How do you get the residency of your choice?

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Transposon

What are residencies based on? Board scores? How do they do the match? What factors lend to someone getting a residency over another.
I am interested in Radiology, Infectious diseases, and Pathology. Are these fields tough to go into as a DO? Is the MD route any easier? Thanks...
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Originally posted by transposon:
•What are residencies based on? Board scores? How do they do the match? What factors lend to someone getting a residency over another.
I am interested in Radiology, Infectious diseases, and Pathology. Are these fields tough to go into as a DO? Is the MD route any easier? Thanks...•••


In general, an osteopathic certification makes obtaining any choice residency more of a chore. While there are DO's in every discipline, their numbers are far far less in the more competitive specialities.

Radiology is very tough to get into now, so an MD tract would probably make life a bit easier. Infectious disease is a branch of medicine, and should be relatively easy for a US osteopath to obtain.

Osteopathic medicine really is an ideal choice for those interested in primary care. Unfortunately very few know precisely where their interests lie prior to a broad and comprehensive clinical experience.
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Programs will vary with regard to the importance given various elements of your application, but generally USMLE Step 1, AOA, letters of recommendation, being "known" at a program (ie, by doing an away audition elective there - obviously only feasible at a couple of places), grades and perhaps most importantly (once you've reached this stage) is how well you fit in during interview. Once you've been invited for an interview you can be relatively sure you've passed the minimum academic standards for the program - now the task is to show that you will be a joy to work with over the next several years. Programs invest a lot of time and money into their residents and no one wants a complete &&S^^&AAhole in their program - not a perfect system as every year, in most every program, at least one slips through! ;)

There is no "formula" which will guarantee you a position. As for being a DO, it is true that at some of the more competitive programs in some of the more competitive fields (including Radiology right now which is HOT) you will be seen as less desirable. Not fair, but IMHO it happens. Not much you can do if a program prefers allopaths but know there are a multitude of programs which don't give a hoot about your degree.
 
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All else being equal, it is better to go to an MD school if you are interested in specialized fields, especially radiology which is very competitive this year. In addition, going to the best MD school possible will also give you a slight edge at harder to get residencies within a particular specialty (not just matching in that field). That being said, pathology and ID are fairly easy fields to match into as US grad (MD/DO), especially if you are not interested in academic medicine. The main problem is that although you may think you're going into Rads, ID, or Path, what happens if you change your mind and want to do ENT, orthopaedics, or dermatology? No doubt you will be at a disadvantage as a DO and will have to be that much more superb than your MD colleagues competing for a finite number of spots. This is reality and anyone who tells you otherwise is just fooling themselves.

My advice is to go MD at the best place, study hard, slam the board, get good grades, learn as much as you can, get along well with others, and do what you love.
 
Also, get great letter of recommendations from top known people in the field that know you well, do a 2nd and/or 3rd away rotation in your field and make sure you "shine." Write a personal statement that does not make you sound like 1) a pyscho and 2) or a jr high student in terms of grammer and style.
 
I am a 4th year DO student trying for allopathic radiology and not having much fun. Even though I'm one of the top of my class, have competitive Step I and II, and solid letters, I'm finding it hard to get interviews and have been rejected by many mid-level programs. Also, while on an interview, I was told by one program director that a DO will have a tough time matching this year. Unfair as it may seem, it is reality that DO's are less desirable in competitive specialties at competitive hospitals. Regardless of this fact, I found my osteopathic education to be excellent and was well prepared for my clinical years compared to many other allopathic students in the NYC/LI area. It's just hard for me to stomach the fact that I know I'm better than half the monkeys interviewing for my radiology position, and the only thing holding me back are the two letters after my name. It's pretty sad.
 
Originally posted by pags:
•I am a 4th year DO student trying for allopathic radiology and not having much fun. Even though I'm one of the top of my class, have competitive Step I and II, and solid letters, I'm finding it hard to get interviews and have been rejected by many mid-level programs. Also, while on an interview, I was told by one program director that a DO will have a tough time matching this year. Unfair as it may seem, it is reality that DO's are less desirable in competitive specialties at competitive hospitals. Regardless of this fact, I found my osteopathic education to be excellent and was well prepared for my clinical years compared to many other allopathic students in the NYC/LI area. It's just hard for me to stomach the fact that I know I'm better than half the monkeys interviewing for my radiology position, and the only thing holding me back are the two letters after my name. It's pretty sad.•••

Hi Pags,

I know it must be very frustrating when you feel you are as competitive as your allopathic counterparts. Yet comments like ' I know I'm better than half the monkeys interviewing' doesn't do much to promote your cause. I have defended your chosen discipline adamantly on these forums. At the same time, I think it's important to realize that allopathic students are just as bright as osteopaths. Calling them monkeys out of frustration is simply in poor taste in my opinion.

Allopathic students, especially those applying in radiology are just as bright and competitive as anyone. To make it this far, they have to be.

A much fairer comment would be to express your frustration over not being held to the same standard as your allopathic counterparts. This is a legitimate statement. Yet disparraging these highly competitive candidates sight unseen is not becoming. I will assume that your frustrations got the best of you. Both allopathic and osteopathic schools produce superbly prepared physicians. I would hesitate to castigate entire groups of 'monkeys' who represent the top 1% of the population.

With your scores you should be able to do what you want to. Lets not breed unnecessary animosity. It only serves to further the divide. We are all physicians. I certainly respect your colleagues, and would hope you might extend the same courtesy to mine.

Good luck on the interview trail
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Klebsiella,

I agree with you on all of your points...well said. However, what do you mean by "representing the top 1% of the population"? In what regard?
I vehemently oppose this sentiment (among many in this profession) that we're somehow better, smarter, or whatever...than people who have chosen other professions. Inflated egos are one aspect of medicine I abhor.
Again, I'm not putting words in your mouth, I'm just asking for clarification.
 
Originally posted by Teufelhunden:
•Klebsiella,

I agree with you on all of your points...well said. However, what do you mean by "representing the top 1% of the population"? In what regard?
I vehemently oppose this sentiment (among many in this profession) that we're somehow better, smarter, or whatever...than people who have chosen other professions. Inflated egos are one aspect of medicine I abhor.
Again, I'm not putting words in your mouth, I'm just asking for clarification.•••

Greetings Teufelhunden,

Point well made. I too find it discouraging when physicians behave in such a manner. Having said that, physicians do spend considerably more time and effort training in their respective field than most other disciplines. Does this make us better? Heck No! It makes us kind of silly if you ask me. Spending 4 years of rigorous undergrad, 4 years of even tougher med school. Internship, Residency, and finally a fellowship. At the end of this long arduous journey, we have lost perhaps millions in opportunity cost, and have suffered physical and mental anguish all in the name of humanity (at least I would like to think so).

While physicians may not necessary be inherently smarter than the other professionals (I might argue the contrary in fact, given the years and suffering endured :) ), on average they sure as heck "KNOW MORE". This isn't a comment reflecting an inflated ego. It speaks to the years of incessant learning and toiling in the trenches. This is a profession of constant learning even at the attending stage. How much we know is a product of the process, and their is nothing wrong with patting oneself on the back every once in awhile for this tremendous effort toward a seemingly noble cause.
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Dear Kleb:
You're right, maybe my frustration has gotten the best of me. I'm not trying to put a wedge between both fields, but just telling like it is. Yes, I agree, there are lots of very qualified candidates out there. However, you should see some of these boobs I've interviewed with. Total primates. Sorry, just being accurate here.
 
Well these are frustrating times aren't they pags? What makes the other allopathic people interviewing at the same radiology programs monkeys? What makes you so sure you are better, when you do not know what other applicants bring to the table? There is more to matching than grades and board scores once you make the cut off for the interview.

Anyway, like I said, go MD if you want a better chance at competitive residencies.

Oh.. and pags, keep the faith, I think you will match somewhere (unless your poor attitude shows). Please, drop the hotdog attitude. You may learn something from us md monkeys one day when you are a radiology resident at an allopathic radiology residency program.

Let's face another fact, I have some DO friends and they all agree that DO radiology residency programs are on average of dubious quality.
 
I am presuming (yeah, I know) that you're an applicant for medical school at this point. Everyone above me (post-wise) is right and they kinda danced on an issue. "Highly competitive" residencies exhibit trends just like the moon. Anesth is hot now, but 5-6 years from now when you're applying? This is a big prediction to make. Surgery was big for a while - then "slowed" down. etc. etc. Overall, it seems hard to say what is going to be "highly competitive" when we're ready to apply.

I had this big preconceived notion applying to medical school that I wanted EM. After talking with a friend of mine, I realized I don't know Jack about medicine (compared to what I will learn over the next 4 years). I'm approaching my next 2 years with an open mind to see what i like and don't like as I get more and more exposure.

Just some thoughts (I'm chatty tonight)
-A
 
Voxel: I don't think pags was making a comment about MDs in general and I think you know that. He is obviously just frustrated with the application process. We all form opinions of applicants based on our conversations with them. Heck, I've met some applicants who I thought were boobs too (both MDs and DOs). In fact, when I interviewed at some programs I thought the residents were of dubious quality (not necessarily US MDs) and decided to not rank them highly because of that. Obviously, I don't know whether or not this is necessarily true, but it happens sometimes as a result of the limited time we have with applicants, attendings, and residents. The fact is that sometimes we do unfairly pass judgement on people we don't know that well. This is obviously not right, but he wasn't making a comment about MDs in general, just the ones he met. If anything, I found your comments just as inflammatory. Who asked or made a comment about DO Radiology residencies? No one except you. Just because your DO friends said something about DO Radiology residencies doesn't say anything to me. Just because one is a DO doesn't mean they know anything about any of the Radiology programs. I don't assume that every MD knows everything about every allopathic residency out there and you shouldn't assume the same about DOs as well. Are your friends residents at those programs? What programs are they specifically? If those programs are of dubious quality, does it mean that all DO Radiology programs suck or just the ones your friends matched at? There are several allopathic residencies that are of dubious quality as well and each individual program should be judged by its own merit.
 
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Why not ask pags what he thinks of DO radiology residencies? Did he apply to any? Please do not flame me because I am making an statement about current thoughts on DO radiology residencies by DO applicants to radiology programs this year. I never said there aren't MD radiology residencies that are of dubious quality but they (MD) are better than DO radiology residencies on average. I think people will agree on that point and people need to know this when applying for radiology residency (as the first poster thinks he may).

Also, please stop your "who asked you" nonsense. I have the freedom to say what I believe. I don't care if you do not believe me. That is up for the readers to decide. The statement was not meant to be inflammatory, just the current thoughts on residency programs.

Also, I am curious to learn what makes you think certain applicants are "boobs" and certain others are not "boobs"?
 
Thanks Leotigers. I made the comment not to further the MD/DO issue, I'm far beyond that pre-med quandry. I was just commenting about some of the other candidates I've interviewed with and my personal self-worth, although, I do not feel that I'm part of that top 1% category. For some reason, Voxel felt I was MD bashing. Well, I'm not, nor am I a hotdog, for my friends know the truth in that regard. I believe the comments in my first post are obvious to most and do not need to be further clarified for the masses. I decided to attend DO school and now have to swallow all its benefits and disadvantages. This, in turn, might give the original poster something to think about when selecting schools with his future career choices in mind. Although, I'm not directly stating it, I might be giving information on how to get the residency of your choice. At the same time, I'm venting my frustration that I'm sure other DO's sharing in my predicament are facing.

And as for those dubious AOA residencies, you added that fact because you wanted to educate our friend transposon, or, to get back at me in some way???
 
Dear Voxel:

I think my lack of application toward DO radiology residency speaks for itself. Again, I chose to attend osteopathic school and I have to deal with all its glory and detriment. However, I know a boob when I see one.
 
I am educating transposon and he/she will have to take this into consideration as to where they will want to train. I have no ill will towards you, pags. Maybe deep down you are not a hotdog, but that's the way it came across.

I am not sure of your criteria for calling people "boobs", but if they made it to the same interview as you they have a crack at the position just like you.

I actually would welcome a colleague (MD/DO) who has a passion for radiology, does it well, and does not think/act like you posted. I understand it was out of frustration and maybe even anger, but that does not make it right.

If my DO friends are wrong about DO radiology residencies, then please educate us. I am open to learning more about DO radiology residencies.
 
Voxel:

At least when I was interviewing, the applicants would often talk a lot amongst themselves. Some would even discuss their USMLE scores amongst other things. Certain programs would even take us out to dinner the night before so there was ample opportunity to formulate an opinion about someone.

Anyway, I'm not looking to start anything, I just wanted to point out the fact that pags wasn't making a comment about MDs in general. If anything, he has more of a problem with osteopathic medicine rather than allopathic.

Obviously, the allopathic radiology residencies are better on average. However, I was just curious as to why you would bring this up since no one asked. I'm doing an allopathic residency, but it's not because all osteopathic ones suck. There are some that are indeed better than allopathic residencies, but in general, they are worse. The problem is that the osteopathic match is BEFORE the allopathic one and if I could formulate a match list with the top allopathic and osteopathic programs I would. As it stands, since the osteopathic match occurs first, I would be dropped from the allopathic match if I match into an osteopathic residency. This acutally sucks, in my opinion, and is just a way the AOA tries to keep DOs in the fold. Some of the best DOs out there who want to go into fields such as Orthopedic Surgery, ENT, Neurosurgery face this dilemma each year. Do they take take the chance that they do not match at all and can't go back and do the osteopathic match, or do they do the osteopathic match and bypass the possibility of matching at a place like UCLA, UC Davis, or another allopathic residency?

Well....good luck to both of you in the match this year. I've met quite a few Radiology casualties (both US MDs and DOs) so you're not alone pags. I think the unmatch rate is actually higher than listed because many apply to backup specialties. In case you don't match, you should consider doing a TY instead of FP. This way you could apply again next year without the program losing any funding.

P.S. I'm a boob when it comes to knowledge about osteopathic radiology residencies. :) I've heard that a few of the ones in Michigan and Chicago are pretty good. Namely, the Pontiac, Botsford, and Bi-County hospitals in Michigan. Many people don't realize that there are no hospitals/residencies which are purely staffed by DOs. In almost all of the osteopathic hospitals and residencies, you are trained by both MDs and DOs. I'm not making any sort of statement, just stating a fact. I never applied or interviewed for osteopathic residencies, but I've always felt that they've been unfairly given a bad rap. I'd be curious to hear real experiences from residents in the program as well. I'm guessing that for those who are truly passionate about Radiology, sometimes it is better to do an osteopathic radiology residency and be a best friend, than to not match at all. ;)
 
I second the notion of doing a transitional year instead of FP. Also, there are medicare GME funding issues if you ever plan to switch back to radiology. FYI, radiology residency spots open up throughout the year and people do drop into those spots who did not match the prior year. At my medical school, one guy who did not match into radiology dropped into a program for next year. I also know of a guy who did not match derm last year, but managed to get into a derm residency for next year. All hope is not lost. Keep the faith and networking alive. :)
 
I would have thought that DO's would have a lot of options when it comes to residencies as they could apply to both Osteopathic matches as well as to Allopathic ones. Why is it that, usually, only 1 person in a graduating medical class would go into a residency like Pathology. Is that because it's a tough residency to get or is that Pathology is not a residency that people want. I want to eventually take a fellowship after Pathology and maybe do some teaching on the side. Are these goals doable as a DO? Suppose I take phd courses in this area as well, would that help my chances?

Thanks all
 
The problem with applying for both matches is that the osteopathic match is approximately a month earlier than the NRMP match. This creates a problem if one matches on the DO side; the NMRP match becomes void. So, it's best to choose early on where you want to go. Pathology should not be hard to match as a DO. Last I heard, Pathology is not very competitive at this point. I would say it's DOable. :)
 
Great! I'm going to revive pathology so-to-speak! :D Why do people avoid this residency? To me, it seems like a great field that requires a lot of knowledge.
 
Originally posted by ligand:
•Great! I'm going to revive pathology so-to-speak! :D Why do people avoid this residency? To me, it seems like a great field that requires a lot of knowledge.•••

Revive away ! :)

Pathology certainly has it's shining points. I think a lot of people stay away because of limited clinical exposure. It is more a laboratory field in some people's view. It is undoubtedly an essential field. But if you are keenly interested in interacting with patients, it may not be the most appropriate choice.
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Just to comment on Pathology...
It a fairly open field. And there are several DOs in path that I know..
that being said Pathology is getting more competative... the numbers have been going up.

So in the future it might change... but still lots of FMGs go into path, and the paper rank order goes MD, DO, FMG... so.

(and I know lots of great DOs, :p )
 
Goofy said:
Originally posted by transposon:
•What are residencies based on? Board scores? How do they do the match? What factors lend to someone getting a residency over another.
I am interested in Radiology, Infectious diseases, and Pathology. Are these fields tough to go into as a DO? Is the MD route any easier? Thanks...•••


In general, an osteopathic certification makes obtaining any choice residency more of a chore. While there are DO's in every discipline, their numbers are far far less in the more competitive specialities.

Radiology is very tough to get into now, so an MD tract would probably make life a bit easier. Infectious disease is a branch of medicine, and should be relatively easy for a US osteopath to obtain.

Osteopathic medicine really is an ideal choice for those interested in primary care. Unfortunately very few know precisely where their interests lie prior to a broad and comprehensive clinical experience.
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I don't want to step out of my boundaries but I was under the impression that the smaller numbers of DOs in competitive specialties was due, in part, to their smaller numbers overall. I think DOs currently only make up ~5% of practicing physicians in the US. I have been told that due to the large numbers of very qualified people applying for some of the super competitive residencies there will be many very qualified people who are not accepted. A radiologist I spoke to recently told me that of the 60 they interviewed last year there wasn't one who didn't have excellent Step I scores and excellent letters.
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Last edited:
I also wanted to comment that it is refreshing to see DOs and MDs being respectful to one another. I think that today the 2 paths to becoming a physician have much more in common than not. This seems to be a message that is lost in the premed forums I had frequently visited before starting medical school.
 
I always do this.......revive threads that haven't been touched in 10 years......Sorry everyone. Didn't pay attention to the date before I started posting.
 
pags said:
The problem with applying for both matches is that the osteopathic match is approximately a month earlier than the NRMP match. This creates a problem if one matches on the DO side; the NMRP match becomes void. So, it's best to choose early on where you want to go. Pathology should not be hard to match as a DO. Last I heard, Pathology is not very competitive at this point. I would say it's DOable. :)
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It is unfortunate but there is still a prejudice against DOs in certain fields. So the more competitive the field, the safer you are being from an allopathic school.

Pathology is becoming more competitive as many students are starting to view it as a lifestyle specialty. It is not as competitive yet as the ROAD, EM or surgical subspecialties. However, path seems to cycle every few years like anesthesia.
 
Transposon said:
Great! I'm going to revive pathology so-to-speak! :D Why do people avoid this residency? To me, it seems like a great field that requires a lot of knowledge.
Click to expand...

My understanding is the problem isn't landing the residency...it's landing a job when you get out.
 
Get a high USMLE score and, if it is offered at your school before residency applications go out, get AOA. A lot of competitive programs screen with USMLE scores and to a lesser degree AOA status (again if it is offered before apps go out at your school--some schools do not offer AOA until after residency apps go out and there is a box to check on eras if that is the case). Back to screening, if you have a low USMLE score, no matter how stellar you are, some competitive residency programs will just toss out your application. I know a lot of good people who haven't been invited to some interviews at top programs for competitive residencies because of low USMLE scores. I think you need to get over 240 to be generally safe.
Besides that, obviously do well in your rotations, most importantly those related to whatever you are applying in, and try to do some research.
 
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