Go where you'd be happiest...right?

[DrMattOglesby]

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okay, so i hate to be a stick in the mud--but this post might subconsciously reflect my anxiety level and any attempts to justify getting into medical school this year...i dont know.
anyhow, i was reading around on the osteopathic medical student forum and i came across some great wisdom, "if you end up at a school where you will be happy, then you will succeed." or something along those lines. but here is my issue; i am somewhat drawn to the island life and went to school in miami, FL.
my top choice DO schools are all the ones where the weather is the warmest (western, ATSU-SOMA, Midwestern Arizona, GA-PCOM, NSU, and LECOM Bradenton).
I was reading up on the Caribbean schools like Ross and SGU. I REALLY like the idea of spending ~2yrs out in the islands doing my basic med sciences. I had talked at length with my molecular bio professor about attending a med school out there and he said it all boils down to the individual and how much they are willing to put into it. Not unlike anything i have heard here.
In addition to the island life (that im sure many people disdain due to 'inadequate' living conditions), they also have many of their rotations available back in my college town of Miami, FL. I REALLY like that.
the downsides (i consider to be the worst) are these:
1) It is supposed to be tougher to match into residencies
2) I dont get to learn OMM/OMT

but i keep thinking to myself, if you are in a place where you are happy, then you will succeed.
sorry, i guess im just venting my frustrations so everyone can share in my anxiety.
matt.

 

[endocardium]

okay, so i hate to be a stick in the mud--but this post might subconsciously reflect my anxiety level and any attempts to justify getting into medical school this year...i dont know.
anyhow, i was reading around on the osteopathic medical student forum and i came across some great wisdom, "if you end up at a school where you will be happy, then you will succeed." or something along those lines. but here is my issue; i am somewhat drawn to the island life and went to school in miami, FL.
my top choice DO schools are all the ones where the weather is the warmest (western, ATSU-SOMA, Midwestern Arizona, GA-PCOM, NSU, and LECOM Bradenton).
I was reading up on the Caribbean schools like Ross and SGU. I REALLY like the idea of spending ~2yrs out in the islands doing my basic med sciences. I had talked at length with my molecular bio professor about attending a med school out there and he said it all boils down to the individual and how much they are willing to put into it. Not unlike anything i have heard here.
In addition to the island life (that im sure many people disdain due to 'inadequate' living conditions), they also have many of their rotations available back in my college town of Miami, FL. I REALLY like that.
the downsides (i consider to be the worst) are these:
1) It is supposed to be tougher to match into residencies
2) I dont get to learn OMM/OMT

but i keep thinking to myself, if you are in a place where you are happy, then you will succeed.
sorry, i guess im just venting my frustrations so everyone can share in my anxiety.
matt.

Well, you are fortunate that this is a good forum for airing out this sort of thing. I expect that you'll receive lots of good comments.

In terms of what I think: I'd stick to the US medical schools. You may think you'll be happier on the Islands, but even folks who go there say that it's tougher. If nothing else, like being isolated and without basic foodstuffs and conveniences, etc., the class sizes are much larger and the attrition rate tends to be rather significant. At the end of the day there are fewer guarantees and more risks from attending a school in the Caribbean. If you have other options, I wouldn't recommend going this route.

Other than that, given a school in the states, you can't go wrong. Choose where you'll be happiest. Do research and dig deeper; know what you are buying.

 

[nlax30]

I agree. Go where you will ultimately be happier. Though there's a lot that factors into that.

Personally I just couldn't leave the US for school. Even if I was single I wouldn't want to go out of country for med school. I also wanted to stay in Florida and have most of my family within a couple hours of me here.

Also, while you could come back to Miami 3rd/4th years and a lot of your rotations there, what about during your first two years? It can be helpful at times to start making some connections/contacts early on and even first year here I've decided to become fairly involved and have attended a couple conventions around the area, will probably do some shadowing/rotations over the summer and look into research here, as well as just generally getting more familiar with the opportunities around me that I will be taking advantage of my 3rd/4th years.

I would think being out of country would hinder some of those opportunities, though you could always fly back for a convention or during summers/breaks.

 

[Eugepae]

okay, so i hate to be a stick in the mud--but this post might subconsciously reflect my anxiety level and any attempts to justify getting into medical school this year...i dont know.
anyhow, i was reading around on the osteopathic medical student forum and i came across some great wisdom, "if you end up at a school where you will be happy, then you will succeed." or something along those lines. but here is my issue; i am somewhat drawn to the island life and went to school in miami, FL.
my top choice DO schools are all the ones where the weather is the warmest (western, ATSU-SOMA, Midwestern Arizona, GA-PCOM, NSU, and LECOM Bradenton).
I was reading up on the Caribbean schools like Ross and SGU. I REALLY like the idea of spending ~2yrs out in the islands doing my basic med sciences. I had talked at length with my molecular bio professor about attending a med school out there and he said it all boils down to the individual and how much they are willing to put into it. Not unlike anything i have heard here.
In addition to the island life (that im sure many people disdain due to 'inadequate' living conditions), they also have many of their rotations available back in my college town of Miami, FL. I REALLY like that.
the downsides (i consider to be the worst) are these:
1) It is supposed to be tougher to match into residencies
2) I dont get to learn OMM/OMT

but i keep thinking to myself, if you are in a place where you are happy, then you will succeed.
sorry, i guess im just venting my frustrations so everyone can share in my anxiety.
matt.

hang in there! schools are really looking for well-rounded individuals. mcat and gpa are not the only determining factors. plus, your bcpm is well above average and you've got excellent ECs.

i'm not sure if you saw this, but it's one of the countless threads regarding u.s. do vs caribbean md: http://forums.studentdoctor.net/showthread.php?t=489936

lastly, even if you get into a school that may not be one of your top choices, keep in mind that you'll only be there for about 2 years and you can pick your rotation sites elsewhere.

best of luck!

 

[J1515]

okay, so i hate to be a stick in the mud--but this post might subconsciously reflect my anxiety level and any attempts to justify getting into medical school this year...i dont know.
anyhow, i was reading around on the osteopathic medical student forum and i came across some great wisdom, "if you end up at a school where you will be happy, then you will succeed." or something along those lines. but here is my issue; i am somewhat drawn to the island life and went to school in miami, FL.
my top choice DO schools are all the ones where the weather is the warmest (western, ATSU-SOMA, Midwestern Arizona, GA-PCOM, NSU, and LECOM Bradenton).
I was reading up on the Caribbean schools like Ross and SGU. I REALLY like the idea of spending ~2yrs out in the islands doing my basic med sciences. I had talked at length with my molecular bio professor about attending a med school out there and he said it all boils down to the individual and how much they are willing to put into it. Not unlike anything i have heard here.
In addition to the island life (that im sure many people disdain due to 'inadequate' living conditions), they also have many of their rotations available back in my college town of Miami, FL. I REALLY like that.
the downsides (i consider to be the worst) are these:
1) It is supposed to be tougher to match into residencies
2) I dont get to learn OMM/OMT

but i keep thinking to myself, if you are in a place where you are happy, then you will succeed.
sorry, i guess im just venting my frustrations so everyone can share in my anxiety.
matt.

Sounds like an easy decision to me. If you WANT to live on the islands for 2 years then go for it. Don't listen to people who say it's tougher to match into blah blah blah. Nobody knows for sure and most likely it varies with each residency program. Perhaps when FMGs say it's tougher it is not because of their FMG status but because they are a subpar candidate in some way.

 

[DrMattOglesby]

hang in there! schools are really looking for well-rounded individuals. mcat and gpa are not the only determining factors. plus, your bcpm is well above average and you've got excellent ECs.

i'm not sure if you saw this, but it's one of the countless threads regarding u.s. do vs caribbean md: http://forums.studentdoctor.net/showthread.php?t=489936

lastly, even if you get into a school that may not be one of your top choices, keep in mind that you'll only be there for about 2 years and you can pick your rotation sites elsewhere.

best of luck!

I think that thread you linked to was moreso a phrase of the annoying question, "DO vs. MD."
my conflict isn't about the initials, its about happiness in studying medicine.
im sure you perceived that much though.

I think it might be best to put in applications to St. George's and Ross
and just wait and see what happens anyways.
thanks for your post though, quite nice to hear

 

[endocardium]

Sounds like an easy decision to me. If you WANT to live on the islands for 2 years then go for it. Don't listen to people who say it's tougher to match into blah blah blah. Nobody knows for sure and most likely it varies with each residency program. Perhaps when FMGs say it's tougher it is not because of their FMG status but because they are a subpar candidate in some way.

Well, I wasn't referring to the match. I'm sure he'll do fine no matter where he goes, since he seems like a solid person. What concerns me is if he truly knows what it's like to attend a Caribbean medical school. Most people I've talked to who attend one, suggest that it would be better to attend a school in the states. Maybe it's sample bias on my part, but it does give one pause.

 

[scpod]

I'm one who often says "go where you will be happiest" but within reason. The living conditions at many of these schools are more like you would find in a third-world country-- not what you would find in the tropical regions of the US. Look at the cost factor too. Many of them will cost you much more than any US school and you won't be able to get the same financial package that you would in the US. If your credit is good, though, they'll gladly take you. One final thing to consider is that they really don't care whether you struggle or graduate because they'll have just as many people in the next class-- 600 or more in some places. US schools really do tend to bend over backwards to help struggling students and to help them pass the boards. Offshore schools really don't give a damn whether you pass the boards or not as long as you have money or credit to pay their fees.

If you have taken all of that into consideration and still think you would be happiest there, then go visit the place and talk to the existing students. If you're still in favor of it, then I say go for it.

 

[DragonWell]

Something to keep in mind is that your concept of the "island life" is likely going to change completely once you add med school to the equation. While I agree that it's important to not be somewhere that makes you so miserable that it distracts you from your studies, choosing a school for the "perks" the environment offers may not be the wisest call.

Once school begins, you will be so consumed that where you are will become more or less incidental to what you need to get done. I'm a half-hour from one of the nicest beaches in the US, and I haven't seen it in 5 months, but my *ss has practically worn through my reading chair. My advice is to focus on the school first, and the environment and geography only in a rudimentary way - ie do I want big city, rural, midwest, northeast, etc.

 

[pamolive]

Well... here's my two cents. I have A LOT of FMGs in my family, and they all say the same thing, do whatever you can to stay in the US. A lot of them went to medical school in India, some at SGU. One cousin in particular who graduated from school in India got in the 99th percentile on both step 1 and 2 and is having so much trouble matching into a residency program. The few who went to SGU are so unhappy with their placements. The bottom line is that allo residencies here will preferentially take domestically trained MDs, then DOs, and then FMGs. If you want to be competative as an FMG you have to have scores in the upper 90th percentiles. Honestly, it's only 2 years. If you get accepted to a school in the US, even if its UNE or LECOM, where you don't think you'll be that happy, just take it. You'll be so much better off in the end. 2 years vs the rest of your career.

 

[scpod]

....I'm a half-hour from one of the nicest beaches in the US, and I haven't seen it in 5 months, but my *ss has practically worn through my reading chair.....

LOL....sooooooo true. I have my own heated pool and jacuzzi. I like to look at them every now and then....but can hardly remember the last time I had a chance to actually get into them.

 

[DrMattOglesby]

just wanted to throw this out there, but i know it means nothing coming from a pre-med student:

I am interested in these residencies (as of 2/3/08 <---important qualifier)

1) Cardiothoracic surgery
--im sure this will be insanely difficult to match into as an FMG (although i believe one first begins with general surgery and eventually does a fellowship in this...i dont know how it works)

2) Physical Medicine and Rehabilitation
--this is one place where osteopathic school would prove more useful after graduation (than allopathic training). and ive been eye-ing some sports medicine fellowships already. Plus, I dont think this is that competitive of a residency to match into.

 

[MaximusD]

Matt, I know you're looking to get out of this mess. The application process is daunting. Everyone in this forum understands, trust me.

The fact is, however, that you are not a subpar applicant. Your MCAT isn't stellar, but your application as a whole is superb.

Two things:

1. I can almost guarantee a school is going to get back to you this cycle that is in the US.

2. If they do not by some freak occurence, you WILL get into a good DO school next cycle.

With 1 & 2 in mind, I cannot suggest that you go to the caribbean.

The bottom line is this isn't about where you are happiest in the short-term. It is where you are going to be happiest as a result of your four hard-fought years of medical school. I don't love Philadelphia 😱 but it is an excellent medical city. Conversely, the caribbean may be a nice change of scenery but there are mounds of evidence in these forums that, while the education may be challenging and thorough, producing highly skilled physicians, the match figures are unimpressive at best and downright dissapointing at worst. If you had a 3.0 and a 20 MCAT and had no desire to improve those stats, I might begrudgingly give you a nod that the carib is a viable choice.

As it stands, I cannot do so. Please reconsider and stay in the US. You will thank yourself in the future. 👍

 

[lord_jeebus]

If you're interested in CT surgery and PM&R, which are basically 100% different in every way, you are at risk of falling in love with a competitive specialty in the future.

Do not go Caribbean; it is important to be happy for 4 years of med school but it is most important to land a career in which you will be happy for life. If you're in the situation of trying to land a competitive residency as an FMG, no amount of sunshine and beaches will make you happy.

 

[spazzz]

The bottom line is this isn't about where you are happiest in the short-term. It is where you are going to be happiest as a result of your four hard-fought years of medical school. I don't love Philadelphia 😱 but it is an excellent medical city. Conversely, the caribbean may be a nice change of scenery but there are mounds of evidence in these forums that, while the education may be challenging and thorough, producing highly skilled physicians, the match figures are unimpressive at best and downright dissapointing at worst. If you had a 3.0 and a 20 MCAT and had no desire to improve those stats, I might begrudgingly give you a nod that the carib is a viable choice.

As it stands, I cannot do so. Please reconsider and stay in the US. You will thank yourself in the future. 👍

can't agree enough, it's bizzare to hear this stuff all the time about being really happy at a school, etc. I really doubt everyone in the allopathic threads are really in love with all Rochester MN has to offer, or what Baltimore MD has to offer except the fact that they have 2 of the best med schools in the country...go to a school where you will have the best education.

 

[TexasTriathlete]

Baltimore is such an incredible ****hole. It is probably the ****tiest city in America.

Having said that, if I decide that trauma surgery is for me, I've definitely got one eye on that shock fellowship. Of course, that's a ways down the road.

 

[DrMattOglesby]

If you're interested in CT surgery and PM&R, which are basically 100% different in every way, you are at risk of falling in love with a competitive specialty in the future.

Do not go Caribbean; it is important to be happy for 4 years of med school but it is most important to land a career in which you will be happy for life. If you're in the situation of trying to land a competitive residency as an FMG, no amount of sunshine and beaches will make you happy.

I took a medical specialty aptitude test on many occasions and consistently scored with my number one option being CT surgery.
I like PM&R because of their focus on empowering the patient to take health into their own hands...and I shadowed a really great PM&R doctor.
I am also shadowing a family physician (really nice hours), i volunteer in the ER, did a 'clinical student internship' under a pulmonologist in the ICU, so i feel comfortable in saying that i am getting some fair exposure in a number of specialties.
but just to throw this out there as well...the neurologist i shadowed wanted nothing else more than to go into OB/GYN...and now look at her, neurology!
i just hope that by the time i graduate, I wont have to worry about choosing a specialty that will help pay off loans, but that ill be able to choose one based on what i love doing...maybe the next president will have some effect on this???

 

[lord_jeebus]

Medical specialty aptitude tests are worthless.

My specialty of choice is in the bottom half!

 

[spazzz]

I took a medical specialty aptitude test on many occasions and consistently scored with my number one option being CT surgery.
I like PM&R because of their focus on empowering the patient to take health into their own hands...and I shadowed a really great PM&R doctor.
I am also shadowing a family physician (really nice hours), i volunteer in the ER, did a 'clinical student internship' under a pulmonologist in the ICU, so i feel comfortable in saying that i am getting some fair exposure in a number of specialties.
but just to throw this out there as well...the neurologist i shadowed wanted nothing else more than to go into OB/GYN...and now look at her, neurology!
i just hope that by the time i graduate, I wont have to worry about choosing a specialty that will help pay off loans, but that ill be able to choose one based on what i love doing...maybe the next president will have some effect on this???

the state of healthcare is going to be crap for us pending physicians within the next election.

 

[TexasTriathlete]

I took one of those, and it told me OB/GYN.

OB/GYN is probably the only specialty that I am absolutely certain I do not want to go into. Obviously, I could change my mind, but the medmal insurance is ****ing absurd, and I am not sure that I could ever be as good at it as a doc who has years of experience with their own vagina and uterus.

 

[prionsRbad]

I took one of those, and it told me OB/GYN.

OB/GYN is probably the only specialty that I am absolutely certain I do not want to go into. Obviously, I could change my mind, but the medmal insurance is ****ing absurd, and I am not sure that I could ever be as good at it as a doc who has years of experience with their own vagina and uterus.

👍Good call. Guys that are super into OB/GYN always creeped me out a bit . . . I just don't get it.

 

[spicedmanna]

Yeesh, forget about those assessments.

You should be thinking this, with respect to choosing a school: choose the one that will best prepare you for residency and will ease your way into the best program you can match into. The rest, unless there are extenuating circumstances, are more trivial factors. For the most part, your chair, your books/notes, and your desk, are going to your environment for 2 years.

 

[EEL08]

👍Good call. Guys that are super into OB/GYN always creeped me out a bit . . . I just don't get it.

Excuse me? My husband's lifelong dream has been to be an OB/GYN. Are you saying he's a creep? 😉 jk

 

[tkim]

 

[TexasTriathlete]

👍Good call. Guys that are super into OB/GYN always creeped me out a bit . . . I just don't get it.

Don't get me wrong, I'm sure I could be good at it, but I think I'd always have that doubt in the back of my mind. I don't want to go into anything where I might end up second-guessing my decision, and with OB/GYN, I think I would.

 

[t-funk]

Pretty funny chart TKIM. I have always thought I wanted to go into either EM or Psychiatry. What does that mean? Actually, I've been doing a lot of research into PM & R and think I'm getting pretty interested in that. And that one's not on the chart. 😀

 

[t-funk]

Don't get me wrong, I'm sure I could be good at it, but I think I'd always have that doubt in the back of my mind. I don't want to go into anything where I might end up second-guessing my decision, and with OB/GYN, I think I would.

I already know I could never do OBGYN. There is no way I could look at vaginas all day.

 

[DrMattOglesby]

the state of healthcare is going to be crap for us pending physicians within the next election.

who's to say the state of our healthcare isnt crap already though?
is it going to be whats best for the physician or whats best for the patient?
i think if universal health care comes to fruition, or some modification thereof, they should make medical school cheaper in any number of ways that could be done.

 

[spicedmanna]

who's to say the state of our healthcare isnt crap already though?

There's a great deal of evidence that suggests it already is. In fact, it is well known to be in crisis. I think we need a shift in the way we are doing things. However, just like everyone else, I have no clue what the answer is going to be. Probably, like most things, it's going to require a complex solution. After all, it's a very complex problem.

 

[spazzz]

who's to say the state of our healthcare isnt crap already though?
is it going to be whats best for the physician or whats best for the patient?
i think if universal health care comes to fruition, or some modification thereof, they should make medical school cheaper in any number of ways that could be done.

yeah, i agree, it's already crap. but it's eventually going to get better for patients, but not necessarily for the healthcare providers

 

[nlax30]

👍Good call. Guys that are super into OB/GYN always creeped me out a bit . . . I just don't get it.

Have a good friend I went to high school with who is now in his OB/GYN residency, all throughout school though he was set on cardio and then changed in med school.

I'll admit it is appealing, with the mix of clinical and surgical time. I am absolutely fascinated by surgery but just am not sure if I want to commit to that sort of lifestyle.

 

[pamolive]

who's to say the state of our healthcare isnt crap already though?
is it going to be whats best for the physician or whats best for the patient?
i think if universal health care comes to fruition, or some modification thereof, they should make medical school cheaper in any number of ways that could be done.

That's definitely a good idea. Doubt it'll happen though.

If you're really interested in CT surgery, keep in mind that you'll most likely have to be published in order to land that fellowship. Are you published already? If not, you're going to need to be at a school with good research opportunities, or you'll have to take a year or so off. Just keep that in mind while you're looking at schools.

 

[HrvatskiDoktor]

Hey MrMatt,

I want to pose this question for you.

Have you ever lived outside of the US? I know that the Caribbean is close, and that the world is getting much smaller, but I wouldn't recommend moving there for med school unless you have spent extensive time out of the country.

I almost moved to Europe to go to med school, it seemed like such a sweet deal (no mcat, no 2 applications and interview, beautiful country and city that I love) and I had lived there for 3 months. I'm so glad that I decided not go to school there, but hope to some day live and work overseas.

If you are interested in island life my best advice would be to go to school in the States and do some international rotations and look into doing work there after residency.

PM me if you want more details about my deciding not to go abroad.

HD

 

[lord_jeebus]

If you're really interested in CT surgery, keep in mind that you'll most likely have to be published in order to land that fellowship. Are you published already? If not, you're going to need to be at a school with good research opportunities, or you'll have to take a year or so off. Just keep that in mind while you're looking at schools.

Not really, most general surgery residencies have opportunities for research. Med school research isn't going to be that crucial by the time one applies for CT fellowship (although it would certainly help).

My understanding is that right now, there are way more fellowship spots than applicants for CT, due to the poor state of the field.

 

[physicsnerd42]

okay, so i hate to be a stick in the mud--but this post might subconsciously reflect my anxiety level and any attempts to justify getting into medical school this year...i dont know.
anyhow, i was reading around on the osteopathic medical student forum and i came across some great wisdom, "if you end up at a school where you will be happy, then you will succeed." or something along those lines. but here is my issue; i am somewhat drawn to the island life and went to school in miami, FL.
my top choice DO schools are all the ones where the weather is the warmest (western, ATSU-SOMA, Midwestern Arizona, GA-PCOM, NSU, and LECOM Bradenton).
I was reading up on the Caribbean schools like Ross and SGU. I REALLY like the idea of spending ~2yrs out in the islands doing my basic med sciences. I had talked at length with my molecular bio professor about attending a med school out there and he said it all boils down to the individual and how much they are willing to put into it. Not unlike anything i have heard here.
In addition to the island life (that im sure many people disdain due to 'inadequate' living conditions), they also have many of their rotations available back in my college town of Miami, FL. I REALLY like that.
the downsides (i consider to be the worst) are these:
1) It is supposed to be tougher to match into residencies
2) I dont get to learn OMM/OMT

but i keep thinking to myself, if you are in a place where you are happy, then you will succeed.
sorry, i guess im just venting my frustrations so everyone can share in my anxiety.
matt.

Go to one of the DO schools.

I haven't read any of the other responses on this thread, but my take is this: All other things being equal, go where you'd be happiest. If your choice were between two DO schools that were roughly the same price, then I would definitely tell you to choose based on happiness. But in this case, all other things aren't equal. I have a friend who is doing vet school in the Caribbean, and island life is not all it's cracked up to be.

More importantly, though, is the academic environment at a foreign MD school vs. pretty much any school (MD or DO) in the US. Most Caribbean schools have atrocious attrition rates and huge classes (contrast this to US med schools where class sizes are smaller and, with few exceptions, once you're in you will be a physician). Yeah, some people get good residencies in the US from a Caribbean school, but those are only the very best from every entering class. Speaking as someone who goes to a very collaborative and supportive US med school: I can't possibly imagine completing medical training with my sanity intact if I had to constantly be competing with my classmates. It will also be easier to get into a solid residency program if you're coming from a US school.

You have no idea that (other than the weather) that you would be happier in the Caribbean. So why would you forgo a perfectly good US medical education to end up in the Caribbean? While I am going to school in one of the coldest states in the US, I would not want to be anywhere else because of the quality of my education and the cooperation and support I get from my classmates, professors, and administration.

 

[justletmeinplz]

just wanted to throw this out there, but i know it means nothing coming from a pre-med student:

I am interested in these residencies (as of 2/3/08 <---important qualifier)

1) Cardiothoracic surgery
--im sure this will be insanely difficult to match into as an FMG (although i believe one first begins with general surgery and eventually does a fellowship in this...i dont know how it works)

2) Physical Medicine and Rehabilitation
--this is one place where osteopathic school would prove more useful after graduation (than allopathic training). and ive been eye-ing some sports medicine fellowships already. Plus, I dont think this is that competitive of a residency to match into.

I was once in/am still in a similar position. Don't really care about the initials, just want to be an effective physician. I applied to SGU for the fall of 2007, was accepted, and chose not to go. Visiting an island might be a lot of fun, but living one one while receiving a subpar medical education...not so much. I'd stay in the US. It's even worth waiting till next year and retaking the MCAT if you have to, IMO.

If you want to pursue physical medicine and rehab, you're probably right about DO being an excellent choice. There is even a DO on faculty at Shands (which says a lot IMO) for Physical Medicine and Rehab, though it doesn't seem they have taken any DO residents lately.