How competitive is DO Ortho

[walkerahl]

I will be starting this year as a MS1, and because I have nothing to do these last few months except live on SDN , Ive been looking into possible specializations. I understand that there are 88 spots for over 200+ applicants, but how does that rank with other competitive specialties. In other words, am I aiming too high.

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[FrkyBgStok]

Crazy competitive. There isn't anything wrong with setting a goal, but you will likely change your mind. Just worry about getting the best scores you can. Even boards are a long way away.

 

[walkerahl]

Crazy competitive. There isn't anything wrong with setting a goal, but you will likely change your mind. Just worry about getting the best scores you can. Even boards are a long way away.

Thats some good advice. You sound pretty knowledgable for a pre-MS1.

 

[Bacchus]

Thats some good advice. You sound pretty knowledgable for a pre-MS1.

I don't think the smiley was tongue in cheek; but I will agree.

I don't know how many AOA ortho spots there are, but I found out today my school matched 9 of those spots.

 

[Dissected]

It's really tough.

See how your step I goes and if you can't see yourself doing anything else do what you have to do.

But it's really tough!!

 

[SpecterGT260]

So is it the limited number of seats that makes it so competitive? I stumbled upon this article recently:
http://www.jaoa.org/content/106/9/568.full
the JAOA attempted to correlate COMLEX with USMLE and did so quite successfully with an R^2 = .68, r=.85. But according to that and the 2009 AOA match stats , the average accepted COMLEX was equivalent to a USMLE 202. I would think that the majority of DOs entering the ACGME match would be highly competitive for the AOA ortho if they were so inclined.

 

[donkeykong1]

In addition to audition rotation, 600+ on the COMLEX is usually the magic number to get AOA ortho, rads, optha, urology, derm. AOA gas isn't that competitive, as most students go ACGME.

Get 550+ and you still have a decent chance, provided you reveal your surgical skills on your ortho rotation.

 

[SpecterGT260]

In addition to audition rotation, 600+ on the COMLEX is usually the magic number to get AOA ortho, rads, optha, urology, derm. AOA gas isn't that competitive, as most students go ACGME.

Get 550+ and you still have a decent chance, provided you reveal your surgical schools on your ortho rotation.

the 2009 AOA stats were Ortho - 562, rads - 569, ophtho - 550, urology - 548. That pdf I linked did not have derm though.... (unless I missed it). 600+ would sit you pretty comfortably.

 

[donkeykong1]

the 2009 AOA stats were Ortho - 562, rads - 569, ophtho - 550, urology - 548. That pdf I linked did not have derm though.... (unless I missed it). 600+ would sit you pretty comfortably.

yup, things have gotten more competitive . the residency selection adviser at my school claims that 600 is the magic number to match comfortably into those highly competitive programs. However, your performance on the audition rotation especially in the surgical specialties does play a significant role.

 

[cougardiver]

I don't think the smiley was tongue in cheek; but I will agree.

I don't know how many AOA ortho spots there are, but I found out today my school matched 9 of those spots.

For those of us watching...what school is that?

 

[donkeykong1]

For those of us watching...what school is that?

pcom is the school he was referring to

 

[cougardiver]

pcom is the school she was referring to

thanks

 

[Postictal Raiden]

the 2009 AOA stats were Ortho - 562, rads - 569, ophtho - 550, urology - 548. That pdf I linked did not have derm though.... (unless I missed it). 600+ would sit you pretty comfortably.

What USMLE score and percentile does this equate to?

 

[donkeykong1]

What USMLE score and percentile does this equate to?

USMLE Step 1 = 67.97 + 0.24 × 600= about a 212

note: this algorithm is meaningless. just ask some of the 3rd year med students on here who took both.

 

[surgeryDO]

I will be starting this year as a MS1, and because I have nothing to do these last few months except live on SDN , Ive been looking into possible specializations. I understand that there are 88 spots for over 200+ applicants, but how does that rank with other competitive specialties. In other words, am I aiming too high.

When I shadowed I got to talk with an Ortho resident and he said you basically have to be in at least the top 10% of your class to try and match into ortho.

 

[Bacchus]

pcom is the school she was referring to

One of these declaratives are wrong. Either PCOM or she.

 

[Sam212]

When I shadowed I got to talk with an Ortho resident and he said you basically have to be in at least the top 10% of your class to try and match into ortho.

bollocks

 

[donkeykong1]

One of these declaratives are wrong. Either PCOM or she.

ehh apologies, its he then.

 

[Dissected]

What USMLE score and percentile does this equate to?

It's difficult to equate. There's really no reliable formula.

COMLEX of 562 is 79th percentile (NBOME calculator)

MD Ortho average last year was ~240 (230 for independents)

USMLE Step 1 = 67.97 + 0.24 × 600= about a 212

note: this algorithm is meaningless. just ask some of the 3rd year med students on here who took both.

lol, yea that is a crappy conversion. If you can break 600 on comlex you can easily break the mean USMLE score (222+)

When I shadowed I got to talk with an Ortho resident and he said you basically have to be in at least the top 10% of your class to try and match into ortho.

Don't listen to this. Class rank, while taken into account, is not as important compared to boards and audition performance. Try and stay top 25%, but top half isn't the end of the world.

 

[SpecterGT260]

USMLE Step 1 = 67.97 + 0.24 × 600= about a 212

note: this algorithm is meaningless. just ask some of the 3rd year med students on here who took both.

It's difficult to equate. There's really no reliable formula.

COMLEX of 562 is 79th percentile (NBOME calculator)

MD Ortho average last year was ~240 (230 for independents)



lol, yea that is a crappy conversion. If you can break 600 on comlex you can easily break the mean USMLE score (222+)



Don't listen to this. Class rank, while taken into account, is not as important compared to boards and audition performance. Try and stay top 25%, but top half isn't the end of the world.

no tactful way to say this.... these posts seem like the sort of blind anti-anti-DO stuff that just comes across as ignorant.

We are going to call the algorithm worthless after it is published by the JAOA, an osteopathic journal, and it uses 150+ students to arrive at a nearly perfect fit of the data (r=.85)? That is pretty stinkin reliable....

and yes, a 600 COMLEX translates to a 212 by this formula. A 600+ with a little wiggle room is not at all unreasonable to equate to a score that beats the nat average USMLE. You basically showed that the conversion is pretty close and then concluded that it is not


here is the thing - given the source and fit of the data, I choose to believe the equation works rather well. Nothing about applying this to the AOA match has any bearing on the DOs that match ACGME. All this is really showing is that the AOA is matching neurosurgery residents who would have barely passed USMLE, but any and all DOs going ACGME are held to equal standards and uphold the claim that MDs and DOs are indistinguishable. IMO the AOA is just hurting this claim via its match

 

[SpecterGT260]

Just to reiterate, you are choosing to reject published data from a source that, if biased, would only skew in favor of DOs in favor of some anecdotal evidence from a buddy in 3rd year.

I would say your argument is reasonable but only if your friend has taken each test more than 150 times and performed a statistical comparison.

 

[donkeykong1]

no tactful way to say this.... these posts seem like the sort of blind anti-anti-DO stuff that just comes across as ignorant.

We are going to call the algorithm worthless after it is published by the JAOA, an osteopathic journal, and it uses 150+ students to arrive at a nearly perfect fit of the data (r=.85)? That is pretty stinkin reliable....

and yes, a 600 COMLEX translates to a 212 by this formula. A 600+ with a little wiggle room is not at all unreasonable to equate to a score that beats the nat average USMLE. You basically showed that the conversion is pretty close and then concluded that it is not


here is the thing - given the source and fit of the data, I choose to believe the equation works rather well. Nothing about applying this to the AOA match has any bearing on the DOs that match ACGME. All this is really showing is that the AOA is matching neurosurgery residents who would have barely passed USMLE, but any and all DOs going ACGME are held to equal standards and uphold the claim that MDs and DOs are indistinguishable. IMO the AOA is just hurting this claim via its match

so you're telling me a study involving 155 osteopathic students at a single DO school named Kirksville College of Osteopathic Medicine that took both USMLE Step 1 and COMLEX-USA Level 1 is completely representative of the nearly 1,000+ DO students that take both exams?

These are two different exams. With different material and different ways of asking questions. Bottom line, if you're a DO apply ACGME anything, just take the USMLE. plain and simple.

check out these threads for what is reality among attendings and residents regarding this crappy algorithm:

http://forums.studentdoctor.net/showthread.php?t=761284
http://forums.studentdoctor.net/showthread.php?t=331184
http://forums.studentdoctor.net/showthread.php?t=114016
http://forums.studentdoctor.net/showthread.php?t=637024
http://forums.studentdoctor.net/showthread.php?t=335339
Also I'm too lazy too count, but among these threads I find at least 30+ attendings/residents who took both and do considerbly better on the USMLE than what the algorithm predicts. And I'm sure I can find even more to disprove this lousy finding.

 

[SpecterGT260]

Yeah you're right... I wouldn't trust anything the AOA publishes either

 

[SpecterGT260]

This is why stats are so cool. For every one of those 30 you reference, there is very likely someone who did worse than the algorithm would have predicted. This is why the r squared value is. 68 and not 1.0

Math :thumbsup:

why is 155 such an unreliable number?
why would including a different school skew the results to favor your rationalization?

This is 10% of the entire population by year and the correlation factor says that of 155 trials (WAY within an appropriate number of trials to satisfy alpha=.05), there was an 80% chance that the equation matches the actual findings. So for 20% of people there may not be such a good match. But for the purposes of correlation the stats are just fine.

now apply this to AOA match stats where the population is quite a bit larger, and if we are saying that 80% of those people are represented accurately by the JAOA conversion factor, then we are still showing a match service which selects applicants with far lower stats than the ACGME.

my opinion is just that the ACGME should be composed of both MDs and DOs calling the shots, and the AOA should not have a separate match unless they allow MDs to compete as well (potentially even using the same conversion that they themselves published )

 

[SpecterGT260]

And Im on my phone again so I can't just edit to add... sorry.. but your 2nd link shows a really good correlation. Several people say they were accurate to within 10 points (including statements of "ot underestimated by 5" that is pretty good as far as predictive value goes)

EDIT: back on the computer now

Here is the thing - I dont see any reason why including other schools and increasing the sample size will automatically skew the USMLE correction upwards. 150 tests is a pretty good number of tests when they correlate so highly. If I were doing any other study and my data was correlated so well I wouldnt worry at all about sample size. In most cases increasing the sample size will increase significance and would be expected to increase R, but not necessarily affect the equation.

and because r is only .85, it is entirely expected that there will be people who are not perfectly characterized. And there will be people who were entirely UNcharacterized by the equation (again... because R is not = 1.0). That is just a fact intrinsic to the numbers. If I wanted to rationalize things away as strongly as you are Id just say that such people are more likely to be vocal about the faults of the equation than these guys

It underestimated my usmle step1 by 5 points.

FWIW, It underestimated my USMLE Step1 by 6 points but was within the SEM (6).

Ric

the formula exactly predicted my usmle score (within 0.25 points). i'm sold.

.

but even if we accept the "SDN pre-osteo conversion factor" and just add 20 points to the equation to account for nearly everyone who says their score was underpredicted, the AOA match stats are still significantly behind the ACGME match stats by another 20-30 points in almost every specialty (ive got a spreadsheet, if you're curious)

and the only point that was made here (and the original question) is that AOA match seems to select lower scoring applicants as a whole. This isnt true for DOs entering ACGME which I stated earlier, so none of this should be misunderstood as DO bashing.

 

[donkeykong1]

And Im on my phone again so I can't just edit to add... sorry.. but your 2nd link shows a really good correlation. Several people say they were accurate to within 10 points (including statements of "ot underestimated by 5" that is pretty good as far as predictive value goes)

what b/c 2 students said it was within 6 points things are good? nah, i call BS on this whole formula that is based on the KCOM Class of 2006, a single curriculum and a single class of DO students.

if the COSGP wants to band together and do a new quantitative analysis based on all DO students who took usmle+comlex and come up with something and get published and provide ACGME PDs with a new tool to compare exams, then that would be awesome.

 

[donkeykong1]

Yeah you're right... I wouldn't trust anything the AOA publishes either

nah, the JAOA like JAMA has some solid yet not so solid stuff as well. its all relative.

 

[Dissected]

no tactful way to say this.... these posts seem like the sort of blind anti-anti-DO stuff that just comes across as ignorant.

We are going to call the algorithm worthless after it is published by the JAOA, an osteopathic journal, and it uses 150+ students to arrive at a nearly perfect fit of the data (r=.85)? That is pretty stinkin reliable....

and yes, a 600 COMLEX translates to a 212 by this formula. A 600+ with a little wiggle room is not at all unreasonable to equate to a score that beats the nat average USMLE. You basically showed that the conversion is pretty close and then concluded that it is not


here is the thing - given the source and fit of the data, I choose to believe the equation works rather well. Nothing about applying this to the AOA match has any bearing on the DOs that match ACGME. All this is really showing is that the AOA is matching neurosurgery residents who would have barely passed USMLE, but any and all DOs going ACGME are held to equal standards and uphold the claim that MDs and DOs are indistinguishable. IMO the AOA is just hurting this claim via its match

A sample size of 155? From one class at one school!? And it was published in a journal??? 6 years ago?? Wow, that's really impressive!
**That is a very small sample from an isolated population..and a significant amount of time has passed since it was published. Wanna talk about bias?

To the bolded text: 10 points is not a little wiggle room. That is a big difference in score on the USMLE. In fact, most people I've encountered that score 600+ on the comlex are scoring 230's, 240's+.

It's a crappy formula for a lot of reasons. You can choose to deny it but that doesn't change things. The formula hurts DO's who only take the comlex if a PD decides to use it. This is a FACT, considering the average score on comlex is a 500 which comes out to 188. That equals the passing score. A standard dev. above the mean on comlex (582) is still only a 208. That sucks. That is why DO students take the USMLE - to prove that they can (and do) score higher than the "predicted" value.

Have you taken either exam yet?

 

[donkeykong1]

And Im on my phone again so I can't just edit to add... sorry.. but your 2nd link shows a really good correlation. Several people say they were accurate to within 10 points (including statements of "ot underestimated by 5" that is pretty good as far as predictive value goes)

EDIT: back on the computer now

Here is the thing - I dont see any reason why including other schools and increasing the sample size will automatically skew the USMLE correction upwards. 150 tests is a pretty good number of tests when they correlate so highly. If I were doing any other study and my data was correlated so well I wouldnt worry at all about sample size. In most cases increasing the sample size will increase significance and would be expected to increase R, but not necessarily affect the equation.

and because r is only .85, it is entirely expected that there will be people who are not perfectly characterized. And there will be people who were entirely UNcharacterized by the equation (again... because R is not = 1.0). That is just a fact intrinsic to the numbers. If I wanted to rationalize things away as strongly as you are Id just say that such people are more likely to be vocal about the faults of the equation than these guys





.

but even if we accept the "SDN pre-osteo conversion factor" and just add 20 points to the equation to account for nearly everyone who says their score was underpredicted, the AOA match stats are still significantly behind the ACGME match stats by another 20-30 points in almost every specialty (ive got a spreadsheet, if you're curious)

and the only point that was made here (and the original question) is that AOA match seems to select lower scoring applicants as a whole. This isnt true for DOs entering ACGME which I stated earlier, so none of this should be misunderstood as DO bashing.

first off r=.68 in the study. and I totally understand what you're getting at. HOWEVER when we're talking about a study comparing board exams for all DOs that is solely based on students going through a single curriculum at one school, that is just absurd.

And you know what in hindsight, I actually find no reason why this study was done in the first place. Besides for individual merit, some schools are stronger than others in preparing students for board exams---this is clearly reflected in 1st time board pass rates. so doing a DO school wide study in an effort to find a reflective algorithm would be a silly idea.

my idea: either abolish the comlex and add OMM to the USMLE for DOs, or continue to take usmle+comlex.

 

[SpecterGT260]

A sample size of 155? From one class at one school!? And it was published in a journal??? 6 years ago?? Wow, that's really impressive!
**That is a very small sample from an isolated population..and a significant amount of time has passed since it was published. 1) Wanna talk about bias?

To the bolded text: 2) 10 points is not a little wiggle room. That is a big difference in score on the USMLE. In fact, 3) most people I've encountered that score 600+ on the comlex are scoring 230's, 240's+.

It's a crappy formula for a lot of reasons. You can choose to deny it but that doesn't change things. The formula hurts DO's who only take the comlex if a PD decides to use it. This is a FACT, considering the average score on comlex is a 500 which comes out to 188. That equals the passing score. A standard dev. above the mean on comlex (582) is still only a 208. That sucks. That is why DO students take the USMLE - 4) to prove that they can (and do) score higher than the "predicted" value.

5) Have you taken either exam yet?

1) none of the things you mention in your first paragraph contribute to bias (except maybe 1 school... so we will just assume for your sake that KCOM students score lower on USMLE vs all other COMs holding everything else equal... right )


2) 10 points IS a little wiggle room in a CORRELATION. This is why the subject is so frustrating. Many of you cannot seem to understand the real meaning of averages and error. An effective correlation will still ALWAYS have a subset of data points that are not perfectly predicted and yet the correlation remains valid. This is just math.

3) I suspect you n value for the claim about most people you have encountered is significantly less than 155. hypocrisy much?

4) nobody is saying that a DO student should not take the USMLE. IMO it is an excellent idea for any who want to go to an ACGME program. Better to not leave things to chance. However this excludes AOA match stats from any sort of comparison and such a privileged status as "uncritiquable" is inappropriate.

5) this is a straw man argument. Nothing about whether or not I have taken the test lends validity to the study in any way. Once again, you are attempting to use n=1 anecdote to prove your point. Lets say I had taken both. then what? I have already addressed the fact that in a correlative study nearly NOBODY will be precisely predicted (at least by % of the population), and that nearly everyone (in this case 80%) of people will be predicted to a high degree.

 

[SpecterGT260]

first off r=.68 in the study. and I totally understand what you're getting at. HOWEVER when we're talking about a study comparing board exams for all DOs that is solely based on students going through a single curriculum at one school, that is just absurd.

And you know what in hindsight, I actually find no reason why this study was done in the first place. Besides for individual merit, some schools are stronger than others in preparing students in board exams---this is clearly reflected in 1st time board pass rates. so doing a DO school wide study in an effort to find a reflective algorithm would be a silly idea.

my idea: either abolish the comlex and add OMM to the USMLE for DOs, or continue to take usmle+comlex.

r= .85. R^2 is .68. take the square root of that.

but this is beside the point. The OP is about AOA ortho being so competitive. Even if we are extra forgiving (unless we are completely rejecting any correlation which I think is silly... because the only way there would NOT be a correlation between the scores is if neither test is correlated to applicant knowledge. Since both tests are correlated to knowledge, the test scores are correlated to each other.) so... even if we are extra forgiving and give all COMLEX scores a bonus 20 points, the AOA ortho average is still 222 and that was supported anecdotally above by a few posters ehre who claim that a 600 should be a 222. as you posted earlier the ACGME ortho (which could potentially include DO numbers as well) is 240.....

So the question is: what makes AOA ortho so competitive because from what I see, any comparison suggests that a relatively average DO entering the ACGME match would fare rather well in AOA ortho unless there just simply arent enough spots to make the test scores a largely minimal factor.

im not sure how this turned into a "should DOs take the USMLE" thread .... I was still talking about competitiveness of AOA ortho this whole time

 

[donkeykong1]

r= .85. R^2 is .68. take the square root of that.

but this is beside the point. The OP is about AOA ortho being so competitive. Even if we are extra forgiving (unless we are completely rejecting any correlation which I think is silly... because the only way there would NOT be a correlation between the scores is if neither test is correlated to applicant knowledge. Since both tests are correlated to knowledge, the test scores are correlated to each other.) so... even if we are extra forgiving and give all COMLEX scores a bonus 20 points, the AOA ortho average is still 222 and that was supported anecdotally above by a few posters ehre who claim that a 600 should be a 222. as you posted earlier the ACGME ortho (which could potentially include DO numbers as well) is 240.....

So the question is: what makes AOA ortho so competitive because from what I see, any comparison suggests that a relatively average DO entering the ACGME match would fare rather well in AOA ortho unless there just simply arent enough spots to make the test scores a largely minimal factor.

im not sure how this turned into a "should DOs take the USMLE" thread .... I was still talking about competitiveness of AOA ortho this whole time

lol my bad, thought the study mentioned an r value, which would seem more appropriate anyways in our case. ok so take AOA ortho. you're going to need a 240+ USMLE to match ACGME and we're saying in 2011 you need a 600 COMLEX to match comfortably in the AOA. it seems like you won't be satisifed with anything less than an algorithm, so here it is the official donkeykong1 USMLE-COMLEX conversion formula:

USMLE Step 1 = 97.97 + 0.24 × COMLEX-USA Level 1

so a 600 comlex correlated to about a 242 usmle

 

[Dissected]

1) none of the things you mention in your first paragraph contribute to bias (except maybe 1 school... so we will just assume for your sake that KCOM students score lower on USMLE vs all other COMs holding everything else equal... right )

True, but that is very significant bias. You sound like someone who values well designed studies..so I would think that would get to you. In reality, this study can only be applied to students graduating from KCOM if we are going to be purists, right?

Maybe students at KCOM in 2006 performed lower on the USMLE than students normally do across the country. We can't really make a call either way can we? It is too isolated of a study!!

2) 10 points IS a little wiggle room in a CORRELATION. This is why the subject is so frustrating. Many of you cannot seem to understand the real meaning of averages and error. An effective correlation will still ALWAYS have a subset of data points that are not perfectly predicted and yet the correlation remains valid. This is just math.

Got me there.

Still..if this formula does under-predict (which I'm convinced it does for most students), what a detriment to an otherwise qualified applicant.

5) this is a straw man argument. Nothing about whether or not I have taken the test lends validity to the study in any way. Once again, you are attempting to use n=1 anecdote to prove your point. Lets say I had taken both. then what? I have already addressed the fact that in a correlative study nearly NOBODY will be precisely predicted (at least by % of the population), and that nearly everyone (in this case 80%) of people will be predicted to a high degree.

Merely curious. Settle down.

People who have taken both understand how terribly written the comlex is, which is a major factor for why a lot of folks under-perform. Some can get past the BS and answer the questions while some can't handle the hazy nature of the questions.



As an aside..the passing scores and averages for the usmle have climbed since 2006 when this article was published, which would alter the formula a bit, would it not?

 

[SpecterGT260]

Ok. We are getting g away from the OP. I think a combination of the jaoa and sdn anecdotes show that even with the under representation, the AOA stats are not on par with the acgme. If we are rejecting that then there isn't any further point of discussion: AOA ortho is competitive for the same reasons acgme ortho is. I think it has a little more to do with seats though, and my major point this whole time is that the average DO applying acgme by stays alone would fare well in the AOA match