How much does DO vs MD matter for psychiatry residencies?

[amerepedestrian]

Context: I've been accepted into several DO schools but am on hold at several MDs, wondering how to process my likely fate of becoming a DO. I think a part of me is just looking for validation of the choice to go the DO route in case I don't get into any MD programs, but I want to be completely realistic. Anyway, I've read a lot about general DO vs MD issues on here but wanted to specifically ask this question for pre-medical students who are leaning toward traditionally less-competitive specialties.

My understanding is that highly competitive ACGME residencies are extremely difficult for DO students to land regardless of grades, scores, or recommendations. However, I don't currently have any reason to believe I'd want to pursue any of these specialties (orthosurg, derm, ophtho, etc.) After shadowing many different types of physicians for many thousands of hours, I just don't see myself going into a highly-specialized field that does not allow physicians many opportunities to help patients on a psychosocial level.

It's possible that I will want to go into neurology instead of psychiatry (or something completely different), and I can't predict the future, but I have had a ton of practical experience with psych patients that only reinforced my longtime desire to be a psychiatrist. I'm just wondering if going the DO route would likely shut down any prestigious opportunities for me given my interest in this mildly-to-moderately competitive specialty.

Yes, I know prestige shouldn't matter much, but that isn't my primary reason for pursuing the medical path, and I want to know what I'm really dealing with here in terms of how high my hopes should reside. My dream is to be a practicing psychiatrist in a big, liberal city, and I am interested in research. How much would DO vs MD affect my chances of landing a highly-coveted psychiatry residency, say, at UCSF, Yale, or OHSU, other things equal?

Thanks for your time 🙂

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[libertyyne]

@Stagg737 might be able to shine some insight into this question.

That being said, common wisdom is you go MD if you want the more prestigious academic programs, it doesnt make it impossible for DO's. It is just that DO schools on average with their lack of research and lack of residency programs makes it more difficult to build up a competitive resume for places that you have mentioned.

 

[Anti-PD1]

If you have a choice, go MD, for a million reasons.

Let's just look at the data, we'll talk ACGME right now because that's the future. There are osteopathic programs being converted to ACGME programs, so the following may not be as bad. The 2016 NRMP Program Director Survey:

http://www.nrmp.org/wp-content/uploads/2016/09/NRMP-2016-Program-Director-Survey.pdf

81% of psychiatry programs interview osteopathic applicants. 19% do not. 25% of programs seldom or never rank osteopathic applicants.

What does that mean? You'll be fine as a DO. Psychiatry is very DO friendly, maybe a batch of programs are off limits.

 

[ndafife]

How much would DO vs MD affect my chances of landing a highly-coveted psychiatry residency, say, at UCSF, Yale, or OHSU, other things equal?

For psychiatry in general, MD vs DO won't matter. For the places you listed, yes, it really does. I just did a quick look at their current residents, and OHSU was the only one with a DO. Granted there may be lots of reasons for that, but I'd say with pretty good certainty that you're not going to be a good candidate for UCSF or Yale with a DO, and you're at a minimum digging yourself a hole at OHSU

 

[Lawpy]

How much would DO vs MD affect my chances of landing a highly-coveted psychiatry residency, say, at UCSF, Yale, or OHSU, other things equal?

It becomes significantly harder to match into these programs as a DO. It's important to realize that the more competitive a residency program or speciality is, the worse the anti-DO bias will be.

 

[Stagg737]

I'll answer the specific questions the best I can, but I'm also going to break down a few other points because I think they're worth addressing. Also, while I'll do my best and appreciate the tag (@libertyyne ), I think there are several others who could answer this far better than I could, so I'll be tagging them as well in case they have anything to add or corrections to make: @OldPsychDoc , @MacDonaldTriad , @splik , @EarlyCareerAcademicPsych , @WingedOx , @Mad Jack .

My understanding is that highly competitive ACGME residencies are extremely difficult for DO students to land regardless of grades, scores, or recommendations. However, I don't currently have any reason to believe I'd want to pursue any of these specialties (orthosurg, derm, ophtho, etc.)

This is true in all fields, not just the competitive ones. Even in the least competitive fields, the elite programs get elite applicants because not every superstar/stud applicant chooses the most competitive specialties. There are people with 250+ boards in every field. That being said, the base score needed just to break into the field is a much lower threshhold for fields like psych or neuro compared to ortho or derm. Think of your DO degree as a handicap on your boards. At some places it won't matter much. At elite programs (regardless of field), it matters much more.

It's possible that I will want to go into neurology instead of psychiatry (or something completely different), and I can't predict the future, but I have had a ton of practical experience with psych patients that only reinforced my longtime desire to be a psychiatrist.

Do not assume you'll still want to go into psych come match time. Most people I know are entering a different field than what they originally wanted, some with drastic changes in terms of what we pursue (myself included). If that's what you want to do in 4 years that's great, but you may end up loving an extremely competitive field. If you do, you'll want to make sure you've done everything possible to increase your odds of getting into those programs, that includes pursuing an MD over DO. There are a select few situations where I'd recommend a DO over MD. However 99.99% of the time, I'd say go MD given the choice.

Yes, I know prestige shouldn't matter much, but that isn't my primary reason for pursuing the medical path, and I want to know what I'm really dealing with here in terms of how high my hopes should reside. My dream is to be a practicing psychiatrist in a big, liberal city, and I am interested in research. How much would DO vs MD affect my chances of landing a highly-coveted psychiatry residency, say, at UCSF, Yale, or OHSU, other things equal?

You don't need to attend a prestigious residency to practice in a big, liberal city or to do research. It may help if you're trying to go into academics (which would make doing research easier), but there's a very high demand for psychiatrists and a lot of research yet to be done in the field. However, if you're looking to go to an elite psychiatry residency the degrees definitely may matter. I'd like to say that in 3-4 years after the merger is through the bias will be significantly decreasing, but I don't know. If I were you, I'd put my deposit down at your favorite DO school and if you end up with an MD acceptance you should take it.

 

[splik]

How much would DO vs MD affect my chances of landing a highly-coveted psychiatry residency, say, at UCSF, Yale, or OHSU, other things equal?

OHSU would not be considered a highly-coveted psychiatry residency unless you like rain, racism, and strip clubs. they have plenty of DOs. its not a competitive program.

you would have no chance of doing a psychiatry residency at Yale or UCSF at the current time as a DO student.

 

[Mad Jack]

It's getting tougher and tougher to match psych each year. With my stats some people were shocked at how broadly I had to apply to get enough interviews. Being a DO is certainly going to make it harder to match psych at all, period, given current trends, but a psych match is still totally possible. Yale and UCSF don't take DOs, at all, ever. Some good programs do, but you'll need one hell of a resume and to take Step 1 and Step 2 to even get a look from them.

 

[amerepedestrian]

First of all, thank you all for your informative responses!

Second, before I started this thread, this one was contributing to many of my working assumptions:

Osteopathic DO friendly Psychiatry Residency Programs

It seems like things have changed significantly in the last few years if OHSU is not considered a strong residency, Yale and UCSF are so staunchly considered off-limits, and assuming I’m still hoping to match psych (which I acknowledge may certainly change), DO might be a significant handicap due in part to the increasing competitiveness of psychiatry.

 

[MacDonaldTriad]

[QUOTE="Stagg737, post: 19722304, member: 557103] if you end up with an MD acceptance you should take it.[/QUOTE]

This is becoming increasingly good advice. You can be for or against this trend, but this is direction things seem to be going.

 

[amerepedestrian]

If I were you, I'd put my deposit down at your favorite DO school and if you end up with an MD acceptance you should take it.

My plan exactly!

So much valuable information in this post—I can’t thank you enough for sharing your perspective. I will take it with me wherever I go.

It's getting tougher and tougher to match psych each year. With my stats some people were shocked at how broadly I had to apply to get enough interviews. Being a DO is certainly going to make it harder to match psych at all, period, given current trends, but a psych match is still totally possible. Yale and UCSF don't take DOs, at all, ever. Some good programs do, but you'll need one hell of a resume and to take Step 1 and Step 2 to even get a look from them.

A lot of interesting points here. While the general consensus seems still to be that psychiatry is one of the easier specialties to break into (average Step scores of matched applicants place it around neuro and well above family medicine the last time I checked), I have heard from my ___insert competitive specialty___ boss that it’s becoming more difficult. Why do you think that is? My boss thinks it’s because it’s one of the “lifestyle specialties,” (most of this is coming from her MS3 daughter) but I’m wondering what else there is to it.

I’m curious also about what you mean by “resume.” I know there are varying perspectives on this, but I’ve read that extracurriculars don’t really mean jack come match time. I’m willing to do whatever it takes to match into a strong residency and want to know how I should structure my time outside of curricular studying and board prep.

 

[Mad Jack]

First of all, thank you all for your informative responses!

Second, before I started this thread, this one was contributing to many of my working assumptions:

Osteopathic DO friendly Psychiatry Residency Programs

It seems like things have changed significantly in the last few years if OHSU is not considered a strong residency, Yale and UCSF are so staunchly considered off-limits, and assuming I’m still hoping to match psych (which I acknowledge may certainly change), DO might be a significant handicap due in part to the increasing competitiveness of psychiatry.

Yale and UCSF have always been off-limits to DOs. Yale takes DOs for fellowship, but their psychiatry residency is as competitive as many top IM programs.

 

[Kingsmen2018]

if u get an MD take it. But if u don't DO will be fine

 

[libertyyne]

My plan exactly!

So much valuable information in this post—I can’t thank you enough for sharing your perspective. I will take it with me wherever I go.



A lot of interesting points here. While the general consensus seems still to be that psychiatry is one of the easier specialties to break into (average Step scores of matched applicants place it around neuro and well above family medicine the last time I checked), I have heard from my ___insert competitive specialty___ boss that it’s becoming more difficult. Why do you think that is? My boss thinks it’s because it’s one of the “lifestyle specialties,” (most of this is coming from her MS3 daughter) but I’m wondering what else there is to it.

I’m curious also about what you mean by “resume.” I know there are varying perspectives on this, but I’ve read that extracurriculars don’t really mean jack come match time. I’m willing to do whatever it takes to match into a strong residency and want to know how I should structure my time outside of curricular studying and board prep.

http://www.nrmp.org/wp-content/uploads/2016/09/NRMP-2016-Program-Director-Survey.pdf

 

[Mad Jack]

My plan exactly!

So much valuable information in this post—I can’t thank you enough for sharing your perspective. I will take it with me wherever I go.



A lot of interesting points here. While the general consensus seems still to be that psychiatry is one of the easier specialties to break into (average Step scores of matched applicants place it around neuro and well above family medicine the last time I checked), I have heard from my ___insert competitive specialty___ boss that it’s becoming more difficult. Why do you think that is? My boss thinks it’s because it’s one of the “lifestyle specialties,” (most of this is coming from her MS3 daughter) but I’m wondering what else there is to it.

I’m curious also about what you mean by “resume.” I know there are varying perspectives on this, but I’ve read that extracurriculars don’t really mean jack come match time. I’m willing to do whatever it takes to match into a strong residency and want to know how I should structure my time outside of curricular studying and board prep.

Research, high step scores, LoRs from big names in the field, honors from well-respected psych aways, etc is what I mean by resume. You have to have your **** together now more than ever. And psych is getting more competitive largely because of a mix of increasing compensation, changing medical student attitudes, and increasing US class sizes on the MD and DO side of things. I just like the challenge of mental illness and the profound difference we can make, but several of my classmates are quick to admit they are all about the lifestyle.

 

[Goro]

Yale and UCSF have always been off-limits to DOs. Yale takes DOs for fellowship, but their psychiatry residency is as competitive as many top IM programs.

Not one of mine, but is this guy an anecdote, outlier, or door-kicker?

I'm actually surprised that I found this data point, just by googling "DO and USCF-Psychiatry."

Dr. Paul Elizondo III, DO – San Francisco, CA | Psychiatry

 

[Mad Jack]

Not one of mine, but is this guy an anecdote, outlier, or door-kicker?

I'm actually surprised that I found this data point, just by googling "DO and USCF-Psychiatry."

Dr. Paul Elizondo III, DO – San Francisco, CA | Psychiatry

Outlier. I must confess I don't know UCSF as well as I know Yale.

 

[libertyyne]

Not one of mine, but is this guy an anecdote, outlier, or door-kicker?

I'm actually surprised that I found this data point, just by googling "DO and USCF-Psychiatry."

Dr. Paul Elizondo III, DO – San Francisco, CA | Psychiatry

probably had strong relationship with UCSF since it isnt that far away from touro.

 

[Goro]

Outlier. I must confess I don't know UCSF as well as I know Yale.

So UNECOM has never sent a grad to Yale Psych? How about Harvard, the Manhattan schools, or Brown?

 

[Mad Jack]

So UNECOM has never sent a grad to Yale Psych? How about Harvard, the Manhattan schools, or Brown?

Harvard, aside from South Shore, is a no go. Same with Yale. I believe Brown has taken DOs in the past, but don't know a whole hell of a lot about the Manhattan elites.

 

[ciestar]

My plan exactly!

So much valuable information in this post—I can’t thank you enough for sharing your perspective. I will take it with me wherever I go.



A lot of interesting points here. While the general consensus seems still to be that psychiatry is one of the easier specialties to break into (average Step scores of matched applicants place it around neuro and well above family medicine the last time I checked), I have heard from my ___insert competitive specialty___ boss that it’s becoming more difficult. Why do you think that is? My boss thinks it’s because it’s one of the “lifestyle specialties,” (most of this is coming from her MS3 daughter) but I’m wondering what else there is to it.

I’m curious also about what you mean by “resume.” I know there are varying perspectives on this, but I’ve read that extracurriculars don’t really mean jack come match time. I’m willing to do whatever it takes to match into a strong residency and want to know how I should structure my time outside of curricular studying and board prep.

Be aware you generally need to score well above your MD counterparts as a DO to be considered “competitive”. I am sure some programs are fine, but with increasing competition, comes a need for higher scores, even higher as a DO.

 

[mwsapphire]

So UNECOM has never sent a grad to Yale Psych? How about Harvard, the Manhattan schools, or Brown?

Harvard, aside from South Shore, is a no go. Same with Yale. I believe Brown has taken DOs in the past, but don't know a whole hell of a lot about the Manhattan elites.

I've always thought the " DO disadvantage" is halfway between the most optimistic and the most pessimistic, it'll limit you, but not to the extent that most people can appreciate. I mean , you wanna do psych, do you need to go to Yale? I mean if you think about it, how many MD grads make it to the tippy top residency they wanted ? It may be difficult as DO, but it's pretty hard for MD as well. ( But theoretically possible for both).

At least, I'm from MA so we don't have a lot of DO's here, but my uncle practices oncology out in Philly ( he has his own practice, he's an MD), and many of his colleagues are DO's. So these are were my opinions come from, but usually situations with polar perspectives, the reality is split down the middle.