If DO degree's went MD would DO schools as a true alternative vanish?

[se20001984]

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humm,

sounds like now the evolution of DO is spreading to its clinical years now

im sure back in the day- the pre -clinicals were on fire for not being adequate.

Now concerns of clinical- the acgme merger is supposed to put clinical education/residency on par with MDs, as they will be adjustng programs accordingly


From the PR that i heard-- there are only about 10% of hospitals that need the proper adjustments

 

[SpecterGT260]

wow

I hate this response... because I can't tell if you just had a lightbulb moment or are stubbornly indignant at the implications of this resident's post.

This isn't the firs time I have heard things like this. I have also heard DO students complain that a scrub nurse was their preceptor for their surgery rotations. This is utterly unheard of in the MD world, and would be completely unacceptable. It takes a good bit of loving gentle coercion (I prefer waling on the occiput mercilessly with a textbook) to convince pre-meds that the pre-clinic years don't matter at all. The clinic years only matter for your letters and residency placement, but you really aren't learning to be a doctor here, and it is residency that all of the real training happens. There is an exponential curve in terms of the importance of each stage of your training with regards to how you will turn out as a physician.

 

[beBrave]

I hate this response... because I can't tell if you just had a lightbulb moment or are stubbornly indignant at the implications of this resident's post.

This isn't the firs time I have heard things like this. I have also heard DO students complain that a scrub nurse was their preceptor for their surgery rotations. This is utterly unheard of in the MD world, and would be completely unacceptable. It takes a good bit of loving gentle coercion (I prefer waling on the occiput mercilessly with a textbook) to convince pre-meds that the pre-clinic years don't matter at all. The clinic years only matter for your letters and residency placement, but you really aren't learning to be a doctor here, and it is residency that all of the real training happens. There is an exponential curve in terms of the importance of each stage of your training with regards to how you will turn out as a physician.

From what I gather here, all the piece of the puzzle matter however actually passing your classes and exams are the core component for med students. Clinical rotations are important but simply for the purpose of giving students exposure in a controlled learning environment where they are less responsible for making decisions and more responsible for making observations.

Based on SDN feedback, residency is where you actually learn how to be a Doctor. Expecting Medical students to act like an Intern is probably unbalanced. I think every school regardless of the degree they give is different and it is the students responsibility to make these observations. Clearly if students don't do well over the first two years in med school, then rotations aren't even an option.

 

[SpecterGT260]

From what I gather here, all the piece of the puzzle matter however actually passing your classes and exams are the core component for med students. Clinical rotations are important but simply for the purpose of giving students exposure in a controlled learning environment where they are less responsible for making decisions and more responsible for making observations.

Based on SDN feedback, residency is where you actually learn how to be a Doctor. Expecting Medical students to act like an Intern is probably unbalanced. I think every school regardless of the degree they give is different and it is the students responsibility to make these observations. Clearly if students don't do well over the first two years in med school, then rotations aren't even an option.

Eh... residents have weighed in saying that programs want students who were properly trained to be residents. If you didn't get a proper experience in medical school it means the program needs to spend time bringing you up to speed. They don't want to do this.

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[beBrave]

Eh... residents have weighed in saying that programs want students who were properly trained to be residents. If you didn't get a proper experience in medical school it means the program needs to spend time bringing you up to speed. They don't want to do this.

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Interestingly the quality of education at DO universities isn't being questioned by the Resident's, instead it is the clinical exposure. GuyWhoDoesStuff went as far as pointing out that this wasn't from an academic perspective. I don't every MD who enters a residency is completely up to speed. Also a lot can happen between the time a 3rd year begins his/her rotations and when they actually finish the program.

Even if the Resident's observations were to apply broadly to every single case involving DO students (that's an incredibly large if), DO rotations and MD rotation's are not 100% identical so DO students can still catch up on basic skills at a later time during their rotation. Teaching styles at DO and MD schools may differ a bit; this does not mean that the quality of the education being received should be questioned. For me, step 1 is to actually get into Med school, step 2 is to Do well in classes and on exams; step 3 is to learn from rotations. Like Pre-Req's, You need to complete steps 1-2 before you advance to step 3 which serves more as a bridge to step 4 (residency) than a roadblock (which exist in steps 1-2).

 

[SpecterGT260]

Interestingly the quality of education at DO universities isn't being questioned by the Resident's, instead it is the clinical exposure. GuyWhoDoesStuff went as far as pointing out that this wasn't from an academic perspective. I don't every MD who enters a residency is completely up to speed. Also a lot can happen between the time a 3rd year begins his/her rotations and when they actually finish the program.

Even if the Resident's observations were to apply broadly to every single case involving DO students (that's an incredibly large if), DO rotations and MD rotation's are not 100% identical so DO students can still catch up on basic skills at a later time during their rotation. Teaching styles at DO and MD schools may differ a bit; this does not mean that the quality of the education being received should be questioned. For me, step 1 is to actually get into Med school, step 2 is to Do well in classes and on exams; step 3 is to learn from rotations. Like Pre-Req's, You need to complete steps 1-2 before you advance to step 3 which serves more as a bridge to step 4 (residency) than a roadblock (which exist in steps 1-2).

I was referring only to the clinical exposure which constitutes half of your medical education. I apologize if I was unclear. You're right in saying not all MD students will be at the proper level at graduation. The idea I was conveying is that there is some fear by some programs with DO students because they don't know if the student has really carried patients before or if they had am experience closer to shadowing. Nobody wants an intern who doesn't know how to juggle patients. I'm not saying this is representative of DOs but rather is something that has been cited specifically as impacting specific programs decisions in ranking. It should just be kept in mind.

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[DrWBD]

As a NYCOM graduate, how has your experience been in the "real world" in NYC as an Osteopathic physician?

I don't practice in NYC.

Your question is a little vague. I see patients, prescribe meds, etc in a private practice.
If I wanted to work in a more academic setting or a more prestigious practice, I'd likely have a hard time in part because of my osteopathic training (although I did residency in an ACGME program).

In this day and age, when most people find their doctor in an insurance company-issued directory rather than word of mouth, patients will either see me because they are unaware of what a DO is or avoid me because I'm a DO (I know this because my MD colleagues who work in the same office have mentioned this a few times when asking their patients how they came to their practice).

 

[SpecterGT260]

I don't practice in NYC.

Your question is a little vague. I see patients, prescribe meds, etc in a private practice.
If I wanted to work in a more academic setting or a more prestigious practice, I'd likely have a hard time in part because of my osteopathic training (although I did residency in an ACGME program).

In this day and age, when most people find their doctor in an insurance company-issued directory rather than word of mouth, patients will either see me because they are unaware of what a DO is or avoid me because I'm a DO (I know this because my MD colleagues who work in the same office have mentioned this a few times when asking their patients how they came to their practice).

What is your specialty?

 

[beBrave]

I don't practice in NYC.

Your question is a little vague. I see patients, prescribe meds, etc in a private practice.
If I wanted to work in a more academic setting or a more prestigious practice, I'd likely have a hard time in part because of my osteopathic training (although I did residency in an ACGME program).

In this day and age, when most people find their doctor in an insurance company-issued directory rather than word of mouth, patients will either see me because they are unaware of what a DO is or avoid me because I'm a DO (I know this because my MD colleagues who work in the same office have mentioned this a few times when asking their patients how they came to their practice).

This is the most clear cut and honest feedback I've ever seen. Evidently Bias does exist. The question is, do you have patients that come to you because you are a DO and if you had to do it again would you have gone the MD route? Will going DO damage my earning potential? Do you believe that it has affected yours? NYCOM is a rather prestigious DO school which does concern me. All in all I'm more interested in DO and it will take a lot to Jade me however if it will make my future as a Physician more difficult (especially when I already know that I want to enter a specialty outside IM and GM) then that is an alarm for concern. You are also located in Long Island which has a good population (I'm from the city). I'm sacrificing way too much to not choose carefully.

My future goals are as much Academic as they are from the perspective of seeing patients. Having an actual DO state this really makes me reconsider which basket I should place more egg's into. One way or another I can't divide them equally; I will either have to place more emphasis on the DO route when putting my applications together or the MD route and both have different pre-req requirements/recommendations that vary by school.

 

[QuackaDO]

Key thing to take home here from the bolded... n=1. I honestly feel bad for the DO students that come to your hospital too cuz that kind of "learning" does sound like it sucks, BUT, to consider it the "norm" is just careless and uninformed. Personally, on my medicine rotations I arrived at 430-500 each morning to preround on my portion of the patient list for the attending. It did not equal 1, except on the first day or two and maxed out about 5 or 6 (just cuz there were other students with me as well so we had to split the patients up). My experience was as much and more of what you described your experience as a student being, but there is a catch. That was one area. If you were to ask me about my surgery or psych experience...
Point is that you CANNOT generalize about the rotations that DOs are put in. Some suck, some are as good or better than comparable MD rotations. Each has to be judged on a case by case basis of "OK, what does this guy really know" because unless you know exactly what my rotations were like then you likely are going to be surprised. In your case though, yes... it does sound like whatever DO school is sending their students into that really needs to reevaluate their clinical placements. All DO schools probably do, in one field or another. The difference between MD and DO clinicals stems mostly from the fact that "most" MD clinicals are set up at established sites with good learning/teaching interactions. Again, not "always", but the majority. DO clinicals are set up where they can find places to put their students and sometimes those spots are phenomenal and sometimes they are just shadows and a waste of time. In time, I think that will average out, but for now the reality is that the sum of DO clinicals are not as good as the sum of MD clinicals, BUT, one example should not be used as the whole because there are SOME damn good clinical rotations out there for DOs... if you get them.

Ok perhaps I was a bit too brief in my post above. But you don't have to travel very far in this forum to see that there are real differences in the quality of clinical year experience/education between MD and DO schools, and that's where the real problem is.

Again this is only one school specifically, but the DO school that sends students to my hospital to do their "core clerkships" is doing its students a HUGE disservice. Their experience is nothing at all like my clerkships, and I went to a pretty average, middle of the road MD school.

Their core Medicine clerkship consists of 4-8 weeks of basically shadowing an intern/attending pair on rounds (and they do not pre-round ever, never arrive earlier than 7AM, maybe write one note if they're more advanced/competent students, etc) . . . and these rounds are not exactly academic rounds. There is almost no learning for them, at least that would take place at a third year student's pace/level. A usual exchange between intern and attending might be as follows:

Intern: "So I put Mr. Smith (a 76 year old demented patient) on Ativan PRN for when he gets agitated."
Attending: "I would switch that to haldol actually, but check his EKG first."

Two extremely important learning points were covered right there (avoiding benzos in the elderly and haldol's [and other antipsychotics'] danger of prolonging the QT). Most of that is already understood by the intern and the attending, and the student is left there to wonder what exactly was going on there (even if he indeed understands those basic concepts, how can he be sure there isn't more he's missing?)

I realize that's a very specific example, but it's how things are run at my hospital, a "core Medicine clerkship" for DO students (it's a small community hospital).

Even worse, one of the most consistent traits I see among the DO students who rotate through my hospital is a complete inability to actually BE A MEDICAL STUDENT. An average non-med student who has read the first few pages of First AID for the Wards could likely perform better than these students, at least for the first week or two. Having never been a part of a teaching hospital, there is just no understanding of how the med student - resident - attending world of interactions occurs. Whereas in most MD schools that have teaching hospitals (so, basically all) it's just a fact that students on inpatient services come in early (sometimes earlier than the intern) to round on their patients (plural, mind you) and write notes and present the patients and their proposed treatment plan to the attending on rounds, this natural daily occurrence just isn't present in smaller non-academic hospitals. They are two very different worlds.


I honestly feel bad for some of the DO students who come to my hospital, because they're paying more for med school than I did and they are getting shafted by their school, big time.

 

[playaodamonth]

Based on what you said your desires are, your questions to yourself should be simple.
1) WHY do I want to become a DO? (As in what, to you, makes becoming a DO more attractive than becoming an MD)
2) Am I truly competitive enough to get into an MD school where this is really a CHOICE of whether to go to MD or DO or am I borderline (or maybe not likely to get into) for MD and DO seems more attractive because I have a better chance?
If the answer to #2 is "yes" and you don't have a REAL strong reason for thinking DO is more attractive than MD then your choice is VERY simple... choose MD (and this is coming from a DO student). Anyone who truly has the choice between DO or MD should choose MD... unless it means going offshore or you are one of the few who are crazy about OMM and the "Osteopathic way".

I had the choice between the 2. I opted for DO because its closer to home, they gave me a scholarship, and I'm semi-interested in having OMM to help treat CLBP and other kinds of pain if all else fails. Plus I want to go into IM, which isn't a big issue for DOs. If I was going for Neuro-Surgery, Cardiothoracic Surgery, or any of those super-specialties or academic medical research, then I would've definitely gone with the MD school.

 

[Osteotastic]

In this day and age, when most people find their doctor in an insurance company-issued directory rather than word of mouth, patients will either see me because they are unaware of what a DO is or avoid me because I'm a DO (I know this because my MD colleagues who work in the same office have mentioned this a few times when asking their patients how they came to their practice).

An example of why a degree designation that gives a more accurate representation of what we practice would benefit our profession.



.

 

[playaodamonth]

An example of why a degree designation that gives a more accurate representation of what we practice would benefit our profession.



.

amen brother 👍

 

[beBrave]

Based on what you said your desires are, your questions to yourself should be simple.
1) WHY do I want to become a DO? (As in what, to you, makes becoming a DO more attractive than becoming an MD)
2) Am I truly competitive enough to get into an MD school where this is really a CHOICE of whether to go to MD or DO or am I borderline (or maybe not likely to get into) for MD and DO seems more attractive because I have a better chance?
If the answer to #2 is "yes" and you don't have a REAL strong reason for thinking DO is more attractive than MD then your choice is VERY simple... choose MD (and this is coming from a DO student). Anyone who truly has the choice between DO or MD should choose MD... unless it means going offshore or you are one of the few who are crazy about OMM and the "Osteopathic way".

Truth be told, I just don't want to become a Doctor that walks into a room and see's a chart and not a person. I'm sacrificing a lot and not for money. Money isn't my motivation. DO schools utilize a holistic approach (I like and believe in the whole person philosophy) however I know MD's should also consider things from a whole person perspective as well however I don't know if that always happens. Second my greatest motivational factor for becoming a Physician is knowing that I am a normal person and with my normal (dedicated talents) I can make it. I don't want to forget to put people first and I want to have good bed side manners and come across as human.

My pursuit for Medicine is to do what will makes me happy, not to line my bank account or satisfy a need for status. My grades were borderline but have steadily improved thanks to my Post Bach work. I have all my pre-req's left to complete and I have yet to get less than an A in any post bach work. Originally I considered DO a just in case option but then the more I learned, the more I fell in love with the philosophy. I've already been thoroughly disciplined by SDN on offshore school options and I would consider an SMP before running oversea's if things didn't pan out.

What does worry me is I already have significant interest in Hematology, Oncology, Neurology, and Psychiatry; I wouldn't want DO to hinder my ability to get my residency placement of choice or preference. I would want to remain in my current state or states close by for residency. I know MD makes you slightly more competitive for residencies. I have a year to get it figured out but a year will go by quickly and who I shadow and where I apply are things I am already working on vigorously. Creating a well balanced application through solid MCAT scores, a high Science GPA; Excellent PB work, a good cumulative GPA and excellent extracurricular activities are my focus to be competitive. There are many competitive applicants in offshore medical schools right now because they focused on only developing fewer area's of their application than they should have otherwise. I feel like DO will give me the medical knowledge, training and background I need while full fulling my my preferred learning style which is a whole person approach and also reminding me that empathy and interpersonal skills are very important in medicine.

 

[username456789]

DO schools utilize a holistic approach

Holy **** I had to stop reading immediately after this.

No wonder the public has no idea what DOs are. Even prospective DO students have no idea what DOs are.

 

[235009]

Truth be told, I just don't want to become a Doctor that walks into a room and see's a chart and not a person. I'm sacrificing a lot and not for money. Money isn't my motivation. DO schools utilize a holistic approach (I like and believe in the whole person philosophy) however I know MD's should also consider things from a whole person perspective as well however I don't know if that always happens. Second my greatest motivational factor for becoming a Physician is knowing that I am a normal person and with my normal (dedicated talents) I can make it. I don't want to forget to put people first and I want to have good bed side manners and come across as human.

I feel like DO will give me the medical knowledge, training and background I need while full fulling my my preferred learning style which is a whole person approach and also reminding me that empathy and interpersonal skills are very important in medicine.

to put it very simply.... the whole "holistic approach" thing is 100% marketing and 0% reality. No one can give you an example of how a DO is more "holistic" because the term is completely fabricated. The DO marketing philosophy relies heavily on the fact that premeds have no clue how medicine is practiced.

If you have the choice, go MD. You will have more doors open and more options when it comes time to apply for residency. That will translate into being able to stay in the region you want and having more opportunities when it comes time to apply for fellowship (given your interest in heme/onc).

 

[beBrave]

Holy **** I had to stop reading immediately after this.

No wonder the public has no idea what DOs are. Even prospective DO students have no idea what DOs are.

Hello Doctor, thank you for letting me know that my understanding of what a DO is in comparison to an MD needs to be re-evaluated. Please let me know where I went wrong and explain the similarities and differences so that prospective DO students are able to have all of the facts right when making the important decision of choosing a Medical program that will provide them with an medical program that is best designed for their interest, capabilities and needs.

to put it very simply.... the whole "holistic approach" thing is 100% marketing and 0% reality. No one can give you an example of how a DO is more "holistic" because the term is completely fabricated. The DO marketing philosophy relies heavily on the fact that premeds have no clue how medicine is practiced.

If you have the choice, go MD. You will have more doors open and more options when it comes time to apply for residency. That will translate into being able to stay in the region you want and having more opportunities when it comes time to apply for fellowship (given your interest in heme/onc).

Having Family Medicine as my only option would nearly defeat much of my effort so I will certainly consider MD more broadly if this is the case.

 

[235009]

Hello Doctor, thank you for letting me know that my understanding of what a DO is in comparison to an MD needs to be re-evaluated. Please let me know where I went wrong and explain the similarities and differences so that prospective DO students are able to have all of the facts right when making the important decision of choosing a Medical program that will provide them with an medical program that is best designed for their interest, capabilities and needs.



Having Family Medicine as my only option would nearly defeat much of my effort so I will certainly consider MD more broadly if this is the case.

that's not what i'm saying. no specialty is completely shut off to DOs (though the most competitive ones are much more difficult to break into). my point is that even with the "noncompetitive" specialties (like IM, which you would need to match into to do a heme/onc fellowship) the more desirable programs (whether due to reputation or location) are very competitive and very difficult (sometimes impossible) for DOs to match at.

basically there is no advantage to going DO over US MD. a small minority might do so due to location considerations (unable to move away from a particular area due to family or other obligations) but in all cases where that is not a consideration you should pick US MD over DO every time.

 

[username456789]

Hello Doctor, thank you for letting me know that my understanding of what a DO is in comparison to an MD needs to be re-evaluated.

You're welcome.

1. DO schools have nothing to do with being "holistic."
2. People who mention that word or anything similar when describing DO school to you are no better than snake oil salesmen.
3. The only "interests, capabilities and needs" that a DO school fits better than an MD school is "willing to accept students with lesser credentials", and, on the verrrrrrrrrrrry rare occasion it's germane, "happens to be located essentially in my backyard" or "omg I just love OMM!"

As Specter said, except in some exceedingly rare cases, if one truly has the choice between MD and DO (and by that I mean they have been accepted to both), choosing MD is to your advantage.

And just because it can't possibly be said enough, please do not make the mistake of thinking that DO schools are somehow more "holistic" or that DOs "treat the patient" in some different way (other than inasmuch as OMM treats a patient). Saying these things to people is worse than telling them "somebody's got a case of the Mondays."

I believe you'd get your ass kicked sayin' something like that, man.

 

[beBrave]

I believe you'd get your ass kicked sayin' something like that, man.

Thank you for the warning. Removing the holistic component, there is no alternative reason I would go to a DO school other than if its the only place I could get in vs an offshore med school (for which I know better). If DO is my only option, I will have no shame attending but I will pay careful attention to the curriculum and training hospitals they are linked to.

I will say though, you have taken away my blissful ignorance of DO schools offering something that MD's don't. It was certainly a nice lie that helped me swallow any concerns when comparing the two degree's. Back to drawing board...sigh.

 

[axiomofchoice]

As an MD student, I find the "holistic" approach argument from the DO world rather offensive. Telling me I don't see my patients as human beings is an attack on my own character. Don't do it....

 

[username456789]

As an MD student, I find the "holistic" approach argument from the DO world rather offensive. Telling me I don't see my patients as human beings is an attack on my own character. Don't do it....

It's the same thing nurses pull rather often too. Sometimes they swap "holistic" out for another classic buzzphrase: "Patient advocate."

 

[beBrave]

It's the same thing nurses pull rather often too. Sometimes they swap "holistic" out for another classic buzzphrase: "Patient advocate."

I initially thought you were mocking me and being biased against DO's (for which I do apologize) however when you strip away buzz words, you are only left with the facts. The attending DO further confirmed that he has experienced some disadvantages going DO. My fear was that I wouldn't see people as people anymore from and MD perspective (I know that sounds biased) but the basis for going DO has always been 'holistic'; you kind of fall in love with the idea of being this great Doctor who connects with all his patients and everyone loves because he see's and treats people like people. Ironically I have met many great MD's in my life who are excellent Doctors and will go the extra mile to help you. Some MD programs also use the holistic phrase as well, so strip away OMT and you really have nothing but a buzz-phrase separating MD and DO programs.

I can certainly see how it can be taken as offensive suggesting that an MD doesn't see patients as people. That is rather dangerous to suggest.

 

[username456789]

I initially thought you were mocking me and being biased against DO's (for which I do apologize) however when you strip away buzz words, you are only left with the facts. The attending DO further confirmed that he has experienced some disadvantages going DO. My fear was that I wouldn't see people as people anymore from and MD perspective (I know that sounds biased) but the basis for going DO has always been 'holistic'; you kind of fall in love with the idea of being this great Doctor who connects with all his patients and everyone loves because he see's and treats people like people. Ironically I have met many great MD's in my life who are excellent Doctors and will go the extra mile to help you. Some MD programs also use the holistic phrase as well, so strip away OMT and you really have nothing but a buzz-phrase separating MD and DO programs.

I can certainly see how it can be taken as offensive suggesting that an MD doesn't see patients as people. That is rather dangerous to suggest.

I'll admit at times I can come off as flippant. But I do agree with the other poster who said that the insinuation that DOs are more compassionate/holistic/whatever can be offensive to MDs (and that's not to say that MDs might not offend DOs in other ways). The "holistic" argument is very much an empty, fluffy marketing ploy.

 

[playaodamonth]

Seems to be a lot of negativity in this thread... especially ones fueled by personal experience. But keep in mind...this is just personal experience, very subjective, differs from person to person. I completely agree, the "holistic" view is not copyrighted by DOs. I've met MDs who are just as holistic, patient-centered, and caring as DOs. The AOA claiming this approach to patient-care is unique to DOs is not right and absolutely not true.

However, this is from my personal experience. No, I am not a resident or an attending, but I have interacted and shadowed many DOs and MDs throughout the last 6 years. Pretty much every DO I shadowed (6 of them) have all been the best doctors I've ever had the pleasure to shadow and work with. One of them pretty much became my role model. Of the MDs I have shadowed and interacted with (8 of them), 3 of them were just as comparable to those DOs (especially Dr. Yohay at Weill-Cornell NY Pres, amazing MD). The remainder, however, were very brief with their patients, chose to limit physical contact as much as possible, and were all about the scripts. I am not generalizing this behavior to all MDs, it is entirely up to the individual to choose how they will treat their patients. Maybe I experienced this with only the MDs because of the mere fact that there are more of them compared to the number of DOs, and so of course you'll have more of a spectrum of good to bad doctors. Or maybe it's because DO programs require students to take OMT, thus increasing the likelihood of their graduates to be more interactive and hands-on with their patients, something I believe is very important in patient care, actual physical contact via diagnosing, treatment, or simply just a hand on the shoulder. But once again, this is my subjective experience.

Also, I live in North NJ. 2 of the DOs I shadowed works in NY. Neither of them said they faced any discrimination or public opposition, and I was sure to ask since I was interested in the DO route. They were asked by patients, however, what their degree was since they never heard of it. Also, neither of them work at the prestigious Weill-Cornell or any of the top NY programs, which are very very very very very very very hard for a DO to get into haha. So there is obviously a bias in a few upscale hospitals. Not a big deal to me though, I wouldn't mind a residency at UC-Irvine or UI-Chicago. But once again, that's just my subjective personal preference and experience

 

[docnotsopc]

.


Haha, no.

THIS. x 1000

Ok perhaps I was a bit too brief in my post above. But you don't have to travel very far in this forum to see that there are real differences in the quality of clinical year experience/education between MD and DO schools, and that's where the real problem is.

Again this is only one school specifically, but the DO school that sends students to my hospital to do their "core clerkships" is doing its students a HUGE disservice. Their experience is nothing at all like my clerkships, and I went to a pretty average, middle of the road MD school.

Their core Medicine clerkship consists of 4-8 weeks of basically shadowing an intern/attending pair on rounds (and they do not pre-round ever, never arrive earlier than 7AM, maybe write one note if they're more advanced/competent students, etc) . . . and these rounds are not exactly academic rounds. There is almost no learning for them, at least that would take place at a third year student's pace/level. A usual exchange between intern and attending might be as follows:

Intern: "So I put Mr. Smith (a 76 year old demented patient) on Ativan PRN for when he gets agitated."
Attending: "I would switch that to haldol actually, but check his EKG first."

Two extremely important learning points were covered right there (avoiding benzos in the elderly and haldol's [and other antipsychotics'] danger of prolonging the QT). Most of that is already understood by the intern and the attending, and the student is left there to wonder what exactly was going on there (even if he indeed understands those basic concepts, how can he be sure there isn't more he's missing?)

I realize that's a very specific example, but it's how things are run at my hospital, a "core Medicine clerkship" for DO students (it's a small community hospital).

Even worse, one of the most consistent traits I see among the DO students who rotate through my hospital is a complete inability to actually BE A MEDICAL STUDENT. An average non-med student who has read the first few pages of First AID for the Wards could likely perform better than these students, at least for the first week or two. Having never been a part of a teaching hospital, there is just no understanding of how the med student - resident - attending world of interactions occurs. Whereas in most MD schools that have teaching hospitals (so, basically all) it's just a fact that students on inpatient services come in early (sometimes earlier than the intern) to round on their patients (plural, mind you) and write notes and present the patients and their proposed treatment plan to the attending on rounds, this natural daily occurrence just isn't present in smaller non-academic hospitals. They are two very different worlds.


I honestly feel bad for some of the DO students who come to my hospital, because they're paying more for med school than I did and they are getting shafted by their school, big time.

Waiting for a pre-med DO to disagree with this..... any minute now.....

But in all seriousness that sucks, I already know some of my rotation sites next year will be garbage and unfortunately some of them are mandatory

 

[K31]

An example of why a degree designation that gives a more accurate representation of what we practice would benefit our profession.

By this, you mean letters that look more like "MD"?

 

[SurgeDO]

I know several people from my undergraduate MD school who have complained that their surgery rotation was mostly taught by a nurse practitioner and a physician assistant. They complained, and the school did something about it supposedly. Granted it's a newer school (< 20 years old), but you are foolish to think stuff like this is limited to DO schools.

There seems to be a consensus on SDN that all MD schools are equivalent to Harvard and all DO schools are ****. Keep in mind the most extreme examples are often the ones mostly talked about.

 

[SpecterGT260]

I'll admit at times I can come off as flippant. But I do agree with the other poster who said that the insinuation that DOs are more compassionate/holistic/whatever can be offensive to MDs (and that's not to say that MDs might not offend DOs in other ways). The "holistic" argument is very much an empty, fluffy marketing ploy.

Yep

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[Osteotastic]

By this, you mean letters that look more like "MD"?

Interesting question coming from an allopathic student. Can you help me understand your motivation for posing this question?

 

[K31]

Interesting question coming from an allopathic student. Can you help me understand your motivation for posing this question?

I just think the whole MD-vs-DO thing is overblown. 99% of us (MD students) don't care either way.

I see you everywhere promoting changing the degree--either to MD, DO or MDO. I don't see the purpose of half-assing it. Either embrace your degree (which the vast majority of your colleagues accept as the equal of their own) or promote a full merger and let the current osteopathic schools be accredited by the LCME and grant MD degrees (I don't think you're opposed to this, but we both know the AOA is strongly).

I think any intermediate step that kinda sounds like MD is counterproductive and likely to be opposed by both sides--the MD side because it invites confusion without having to do the work (ie accreditation) to show equivalence of education, and from the DO side because it decreases the distinctiveness of the degree or whatever it is because the AOA likes to complain about.

Other than that, I've really enjoyed your recent posts--you bring a much-needed dose of realism to the MD-vs-DO threads.

 

[SpecterGT260]

I just think the whole MD-vs-DO thing is overblown. 99% of us (MD students) don't care either way.

I see you everywhere promoting changing the degree--either to MD, DO or MDO. I don't see the purpose of half-assing it. Either embrace your degree (which the vast majority of your colleagues accept as the equal of their own) or promote a full merger and let the current osteopathic schools be accredited by the LCME and grant MD degrees (I don't think you're opposed to this, but we both know the AOA is strongly).

I think any intermediate step that kinda sounds like MD is counterproductive and likely to be opposed by both sides--the MD side because it invites confusion without having to do the work (ie accreditation) to show equivalence of education, and from the DO side because it decreases the distinctiveness of the degree or whatever it is because the AOA likes to complain about.

Other than that, I've really enjoyed your recent posts--you bring a much-needed dose of realism to the MD-vs-DO threads.

It's interesting, last night I was downtown with several people in my class and DOs came up. There is some underlying animosity, and a great deal of misinformation and misunderstanding. Among my classmates I'm actually one of the biggest DO sympathizers 😱

Sympathizer may not be the best word.... but I'm struggling with vocab at the moment. I'm hoping you're following me regardless.

 

[DocVapor]

I still don't understand why anyone thinks that changing the degree to anything OTHER than MD will actually solve the perceived "problems."

For example, what a lay person would see:

MDO - People are still going to wonder what the "O" stands for. You are still stuck explaining the same things you always have.

MD,DO - "Oh, so you have two degrees?" Again, still explaining yourself.

For the people in the know, they still know there's a difference, and if they were discriminatory before, they still will be now.

Problem not fixed.

Keep the DO, be great doctors, and stop crying about it.

 

[sylvanthus]

I still don't understand why anyone thinks that changing the degree to anything OTHER than MD will actually solve the perceived "problems."

For example, what a lay person would see:

MDO - People are still going to wonder what the "O" stands for. You are still stuck explaining the same things you always have.

MD,DO - "Oh, so you have two degrees?" Again, still explaining yourself.

For the people in the know, they still know there's a difference, and if they were discriminatory before, they still will be now.

Problem not fixed.

Keep the DO, be great doctors, and stop crying about it.

👍

 

[SpecterGT260]

👍

👍

 

[SurgeDO]

guys, guys, guys...i think we are going about this all the wrong way.

we should petition the LCME to make all MD-granting schools give out DOs instead.

problem solved.

 

[K31]

Keep the DO, be great doctors, and stop crying about it.

Exactly

 

[Osteotastic]

I just think the whole MD-vs-DO thing is overblown. 99% of us (MD students) don't care either way.

I see you everywhere promoting changing the degree--either to MD, DO or MDO. I don't see the purpose of half-assing it. Either embrace your degree (which the vast majority of your colleagues accept as the equal of their own) or promote a full merger and let the current osteopathic schools be accredited by the LCME and grant MD degrees (I don't think you're opposed to this, but we both know the AOA is strongly).

I think any intermediate step that kinda sounds like MD is counterproductive and likely to be opposed by both sides--the MD side because it invites confusion without having to do the work (ie accreditation) to show equivalence of education, and from the DO side because it decreases the distinctiveness of the degree or whatever it is because the AOA likes to complain about.

Other than that, I've really enjoyed your recent posts--you bring a much-needed dose of realism to the MD-vs-DO threads.

As far as keeping it real. Yes, I do try and do that and I'm glad you appreciate this.

Now in response to your post. You make several assumptions that you present as fact.

One assumption you make is that a more accurate degree representation that includes an M for being doctors of Medicine and not only Osteopathy is "half-assing it" . I disagree here as again we practice medicine. Your colleagues in the ED who went to Osteopathic med schools will most likely not be manipulating patients.

Another assumption you make is that the vast majority of my colleagues accept this. Here I will also have to disagree. You are posting on a site to a majority of pre-meds and med students. I argue that in my observation there is a most certain increase in proportion of support for a more accurate degree representation or switch from DO to MD from stage of med student to resident to physician in practice. As evidenced by 86% of the DOs changing degree to MD when they were given the opportunity to do so in California.

Also you have a contradiction in your post where you state that 99% of MD students don't care either way. You later state that a change in degree designation would be opposed by the MD side because DOs would not have to do the work (ie accreditation) to show equivalence of education. So which is it?

So should the DO designation appear more similar to the MD designation?

Well should it appear more similar to the Chiropractor designation?, the Dentistry designation?

Well which one is more similar (if not indistinguishable in actual practice? )

Or should your degree designation just be DA?

 

[Osteotastic]

guys, guys, guys...i think we are going about this all the wrong way.

we should petition the LCME to make all MD-granting schools give out DOs instead.

problem solved.

: ) Excellent idea

All they would have to do is add a few OMM classes

 

[K31]

What would MDO even stand for, anyhow? Medical Doctor of Osteopathy? I thought DOs were trying to get away from the "osteopathy" label.

I'm well aware that there is virtually no difference in how MDs and DOs practice. My preceptor for my month of FM was a DO in a practice that is exclusively DOs, and I didn't see anything done differently than a MD would have.

And relabeling MDs as "Doctor of Allopathic Medicine" is unacceptable unless the chiropractors get to pick a new name for the DO degree.

 

[SpecterGT260]

Or should your degree designation just be DA?

This is absurd... DO spun itself off of the MD degree by its own choosing. To suggest that the MD degree change in some arbitrary sense of "fairness" to reflect the syntax of the DO degree is just.....

I understand you weren't really suggesting it be changed, but still... this line of reasoning is unreasonable.

 

[Osteotastic]

So .... hold the phone for just a moment here...

K31 and Specter .... you guys are both allopathic students.... and yet you are both strongly defending that the DO degree designation should not change?

I mean what.... not much to do this weekend? No studies? What's up guys?

What's the deal fellas? Am I missing something here ? How does this concern you guys?

 

[SpecterGT260]

So .... hold the phone for just a moment here...

K31 and Specter .... you guys are both allopathic students.... and yet you are both strongly defending that the DO degree designation should not change?

I mean what.... not much to do this weekend? No studies? What's up guys?

What's the deal fellas? Am I missing something here ? How does this concern you guys?

So.... you mean to imply that DO students would be expected to have nothing going on during the weekend? Why does the school one attends impact the validity of the posts here? Hint: It doesn't. That is a fallacy used by some who have nothing else intelligent to say on the matter.

My point has been that no reason exists to do this other than to satisfy the "I wish I had an MD" complex. As others have pointed out, nothing about this change will impact how the patient sees you in a positive or negative fashion.

 

[playaodamonth]

So.... you mean to imply that DO students would be expected to have nothing going on during the weekend? Why does the school one attends impact the validity of the posts here? Hint: It doesn't. That is a fallacy used by some who have nothing else intelligent to say on the matter.

My point has been that no reason exists to do this other than to satisfy the "I wish I had an MD" complex. As others have pointed out, nothing about this change will impact how the patient sees you in a positive or negative fashion.

I'm perfectly happy with a DO, that's why I chose it over MD. For personal reasons of course, not because I think it's superior in any way.

I guess the main reason many DOs want to change it is not for the "I wish I were an MD", but for the simple fact of limited public knowledge of the DO degree. Avoid the hassle of constantly explaining it to family and friends, and future patients. Keeping one unified medical degree in the US seems more clean, clear-cut, uniform, concise, better. Since MDs were here first and are the majority, why not right?

 

[Osteotastic]

So.... you mean to imply that DO students would be expected to have nothing going on during the weekend? Why does the school one attends impact the validity of the posts here? Hint: It doesn't. That is a fallacy used by some who have nothing else intelligent to say on the matter.

My point has been that no reason exists to do this other than to satisfy the "I wish I had an MD" complex. As others have pointed out, nothing about this change will impact how the patient sees you in a positive or negative fashion.

Well speaking of an intelligent post... wow, my head is spinning from your fresh perspective. : )

How bothered you guys seem to be by the prospect of DOs having a similar degree designation. To the extent of arguing on forums that don't apply to you.

 

[SpecterGT260]

I'm perfectly happy with a DO, that's why I chose it over MD. For personal reasons of course, not because I think it's superior in any way.

I guess the main reason many DOs want to change it is not for the "I wish I were an MD", but for the simple fact of limited public knowledge of the DO degree. Avoid the hassle of constantly explaining it to family and friends, and future patients. Keeping one unified medical degree in the US seems more clean, clear-cut, uniform, concise, better. Since MDs were here first and are the majority, why not right?

Then they shouldn't have split off in the first place IMO this logic is backwards. The only thing that will result in no need to explain to patients is if the degree is MD. MDO still requires explanation to the same degree as DO does. I just don't see an argument here that doesnt seem like a sham covering for some other motive.

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[SLC]

So .... hold the phone for just a moment here...

K31 and Specter .... you guys are both allopathic students.... and yet you are both strongly defending that the DO degree designation should not change?

I mean what.... not much to do this weekend? No studies? What's up guys?

What's the deal fellas? Am I missing something here ? How does this concern you guys?

My advice to you is to not engage Specter. Just click on his post history and you'll see that essentially his entire presence on SDN is devoted to arguing in this exact type of thread. I'll just leave it at that and I encourage you to do the same if you want any chance of this thread remaining productive for long. Take his post, consider what you will, but please don't engage him, for the sake of the thread.

And as for me, and my opinion on the topic. I say leave things the way they are, both degrees are already on a level playing field in terms of practice rights, pay, and to a lesser extent ability to specialize of desired, what more is needed?

My experience, while limited obviously to my own encounters with patients, has been that patients who don't know the difference between MD and DO, don't care about any difference in letters. Hell, they usually think the Medical Assistant is a doctor.

99% of the time if they even notice the difference in initials and ask what DO stands for, a quick explanation that there are two degrees that lead to the title of Physician is all anyone needs. Anything more than that and their eyes gloss over and you can tell they're not listening anymore anyway.

Additionally, the vast majority of patients who do know the differences will usually say they prefer DO's or even go as far as to say they seek DO's out or will only see DO's when given the choice.

But on the whole, the overwhelming majority see stethoscope and assume doctor. They don't care about crap like this so why fuss over it?

 

[SpecterGT260]

Well speaking of an intelligent post... wow, my head is spinning from your fresh perspective. : )

How bothered you guys seem to be by the prospect of DOs having a similar degree designation. To the extent of arguing on forums that don't even apply to you.

That's just it.... its an internet forum. The POINT is to discuss. You incorrectly imply that we must have some skin in the game in order to take part in the discussion.

What year of residency are you in, BTW?

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[Osteotastic]

I'm perfectly happy with a DO, that's why I chose it over MD. For personal reasons of course, not because I think it's superior in any way.

I guess the main reason many DOs want to change it is not for the "I wish I were an MD", but for the simple fact of limited public knowledge of the DO degree. Avoid the hassle of constantly explaining it to family and friends, and future patients. Keeping one unified medical degree in the US seems more clean, clear-cut, uniform, concise, better. Since MDs were here first and are the majority, why not right?

Yes, this does get at the crux of the matter.

Public knowledge. So that they know that when they walk through your door you will be practicing Medicine. I agree, it is not about which degree is "better".

 

[SpecterGT260]

Yes, this does get at the crux of the matter.

Public knowledge. So that they know that when they walk through your door you will be practicing Medicine. I agree, it is not about which degree is "better".

So why not just go to an MD school if the need to avoid such explanations is so important to you?

How often is this lack of public knowledge an issue for you?

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