FAQs for DOs interested in psychiatry residency

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Inspired by splik's FAQs for IMGs a few of us have put together something for DOs interested in psychiatry residencies.

This thread is intended to address a few DO specific questions. Multiple members contributed their thoughts and, while each of us had different circumstances and interests, we have tried to come together to provide a basic guide.

If you don't see the answer to your question feel free to post below.

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Should I take the USMLE?
Many programs are willing to accept COMLEX scores and many successful applicants have done well with COMLEX only. Research the programs you are interested in to see if they require the USMLE. To be certain you may want to contact the program coordinator to confirm if they take the COMLEX even if their website explicitly says USMLE only because for the most part they were written to exclude international board exams or specific historic state exams.
The biggest drawback to taking the USMLE is not the expense or time of another board exam, but the risk of not doing well. Although similar, the COMLEX and USMLE are not written the same. Only take the USMLE if you are confident you will score well enough not to damage your application (>210).
 
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What can I do to make my application stand out?
This really isn't any different for DOs than any other applicant. Work hard, get good grades, glowing LORs, write a great personal statement, and interview with a smile. You may choose to address briefly your choice to go to Osteopathic school in your personal statement, or how you believe it will help you in your career as a psychiatrist, but it is not absolutely necessary and may even come off as defensive or off topic if not done properly.
It is not a question of "standing out" as much as it is a fact that you should ensure that every controllable portion of your application is at peak potential. Follow Dr. Toaster's 10 easy steps, and you have a plan:
1. Take the COMLEX Step 2 and the PE early enough that all scores will be back by the time ERAS opens for application submission. You'll be in a better place with Step 1, Step 2 and the PE all back and posted with the rest of your application. It makes you a safer bet. If the program requires the USMLE or you have opted to take the USMLE too, make sure those scores are all back as well. If your scores are not in by the time applications are initially open, programs may e-mail you to ask if you have taken it and what your score is before they offer you an interview, or you may be asked about it on your interview day. If your scores come in during the season be sure to "retransmit" your transcript via ERAS. You will absolutely need to have Level 2s done by rank time as many programs will not rank you without them passed.

2. Send four LORs - period. Many programs only require three, but you have no idea what is in the letters. Four gives you better odds that a blah LOR will be outshone by a better one. On the same note, ask for letters from a variety of writers (i.e. if your OBGYN preceptor loved you, then get a letter from her/him). I feel like the perfect combo is two Psych (one should be a chair letter) and two other (IM, Family, Surgery, whatever is going to be full of strong content). If you do not have a psychiatry chair at your school, as is common for many DO schools, your preceptor letter should be fine.

3. Use your extracurriculars to paint a picture about who you are as a candidate. I most certainly did not write down every single project or volunteer thing I did in med school. Instead, ask yourself what you want the application to say about you. For me, I wanted to show my strong commitment to teaching and add in the quirky flavor of my non-science/medicine related interests. To do this, I actually did list a couple of extensive college extracurriculars (amounted to hundreds of hours), and I filtered my med school experiences.

4. Spend more time on your personal statement than you think you need. Have many sets of eyes read your personal statement. Go through drafts. In all seriousness, I spent about two months working on my PS, went through 4-5 drafts and had no less than ten readers (friends, physicians, mentors, etc). Your personal statement is your introduction to the committee, but it is also a chance to add more cohesion to your application. It should complement and enhance your ECs and function as an outline for the topics you want to discuss during your interview. As a final note, don't write too much. Limit the PS to one printed page.

5. Use your "Hobbies and Interests" section to be a little more casual. You can write what you actually do. If you love fly fishing, cello covers of metal bands and making your own pasta, SAY SO. Literally every interview I went on involved some reference to my H&I section; it was always a conversation starter. One PD told me that he looks at that section before anything else on the application since it can say so much (or so little) about a candidate.

6. Maximize the temporal control. Have ERAS ready to go before it opens. Hit apply the day ERAS opens. Have your contact email forward to your phone, and reply to interview invitations ASAP. I scheduled many an interview while "on a bathroom break" during rotations. My average turnaround time from invite to getting something scheduled with the PC was less than 30 minutes. Plan your boards so that all scores are back before ERAS opens; if this isn't possible, remember that COMLEX scores have to be retransmitted to generate an update.

7. Do not schedule interviews at your top programs at the very beginning of interview season. My top three programs were scheduled mid-season, and that worked out well. Your first few interviews will be a little awkward. Your last few interviews will be a bit bland.

8. Schedule as many interviews as possible. Attend as many as possible. Do not feel safe. Expect to be tired by December, but push through January. You'll be happy once you get to the end and have the luxury of nitpicking. As a corollary, you also may not realize what is important until partway through the season, and you want to be able to cut a program that doesn't fulfill your needs (or cut one where the PD doesn't show up on interview day, ahem).

9. Make sure you have a real reason (or set of reasons) for picking the program you are interviewing at...at least by the interview day. These reasons can be anything, but be sure they are genuine.

10. Be very careful at the interview day (and at the dinner the night before). You do not want to be "that candidate" who won't shut up, brings every topic back to themselves or just can't interact like a normal person. You should be yourself and be genuine, but more of the version of yourself you might be when meeting your significant other's parents.
 
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Which programs are DO friendly?
As far as Psychiatry goes, it does seem that there are more DO friendly programs than not. For an idea of places that have matched/interviewed DOs check out the following thread from 2013
http://forums.studentdoctor.net/showthread.php?t=955375
Even places that have historically not taken DOs may interview you and be open to DOs this year. You will never known unless you apply, or at least call the program coordinator to ask, so don’t leave something of your list just because you think they might not like you. Now is not the time to try and save the extra $25 or whatever it costs to apply. There is always a first. That being said, when applying to programs and making your rank list don’t ONLY put down programs that have never taken a DO in the past- that might come back to bite you.
 
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How many programs should I rank?
Based on NRMP statistics, it is best to rank ~11 programs to maximize the chances of matching. Therefore, it is best to apply to enough programs to get at least that many interviews. The exact number needed to get enough interviews has a lot of variables: stronger applicants will net more interviews per applications, similar applications to less popular programs will also yield more interview offers. Be honest with yourself about your application, and apply accordingly.
Some DO schools have been known to tell their students to apply to at least 25-40 places. It is a far, far better thing to apply to too many and cancel some interviews. This is a factor you can control; may the odds be ever in your favor. And while you can always apply to more places later in the cycle, be aware that some programs have cut-off dates and at others interview spots get taken quickly.
 
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What questions should I expect during interviews?

It is possible you will be asked questions about being a DO, be prepared to answer:
1. Do you think Osteopathic Medicine is useful in Psychiatry? or a variation of this question
2. Explain X (if you have a red flag)
3. Why DO school?(Hint: don't say "because I didn't get in to MD school")
4. What does COMLEX score ABC mean?
5. What is osteopathic medicine? Consider reviewing the osteopathic oath again and the whole person perspective we have.
6. DO programs may ask you if you are applying for the MD match.

In addition you will definitely be asked the standard questions, for starters:
1. Why Psychiatry?
2. Why this program?
3. Any number of questions related to some interesting thing on your application (remember that you can control the story the application tells)
4. What are you looking for in a residency program?
5. What strengths would you bring to this program?
6. Where do you see yourself in 5/10/15 years?
 
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What questions should I ask during interviews?
If there are any DO residents ask if there is anything special they have to do to get licensed in that state (see “what about the osteopathic internship requirement” below) or if they have any problems moonlighting.
For some more general questions here is a good places to start, you will need a lot more and by the end of interview season you will want to scream when you hear “do you have any more questions for me?”
1. "Can you describe a typical day on service during intern year?" Ask this many times, and see if the answers are consistent. It is best to ask PGY-1s.
2. "What would you change about the program?" Nothing is never the right answer. In addition, too many angry complaints may be a red flag.
3. "When do you see the Program Director?" There is a bigger range of PD interaction with residents than I expected before I finished interview season. Some have true open-door policies and all the residents have a cell number, others are mythical figures occasionally seen at a distance or at Grand Rounds.
4. "What are the strengths of this program?" Self explanatory.
5. "Are didactics protected on service? Are didactics protected off service?" Again, there is a big range that surprised me.
6. "What sort of emphasis does the program place on the PRITE?"
7. "Can you tell me anything about the board pass rate?"
8. Ask a variety of questions about cost-of-living, neat areas to live in the city, fun things to do, etc. One of my favorite conversation starters is "so what is your favorite place to eat?"...remember that these dinners/lunches/etc are awkward for everyone. Toss the kids a bone.
 
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Should I apply to the DO match?
There are not very many DO psychiatry residencies, and while there are a few MD-DO combined programs, the majority is ACGME. For now (2013) this means 2 separate matches. As the DO match occurs before the MD match, if you match into a DO program you must withdraw from the MD match. If there is a DO program that you are interested in, and you can accept that you will be pulled from the MD match if you match there, apply away.
Additionally, most of the current DO programs are very young and are on the smaller side with 2-3 residents a year. For these, and other reasons, the majority of DOs interested in psychiatry end up pursuing ACGME programs.

There is a bit of a dearth of information on the DO residencies but here are some specific details feel free to add more below:

-The oldest program is MSU. For interviews at MSU you can tell them if you are ranking them in both matches or one or the other.
-Some dually accredited programs, e.g. JPS and HFHS, you apply to them as a ACGME programs and rank them in the ACGME match. They will not look at your application in the DO programs application system nor will they rank you in the DO match.

Copied from below in the thread (credit to JamesPhilly) :

-I thought Michigan State was excellent. They are dually accredited and you apply via the AOA. They also have a solid child fellowship that you can just transition to without issue.
-Albert Einstein in Philadelphia is also dually accredited. They are a great program, only child crisis response center (ie child emergency psych) in the city, a fantastic psych hospital with a diverse pt population, they told me they do more ECT than anyone else in the city and I believe it. If you want good ECT/child exposure I would definitely consider apply there.
 
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What's the deal with resolution 42?
If you end up in one of those 4 states that have the osteopathic internship requirement (Michigan, Florida, Pennsylvania, or Oklahoma), you will need to get the resolution 42 waiver and contact the specific state's osteopathic board to see what you need to have done before you can get your full license later in your training. Some medications' prescribing rights may be restricted under a training license. Also, in West Virginia, you need ~40 hours of AOA CME in certain categories with a specific number of hours in OMT.

http://www.osteopathic.org/inside-aoa/Education/postdoctoral-training/Pages/resolution-42.aspx

vcomdo.com/wp-content/uploads/InternshipFAQ-final.docx
 
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Many DO schools do not have the extensive advisor network and “home program” support than MD students have, so find ways to fill that gap. Whether it’s an attending from your rotations or an upperclassman that matched into psychiatry before you (or some folks on SDN), find a network of people with experience who can help you navigate the process.

Feel free to post below or PM purple rain or Dr. Toaster with questions.

Goodnight and good luck
 
This is excellent! Definitely appreciate the work, purple rain. :)
 
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Thank you for this great information. I was wondering if anyone has any recommendations on osteopathic residencies. It's really hard to find information on them. I wanted to know if it is common to do audition rotations for psych (I don't know of anyone who is). Also, are there any specific programs that come to mind as being good places to rotate?
 
I was wondering if anyone has any recommendations on osteopathic residencies. It's really hard to find information on them.

Great questions. We are working on getting some more input on the osteopathic programs and will hopefully post it soon.

I wanted to know if it is common to do audition rotations for psych (I don't know of anyone who is)

Here are my thoughts on audition rotations, others are free to add more. This is based on my experience with ACGME programs and may not correlate to DO programs.

I think in psychiatry the need to do audition rotations at programs of interest is not as great as in some other specialties (surgical, etc). That being said, I think audition rotations are more important for DO applicants (and probably IMGs) than AMGs.In the end you are going to want to do some electives and it can be a great opportunity to do some at programs you are interested in.

There are some real benefits to an audition rotation:

1. You get to show yourself off to a program. For most programs a good audition will get you an interview, and for some a great audition might even land you a spot in the program.

2. You get to see what a program is like for more than just a single day of interviews. I ended up not applying to the program I did an audition at, it was not a great experience.

3. You can score a good LOR assuming you do it early enough in the year (before September) It particular, if you get a letter from a well regarded program it will hold weight everywhere you interview.

The only real drawback to doing an audition rotation is if you do something bad and make a poor impression.

Some notes about timing: as I said above, to get a LOR you really need to do the rotation in August at the absolute latest so you can get the letter and make sure it is uploaded to ERAS. Also, try to avoid audition rotations during interview months (November-January) because it may leave a bad impression if you are missing days to go on interviews. So the PRIME audition rotation months are July-October, but maybe sneak in a November if you have to.

Also, are there any specific programs that come to mind as being good places to rotate?

Nothing specific comes to mind, it really depends on what geographic region you are interested in. As I mentioned about, a LOR from a well regarded program (particularly a personalized letter) will be an asset everywhere you interview.
 
VSAS is awesome. I found some truly unique rotations on it.

I would like to amend that statement to say "VSAS can be awesome." But if you find something you really want nothing beats a good old fashioned phone call where you charm the assistant to help set up your elective.
 
It is possible you will be asked questions about being a DO, be prepared to answer:
<snip>
5. "What is osteopathic medicine?" Consider reviewing the osteopathic oath again and the whole person perspective we have.
Just a piece of advice from the allopathic side of the house:

I've asked a similar question (just conversationally, mind) to rotating osteopathic med students and residents and hear some odd answers. I would try to run your stock answer by allopathic attendings, residents, or med students and see the reaction you get.

The "whole person" answer that I hear a lot often sounds pretty weak, and implies that somehow allopaths just treat an organ system at the expense of the whole patient. I kind of get what osteopaths mean when they say this but if not worded very carefully it comes across self-serving and insulting to the allopathic training path you're hoping to break into.

Great thread, purple rain... purple rain... (can't read your name without repeating it with music in the background)
 
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....
The "whole person" answer that I hear a lot often sounds pretty weak, and implies that somehow allopaths just treat an organ system at the expense of the whole patient. I kind of get what osteopaths mean when they say this but if not worded very carefully it comes across self-serving and insulting to the allopathic training path you're hoping to break into.

And yet is a painfully accurate description of how much of academic allopathic medicine is practiced in its ivory silos.
 
I would like to amend that statement to say "VSAS can be awesome." But if you find something you really want nothing beats a good old fashioned phone call where you charm the assistant to help set up your elective.

They don't look down on that? I thought if they were part of the VSAS system, you weren't supposed to contact them outside of VSAS?
 
Interviewed extensively.....15+ programs, almost all academic centers, Midwest and New England, and never once had the topic of my being a DO come up....My guess is it's MUCH more likely to be a non-issue.
 
Post-residency, are DOs limited in any way in what roles they can take on? Particularly for academic medicine or research.
 
Post-residency, are DOs limited in any way in what roles they can take on? Particularly for academic medicine or research.

As someone about to start residency I do not have the fullest perspective on this question, but my impression is that in psychiatry where you train for residency, rather than where you attend medical school, is the greatest determinant in your career path.

Other more experienced input would be welcome though.
 
In general, you're likely to find your last job is the most relevant. No one much cares where you went to undergrad by the time you're in residency (remember when so many folks were interested in how their undergrad affected their options?). After a few jobs, where you went to residency will be less and less important.
 
As an OMSIV who's been heavily recruited (already) by at least one place, I could only assume they care much less about the initials after your name and more about your pulse and whether or not you have one.
 
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Well, this guy graduated from a DO school, did IM/psych at Rush, got a faculty position at UC Davis, now does research, projects, etc. So it's at least possible.

http://psych.ucsf.edu/faculty.aspx?id=5130

Probably a better example: Professor and Vice Chair of Psychiatry, Director of Child and Adolescent Psychiatry at UCSF
(did Psychiatry residency at the Mayo Clinic and CAP fellowship at Yale)

...so yeah, it's possible.
 
can someone make this thread a sticky?

will definitely come in handy for many a DO-to-be.
 
Post-residency, are DOs limited in any way in what roles they can take on? Particularly for academic medicine or research.

My DO colleague gets requests for manual adjustments from the psych nurses all the time. That's about the only difference I can see at my institution. We are much more interested in smart doctors than whether they're allopathic or not.
 
Will a 560s COMLEX I score be competitive at the majority of ACGME Psychiatry residencies? I do not plan on taking the USMLE unless I must do so.
 
Will a 560s COMLEX I score be competitive at the majority of ACGME Psychiatry residencies? I do not plan on taking the USMLE unless I must do so.

I am only an MS4 myself, so no firsthand experience; however, I think your COMLEX only should be fine as far as what I've heard either openly or privately from a couple of other residents on this forum. Don't really know whether it's good for a "majority" of residencies (as you asked), but if you apply widely you should still get a fair number of interviews without needing the USMLE. I can't say whether or not you'd get into more competitive residencies without the USMLE, but others on this forum have gotten into solid mid-tier places with just the COMLEX. I don't know how many interviews you'd get without having COMLEX 2 completed, but that's a separate issue.
 
Will a 560s COMLEX I score be competitive at the majority of ACGME Psychiatry residencies? I do not plan on taking the USMLE unless I must do so.

It's difficult to say for certain, but I think yes- you would be competitive at a majority of programs. Some programs in all tiers may not consider you just because they only look at USMLE, but the majority won't ignore you just for that. Even so, as I'm sure you know, board scores alone do not a competitive application make. Additionally, it's fair to say compared to someone who scored comparatively on the USMLE (220-230ish I think?) you may be at a disadvantage.

A secondary point is- if you took COMLEX I long enough ago to get your scores back already it has probably been too long for you to easily get that level of information crammed back into your brain to do just as well on USMLE step 1.

Either way you go, please share your experiences on the FAQ here and good luck!
 
I'm curious about USMLE requirements. I took USMLE step 1 but would like to avoid taking step 2 if possible. Do the schools that say USMLE required really need step 2 cs and ck? I can handle taking step 2 ck but I don't think I can afford dropping 2k on step 2 cs.
 
I am only an MS4 myself, so no firsthand experience; however, I think your COMLEX only should be fine as far as what I've heard either openly or privately from a couple of other residents on this forum. Don't really know whether it's good for a "majority" of residencies (as you asked), but if you apply widely you should still get a fair number of interviews without needing the USMLE. I can't say whether or not you'd get into more competitive residencies without the USMLE, but others on this forum have gotten into solid mid-tier places with just the COMLEX. I don't know how many interviews you'd get without having COMLEX 2 completed, but that's a separate issue.

It's difficult to say for certain, but I think yes- you would be competitive at a majority of programs. Some programs in all tiers may not consider you just because they only look at USMLE, but the majority won't ignore you just for that. Even so, as I'm sure you know, board scores alone do not a competitive application make. Additionally, it's fair to say compared to someone who scored comparatively on the USMLE (220-230ish I think?) you may be at a disadvantage.

A secondary point is- if you took COMLEX I long enough ago to get your scores back already it has probably been too long for you to easily get that level of information crammed back into your brain to do just as well on USMLE step 1.

Either way you go, please share your experiences on the FAQ here and good luck!

Oh yeah, I definitely don't have any desire to apply to super competitive places. I'd be more than happy at any solid University program (more focused on staying in the Southeast than anything). Just want to make sure that I'd be in fairly good shape for those types of programs where I'd get good training, but aren't Harvard or Columbia.
 
I'm curious about USMLE requirements. I took USMLE step 1 but would like to avoid taking step 2 if possible. Do the schools that say USMLE required really need step 2 cs and ck? I can handle taking step 2 ck but I don't think I can afford dropping 2k on step 2 cs.

USMLE step 2CK is not needed to be competitive. If you did well on both step 1s there is no need to put yourself through both all over again, you already demonstrated your ability. One context I could see doing USMLE step 2 is if your performance on USMLE step 1 left something to be desired (<210), but even then you would have to do markedly better to really make a difference. In any case- you definitely do not need to do USMLE step 2 CS, save that 2 grand for interview season costs.

Just make sure whichever boards you end up taking your scores are back as close to application release time as possible.
 
USMLE step 2CK is not needed to be competitive. If you did well on both step 1s there is no need to put yourself through both all over again, you already demonstrated your ability. One context I could see doing USMLE step 2 is if your performance on USMLE step 1 left something to be desired (<210), but even then you would have to do markedly better to really make a difference. In any case- you definitely do not need to do USMLE step 2 CS, save that 2 grand for interview season costs.

Just make sure whichever boards you end up taking your scores are back as close to application release time as possible.
I'm not really talking about being competitive, I mean more like a requirement.
Does anyone know if schools get annoyed when you email and ask them questions like this?
 
I'm not really talking about being competitive, I mean more like a requirement.
Does anyone know if schools get annoyed when you email and ask them questions like this?

I've emailed 2-3 programs with this kind of question and they were always very nice and straightforward about it.
 
If you end up in one of those 4 states that have the osteopathic internship requirement (Michigan, Florida, Pennsylvania, or Oklahoma), you will need to get the resolution 42 waiver and contact the specific state's osteopathic board to see what you need to have done before you can get your full license later in your training. Some medications' prescribing rights may be restricted under a training license. Also, in West Virginia, you need ~40 hours of AOA CME in certain categories with a specific number of hours in OMT.

http://www.osteopathic.org/inside-aoa/Education/postdoctoral-training/Pages/resolution-42.aspx

vcomdo.com/wp-content/uploads/InternshipFAQ-final.docx
Would anyone care to explain the AOA required intern year further? Do all psych residencies have a general intern year?
 
And yet is a painfully accurate description of how much of academic allopathic medicine is practiced in its ivory silos.
:)

Also, just to add to the discussion of AOA residencies, although I matched via the acgme I did interview at a few AOA sites.

I thought Michigan State was excellent. They are dually accredited and you apply via the AOA. They also have a solid child fellowship that you can just transition to without issue. If moving was an option, I would have tried to match there via the osteopathic match

Also, Albert Einstein in Philadelphia is also dually accredited. They are a great program, only child crisis response center (ie child emergency psych) in the city, a fantastic psych hospital with a diverse pt population, they told me they do more ECT than anyone else in the city and I believe it. If you want good ECT/child exposure I would definitely consider apply there.
 
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Hi all,

I too am in the position of trying to decide whether or not to take USMLE step 1. Ive gotten my COMLEX step 1 score back and got a 549. Otherwise Im prettty much your average student, in the middle 1/3 of my class in grades. I dont have a preference of MD or DO residency, but i defeinutely want to be in MI/the midwest do to family concerns. Thioughts on if the USMLE would be a good idea?
 
Hi all,

I too am in the position of trying to decide whether or not to take USMLE step 1. Ive gotten my COMLEX step 1 score back and got a 549. Otherwise Im prettty much your average student, in the middle 1/3 of my class in grades. I dont have a preference of MD or DO residency, but i defeinutely want to be in MI/the midwest do to family concerns. Thioughts on if the USMLE would be a good idea?

Your question has already been answered, if you'd just read this page (post 36 onwards).
 
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Sticky? Please? Pretty please...
 
Many programs are willing to accept COMLEX scores and many successful applicants have done well with COMLEX only. Research the programs you are interested in to see if they require the USMLE. To be certain you may want to contact the program coordinator to confirm if they take the COMLEX even if their website explicitly says USMLE only because for the most part they were written to exclude international board exams or specific historic state exams.
The biggest drawback to taking the USMLE is not the expense or time of another board exam, but the risk of not doing well. Although similar, the COMLEX and USMLE are not written the same. Only take the USMLE if you are confident you will score well enough not to damage your application (>210).


What a wise statement that every DO student who is contemplating needs to hear.
 
What a wise statement that every DO student who is contemplating needs to hear.
On the flip-side of that… doing well on the USMLE will give a DO applicant a competitive edge over those who don't take it. I still agree that one shouldn't take it if they are not prepared, but I've seen way too many DO students talk themselves out of taking the USMLE as of late (some of whom would probably do well), often quoting the number of programs that will accept COMLEX. Competition is getting tight folks. Step your game up!
 
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