and I'm sure he'd agree with me to say that we are both physicians down the road. The issue he brings to light is that as a DO and just by choosing the path you've locked yourself out of a whole multitude of top tier and mid tier academic specialties. Now you can go on and say "who cares about stuff like that I'll get the same training at Podunk hospital in Topeka, MO in internal med" and find out that 1) you don't see a variety of pathology that you would working in an inner city academic hospital 2) you can't access research since the program you're in doesn't have any research going for it and you live too far away to go to another inst and 3) you've essentially forced yourself to be a hospitalist because you will not have a competitive resume and additionally, you're a DO.

You can kick and scream and say that's not true but come 4th year you'll realize just how hard it is to get into these academic programs . And instead of accepting it and really pushing to prevent yourself from having a subpar application come residency time because the only research your school offered was OMM and evolutionary anatomy of non human primates you go in and get hit with a huge dose of reality.

For students doing research in medical school, how involved are they in it? I did research at my undergrad and med students would work there too but it seemed like they pretty much did busy work for an hour or so a week and the professor would just tac their name onto the publication. I think it is important to get exposure to the research world but I seriously doubt that medical students are actually participating in a meaningful way. Could just be my own experience though.

And I think no one will deny that there is some significant bias against DOs at "top-tier" (ugh I hate that phrase) university programs, but the argument is whether or not that bias has enough merit to justify the discrimination

 

[AlteredScale]

For students doing research in medical school, how involved are they in it? I did research at my undergrad and med students would work there too but it seemed like they pretty much did busy work for an hour or so a week and the professor would just tac their name onto the publication. I think it is important to get exposure to the research world but I seriously doubt that medical students are actually participating in a meaningful way. Could just be my own experience though.

And I think no one will deny that there is some significant bias against DOs at "top-tier" (ugh I hate that phrase) university programs, but the argument is whether or not that bias has enough merit to justify the discrimination

Im in research (bench work) right now and I can tell you that the amount of time I out in compared to the lab i was in at ucsd is significantly lower. PIs know we dont have a lot of time but they still expect to see a good effort made to be involved in projects. I dont agree that Med students participating in research are just there to get the pub, a lot of of these MD students had signficiant research exp in undergrad and so coming into lab and already knowing how ti do a western, IHC, cardiac puncture, or flow makes it so that you can come in ever week and do some sort of project that you can call your own.

 

[68PGunner]

Alright please keep the name calling down.

Imo, a hospitalist at an academic med center such as tufts has a much different role than an IM trained primary care physician.

I do not think MT is trying to down DOs, he's never said DOs are lower class MDs and I'm sure he'd agree with me to say that we are both physicians down the road. The issue he brings to light is that as a DO and just by choosing the path you've locked yourself out of a whole multitude of top tier and mid tier academic specialties. Now you can go on and say "who cares about stuff like that I'll get the same training at Podunk hospital in Topeka, MO in internal med" and find out that 1) you don't see a variety of pathology that you would working in an inner city academic hospital 2) you can't access research since the program you're in doesn't have any research going for it and you live too far away to go to another inst and 3) you've essentially forced yourself to be a hospitalist because you will not have a competitive resume and additionally, you're a DO.

You can kick and scream and say that's not true but come 4th year you'll realize just how hard it is to get into these academic programs . And instead of accepting it and really pushing to prevent yourself from having a subpar application come residency time because the only research your school offered was OMM and evolutionary anatomy of non human primates you go in and get hit with a huge dose of reality.

See I can accept the fact that DOs are pretty much locked out of top tier academic centers in most cases. However, the idea that DOs are locked out of mid tier programs is a little preposterous. Graduating DOs from older schools this year are still among the group with 3.2-3.4 average gpa and 26 mcat. Graduating DOs in 2020-2022 will be an entire different group w 3.5-3.6 average gpa with 28-29 mcat.

I'm always a firm believer that a school match list is based on the caliber of students.

 

[68PGunner]

Actually they do. An adcom member at my school told me specifically that they prefer students from ivy league schools....and it showed. I undoubtedly had an advantage because I graduated from an ivy league undergrad.
Sent from my iPhone using SDN mobile app

I'm sure that the person you talk to is telling the truth. However, that doesn't explain the fact that every year hundreds of applicants from lower tier undergrads get accepted to top programs while studs like yourself have to settle for lesser programs.

My point is that the impact of your Ivy League undergrad degree is negligible. The same applies to the title DO and MD especially if both candidates come from similar residencies.

 

[AlteredScale]

I'm sure that the person you talk to is telling the truth. However, that doesn't explain the fact that every year hundreds of applicants from lower tier undergrads get accepted to top programs while studs like yourself have to settle for lesser programs.

My point is that the impact of your Ivy League undergrad degree is negligible. The same applies to the title DO and MD especially if both candidates come from similar residencies.

Idk if what hes getting at is saying no low tier undergrad students can get into a top tier medical program but saying that there are many med schools that specifically prefer having students from ivy leagues thus giving those applicants a bit of an upper hand. UCSD SOM takes a crap ton of students from Yale, Columbia, Stanford. No doubt there will be students from small state schools but you can def see a trend in many MD programs.

 

[Mjolner]

See I can accept the fact that DOs are pretty much locked out of top tier academic centers in most cases. However, the idea that DOs are locked out of mid tier programs is a little preposterous. Graduating DOs from older schools this year are still among the group with 3.2-3.4 average gpa and 26 mcat. Graduating DOs in 2020-2022 will be an entire different group w 3.5-3.6 average gpa with 28-29 mcat.

I'm always a firm believer that a school match list is based on the caliber of students.

Clinical training is were the problem is. On SDN people want to argue numbers on the entry side. But PDs Don't seem to care about that. They can see our step scores to determine if we really are late bloomers/diamonds in the tough/etc. the HIGHLY variable, typically inferior clinical training most DO schools offer is what's killing us.

MeatTornado overstates how bad it is, but not by TOO much. Being a DO shuts certain doors in residency selection. I don't care if you got a 6Billion on your step 1, you're not doing IM at Hopkins unless you're holding the PD's family ransom. Once you finish ACGME residency, we're on a level playing field. However, we're coming from (on average) lower quality residency programs so we're gonna face a bit of an uphill climb. Look at top ten cardiology fellowships, how many of those are populated by MD/DO that went to some Podunk community residency program? How many went to a top 20 IM program.
This is how we feel the bite in fellowships.

 

[IslandStyle808]

Clinical training is were the problem is. On SDN people want to argue numbers on the entry side. But PDs Don't seem to care about that. They can see our step scores to determine if we really are late bloomers/diamonds in the tough/etc. the HIGHLY variable, typically inferior clinical training most DO schools offer is what's killing us.

MeatTornado overstates how bad it is, but not by TOO much. Being a DO shuts certain doors in residency selection. I don't care if you got a 6Billion on your step 1, you're not doing IM at Hopkins unless you're holding the PD's family ransom. Once you finish ACGME residency, we're on a level playing field. However, we're coming from (on average) lower quality residency programs so we're gonna face a bit of an uphill climb. Look at top ten cardiology fellowships, how many of those are populated by MD/DO that went to some Podunk community residency program? How many went to a top 20 IM program.
This is how we feel the bite in fellowships.

Even worse, they don't even look at a DO student applications because of the assumed difference in clinical education.

 

[Drrrrrr. Celty]

As someone who was counted in that "primary care" statistic at my med school I can tell you that it's total BS. The majority of those going into IM will either subspecialize or go into hospital medicine (hospitalist) which is the exact opposite of primary care.





I'm not some pre-med who counts up the number of derm and neurosurgery matches on a school's match list to try and determine how good it is. I look at where people are matching, primarily in IM and I haven't seen much improvement. At most only 15-20% are matching at university programs (almost all lower tier or in undesirable locations) and there are some schools that have next to none.

We'll see if these new DO GME spots survive the "merger" and what they'll look like if they do



You don't understand it because you haven't experienced anything yet. First of all as I said above the majority of US MD IM residents who don't subspecialize go on to be hospitalists rather than primary care doctors. A sizable portion do subspecialize, particularly at more academic/prestigious programs, less so at community programs. The degree to which IM subspecialities are competitive depends on who you are and where you're coming from. US MD at a university program - no problem. US MD at community program - tough. DO or IMG at university program - even tougher. DO or IMG at community program - toughest. In terms of competitiveness: GI, Cardiology, Pulm/CC, heme/onc and to a lesser extent rheum and endocrine are competitive. ID, renal, geriatrics - just apply and you'll be fine.

As a first year med student I'd recommend you do more listening than talking regarding these topics. Try not to be defensive. No one is attacking you, we're just giving you a sense of the reality that lies ahead from our experiences.

Except they clearly have improved over the last 10 years. To pretend they haven't is utter trite.

And nearly 90% of DO fellows who apply do end up matching a fellowship. Sure, Cards and GI is unlikely, but honestly there are in-house fellowships.

And hospitalists is suddenly some sort of pristine or out of reach thing for DOs?

And I'm really not defensive. Rejecting your view as trite is not defensive.

 

[Drrrrrr. Celty]

Clinical training is were the problem is. On SDN people want to argue numbers on the entry side. But PDs Don't seem to care about that. They can see our step scores to determine if we really are late bloomers/diamonds in the tough/etc. the HIGHLY variable, typically inferior clinical training most DO schools offer is what's killing us.

MeatTornado overstates how bad it is, but not by TOO much. Being a DO shuts certain doors in residency selection. I don't care if you got a 6Billion on your step 1, you're not doing IM at Hopkins unless you're holding the PD's family ransom. Once you finish ACGME residency, we're on a level playing field. However, we're coming from (on average) lower quality residency programs so we're gonna face a bit of an uphill climb. Look at top ten cardiology fellowships, how many of those are populated by MD/DO that went to some Podunk community residency program? How many went to a top 20 IM program.
This is how we feel the bite in fellowships.

How much of this matters to the average DO? The reason match lists are improving is because more DOs are applying to better programs and scoring better on their steps. But even then, is this really the goal of most DOs? To end up in a higher tier program?

Maybe I'm entirely wrong, but I'll repeat it again. DOs are selecting where they end up, they're not being forced into it. Yes, there's a glass ceiling, but that glass ceiling is not where MeatTornado places it or even where you do.

DOs will match better because the caliber of the students are changing.

 

[68PGunner]

Idk if what hes getting at is saying no low tier undergrad students can get into a top tier medical program but saying that there are many med schools that specifically prefer having students from ivy leagues thus giving those applicants a bit of an upper hand. UCSD SOM takes a crap ton of students from Yale, Columbia, Stanford. No doubt there will be students from small state schools but you can def see a trend in many MD programs.

The only reason why there are tons of students from Ivy League is due to the caliber of students from these schools. An applicant has just as good a chance of getting into top tier med schools provided that they have the average to above average gpa, mcat, and ECs.

My point is that the discrimination factor from med adcom based on the quality of undergrad is minimal. If the bias is real aka Donald Trump Style, there wouldn't be any state school students at top tier MDs. This country is built on merits. The idea applies to all spectrums of life in USA.

 

[68PGunner]

Clinical training is were the problem is. On SDN people want to argue numbers on the entry side. But PDs Don't seem to care about that. They can see our step scores to determine if we really are late bloomers/diamonds in the tough/etc. the HIGHLY variable, typically inferior clinical training most DO schools offer is what's killing us.

MeatTornado overstates how bad it is, but not by TOO much. Being a DO shuts certain doors in residency selection. I don't care if you got a 6Billion on your step 1, you're not doing IM at Hopkins unless you're holding the PD's family ransom. Once you finish ACGME residency, we're on a level playing field. However, we're coming from (on average) lower quality residency programs so we're gonna face a bit of an uphill climb. Look at top ten cardiology fellowships, how many of those are populated by MD/DO that went to some Podunk community residency program? How many went to a top 20 IM program.
This is how we feel the bite in fellowships.

And that IM spot at JHU is competitive to MDs also.

I'm not even interested in IM. However my point is that being a DO doesn't shut out IM options at mid tier programs. Graduating from a mid tier IM residency doesn't shut you out from IM fellowships.

At the end of the day, if your goal is GI, why the hell do you care where you do your fellowship? The deciding factor is money and you will make a competitive GI salary regardless of your program.

 

[Drrrrrr. Celty]

And that IM spot at JHU is competitive to MDs also.

I'm not even interested in IM. However my point is that being a DO doesn't shut out IM options at mid tier programs. Graduating from a mid tier IM residency doesn't shut you out from IM fellowships.

At the end of the day, if your goal is GI, why the hell do you care where you do your fellowship? The deciding factor is money and you will make a competitive GI salary regardless of your program.

Honestly there's an IM resident on this forum at a program that has a inhouse fellowship in Cards that takes mainly from their program. They could end up in cards if they wanted, but they have claimed that they'd rather gut themselves than do Cards.

And same, I'm not interested in IM. But I also recognize that if I did do IM, I'd have a decent shot at a non-cards or Non-Gi fellowship such as allergy or Heme/Onc which are medium competitive, have like 90% match rates for DOs, and also are better lifestyles than Cards.

 

[Mjolner]

Maybe I'm entirely wrong, but I'll repeat it again. DOs are selecting where they end up, they're not being forced into it.

Sorry. You're wrong. I know tons of classmates who came talking about derm, cards, ortho, uro and ENT who are now talking EM, neuro, Pm&r, GS and gas and these are all people at the top of the class. When people truly realize that some specialties and some programs are closed no matter what, they adjust accordingly. Well, the ones who can see the reality that exists, not the reality that they want to exist.

Sure, lots of DO want primary care. But lots want competitive specialties too. To say that none do is a fallacy.

 

[kenjixshadow]

This is one depressing thread. Have you ever seen MD students worry about such topics being discussing here? Whenever I see premeds have acceptances and are deciding between MD & DO, I will point them straight to this thread. Thank god that the specialty I am interested in is DO-friendly. Otherwise, I would have take year(s) off to improve my application and get into an MD school if I were to redo it all over again.

 

[68PGunner]

This is one depressing thread. Have you ever seen MD students worry about such topics being discussing here? Whenever I see premeds have acceptances and are deciding between MD & DO, I will point them straight to this thread. Thank god that the specialty I am interested in is DO-friendly. Otherwise, I would have take year(s) off to improve my application and get into an MD school if I were to redo it all over again.

If someone is dead set on GI Card Ortho etc..., they should absolutely shoot for a MD. Being a MD still doesn't guarantee a slot. There's no sure thing in life. However when your worst option is still a 200k job, that's not a bad spot to be in. My point still stands that people on sdn need to chill out.

 

[IslandStyle808]

This is one depressing thread. Have you ever seen MD students worry about such topics being discussing here? Whenever I see premeds have acceptances and are deciding between MD & DO, I will point them straight to this thread. Thank god that the specialty I am interested in is DO-friendly. Otherwise, I would have take year(s) off to improve my application and get into an MD school if I were to redo it all over again.

Read the Carribean versus DO thread, that one is even more depressing. Even Goro's responses felt like they changed after that thread...

 

[IslandStyle808]

If someone is dead set on GI Card Ortho etc..., they should absolutely shoot for a MD. Being a MD still doesn't guarantee a slot. There's no sure thing in life. However when your worst option is still a 200k job, that's not a bad spot to be in. My point still stands that people on sdn need to chill out.

I think that GI and Cards is still obtainable as long as a DO student shoots for a mid-tier residency. As for the "its hard for MDs too," at the very least their application gets looked at.

 

[Userneedmoreinfo]

Clinical training is were the problem is. On SDN people want to argue numbers on the entry side. But PDs Don't seem to care about that. They can see our step scores to determine if we really are late bloomers/diamonds in the tough/etc. the HIGHLY variable, typically inferior clinical training most DO schools offer is what's killing us.

MeatTornado overstates how bad it is, but not by TOO much. Being a DO shuts certain doors in residency selection. I don't care if you got a 6Billion on your step 1, you're not doing IM at Hopkins unless you're holding the PD's family ransom. Once you finish ACGME residency, we're on a level playing field. However, we're coming from (on average) lower quality residency programs so we're gonna face a bit of an uphill climb. Look at top ten cardiology fellowships, how many of those are populated by MD/DO that went to some Podunk community residency program? How many went to a top 20 IM program.
This is how we feel the bite in fellowships.

I think the original 5 and the 6 public do schools all have good clinical training sites. Quite frankly, in my opinion, many of the new DO (past 10 years) shouldn't open until they have legit clinical sites.