How easy is it for a DO to get a fellowship after an Internal Medicine residency?

[779663]

I know IM lets you specialize and get a fellowship in a variety of specialties such as cardiology, pulmonology, oncology, rheumatology, ID, endocrinology, gastroenterology, hematology etc...

How accessible are these for a DO? Do most IM DOs go on to specialize or do they just stick with practicing general IM? After completing an IM residency are MDs and DOs on relatively equal footing?

I really think I'd like to pursue oncology but am not sure what sorts of odds I have of that actually happening as a DO.

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[Lexdiamondz]

I know IM lets you specialize and get a fellowship in a variety of specialties such as cardiology, pulmonology, oncology, rheumatology, ID, endocrinology, gastroenterology, hematology etc...

How accessible are these for a DO? Do most IM DOs go on to specialize or do they just stick with practicing general IM? After completing an IM residency are MDs and DOs on relatively equal footing?

I really think I'd like to pursue oncology but am not sure what sorts of odds I have of that actually happening as a DO.

You can do Heme/Onc as a DO. It definitely wont be at MSKCC or Dana-Farber, or a huge cancer centre but you can become an oncologist.

It definitely won't be easy though. Academia still has a considerable stigma against DOs, especially at big name institutions but it's still possible at lower and mid tier fellowships. Jefferson has a DO heme onc fellow IIRC.

 

[779663]

You can do Heme/Onc as a DO. It definitely wont be at MSKCC or Dana-Farber, or a huge cancer centre but you can become an oncologist.

It definitely won't be easy though. Academia still has a considerable stigma against DOs, especially at big name institutions but it's still possible at lower and mid tier fellowships. Jefferson has a DO heme onc fellow IIRC.

What about the other subspecialities I've mentioned? I like oncology now but only because that's what the physician I shadowed did. I haven't been exposed to the others as much and so who knows which of those I may end up liking best? I'd like to keep my options open

 

[Lexdiamondz]

What about the other subspecialities I've mentioned? I like oncology now but only because that's what the physician I shadowed did. I haven't been exposed to the others as much and so who knows which of those I may end up liking best? I'd like to keep my options open

They're all possible, but the numbers for DOs are still much lower compared to MDs, and even IMGs. You can do it if you have the CV to back it up, but it's going to be more difficult.

 

[MADD!!!]

To answer your question, DO's, MD's and IMG's have equal footing (more or less) once they get into residencies. BUT, it's very difficult to get into a good IM residency program as a DO or IMG to begin with, so it's like a chain effect. The location of your IM residency and it's prestige are what leverages you for fellowships.

With that said, the only really competitive ones are Gastro (hardest), Cardio, and to a slightly lesser extent Hem/Onc and Pulm/CC. The rest are fairly doable (endo, allergy/immuno, rheum) to EXTREMELY doable (like they'd beg you to come in-- nephro, ID, Hospice/palliative care)

 

[MADD!!!]

http://www.nrmp.org/wp-content/uploads/2017/02/Results-and-Data-SMS-2017.pdf

Check out percentages of US MD's that matched into each fellowship. General rule of thumb is that the more percentage of MD's who applied and filled up spots, the more competitive it is.

 

[Stagg737]

To answer your question, DO's, MD's and IMG's have equal footing (more or less) once they get into residencies. BUT, it's very difficult to get into a good IM residency program as a DO or IMG to begin with, so it's like a chain effect. The location of your IM residency and it's prestige are what leverages you for fellowships.

With that said, the only really competitive ones are Gastro (hardest), Cardio, and to a slightly lesser extent Hem/Onc and Pulm/CC. The rest are fairly doable (endo, allergy/immuno, rheum) to EXTREMELY doable (like they'd beg you to come in-- nephro, ID, Hospice/palliative care)

The bolded is semi-true. Once you're in residency, I believe the stigma for fellowships does go down (if you got into a strong residency), but there are still some MD programs that flat-out don't take DOs. Hopefully this will change in the future, but it's still there. The list of competitiveness of specialty is pretty correct from what I've seen though, and the only fields as a whole I think are more difficult for DOs are GI and Cardio. Pulm and Heme/Onc can be too, but that's much more program dependent from what I've heard. I may be wrong though, as I've always had exactly zero desire to go into IM.

 

[MADD!!!]

The bolded is semi-true. Once you're in residency, I believe the stigma for fellowships does go down (if you got into a strong residency), but there are still some MD programs that flat-out don't take DOs. Hopefully this will change in the future, but it's still there. The list of competitiveness of specialty is pretty correct from what I've seen though, and the only fields as a whole I think are more difficult for DOs are GI and Cardio. Pulm and Heme/Onc can be too, but that's much more program dependent from what I've heard. I may be wrong though, as I've always had exactly zero desire to go into IM.

It's simple, as a DO if you want it, do well, move to a less desired area like the Midwest or Buffalo NY for an academic IM, and get into their fellowship.

For DO's we can get it more or less if you're flexible and willing to live anywhere. Many MD's want it in main cities or prestigious institutions, or by that point they don't care enough to leave for fellowship when they could move home, work, and start a family.

 

[AnatomyGrey12]

It depends on the fellowship like mentioned above. Some of them basically beg you to apply, others are reasonable, some are more difficult. The more I look into it I really don't think cardiology is as difficult as people make it out to be because there are so many spots. You still need a decent residency but people even match cards from community programs. GI is another matter and is the most competitive of the fellowships. As a DO you probably need a mid-tier IM residency to have a realistic shot at GI. Or be at a program with an in-house fellowship. Oncology is a reasonable goal as a DO.

 

[deleted831695]

I know an IMG MD who did residency at a community hospital and matched Heme/Onc. Most fellowships save for GI and Cards are attainable, and even the latter are possible if you're flexible to move anywhere.

 

[OnlyOneZlatan]

Where are the attendings/fellows at to answer this? A bunch of students and pre-meds answering means absolutely nothing because nobody has gone through it to know the intricacies. All I read are a bunch of superficial responses and naive answers

 

[Lexdiamondz]

Where are the attendings/fellows at to answer this? A bunch of students and pre-meds answering means absolutely nothing because nobody has gone through it to know the intricacies. All I read are a bunch of superficial responses and naive answers

NRMP has hard data that you can look at for fellowship matches. They don't have an updated Charting Outcomes but you can see how many DOs match into certain IM, Peds and Surgical specialties.

http://www.nrmp.org/wp-content/uploads/2017/02/Results-and-Data-SMS-2017.pdf
http://www.nrmp.org/wp-content/uploads/2017/02/2016-PD-Survey-Report-SMS.pdf

 

[OnlyOneZlatan]

NRMP has hard data that you can look at for fellowship matches. They don't have an updated Charting Outcomes but you can see how many DOs match into certain IM, Peds and Surgical specialties.

You can hardly extrapolate residency matches because it all depends on the person's desires - academic vs community, geography, lifestyle.... there is absolutely no way you're going to be able to figure out fellowship match. Also have to take into account the number of DOs that go to AOA programs that aren't even a part of the NRMP data who cannot (or less likely to) get into ACGME fellowships.

 

[Lexdiamondz]

You can hardly extrapolate residency matches because it all depends on the person's desires - academic vs community, geography, lifestyle.... there is absolutely no way you're going to be able to figure out fellowship match. Also have to take into account the number of DOs that go to AOA programs that aren't even a part of the NRMP data who cannot (or less likely to) get into ACGME fellowships.

But you can get an idea from the data how many DOs are in a given field, what percentage of PDs offer interviews and rank DOs regularly, etc, which is what OP is asking.

 

[nlax30]

There are soo many variables involved in that pathway to get to the point of of a IM sub-specialty that no one is going to be able to tell you "how accessible" with any reliable accuracy. It's going to ancedotal.

In GENERAL, for ACGME fellowships yea, on average the statistics favor an allopathic applicant over an osteopathic one. Also keep in mind there are osteopathic fellowships in these competitive specialties though that's about to change with the merger.

So really, there's not good answer besides do the best you can and aim for a good well respected IM residency program which can certainly open doors for you.

 

[DrfluffyMD]

I am an USMD applicant applying for an interventional radiology fellowship.

The competitiveness of fellowship programs varies wildly. It's goes from more so than residency match (UCSF IR has 2-3 open spots for example) to begging you to apply (renal, etc)

So the short answer would be that being a DO can be a mark on your CV the same way a poor step 1 score can be on your CV. You can be filtered out if things are ultracompetitive, but if they are not then it doesn't matter.

Plus, there is no way you can really figure out. Just a few years ago Mt Sinai NY IR took a DO from a small community hospital as a fellow. My buddy told me that this year he was not extended an interview despite being an USMD, multiple IR publications and having scored above 240 on step 1 and 2.

So it can be a negative or completey nonfactor simply depends on the math of the match.

Think of residency match as a form of king of the hill. As the size of the hill top decreases, more and more people fall off until at the end only a few people with Harvard undergrad through residency, 270s, mass research and 7 feet tall remains.