Interview Offers to ACGME Programs

[TwinsFan]

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I don't really think anyone has (or should have) an issue with this idea, I certainly don't. Its things like that that make local ACGME programs more willing to take students from my COM as opposed to COMs halfway across the country. Here's the thing though, we aren't talking about comparing people with the same stats and choosing the one from the school you know, we're talking about not even looking at an app based on the school someone goes to alone.

If PDs want to prefer certain schools over others that's their prerogative, but we're talking about a situation where PDs refuse to interview or rank any DOs solely because they're DOs. In that situation, it doesn't matter how much better the CV is of the DO (hypothetically), they still won't be interviewed. I'm against an official policy like that because it excludes people who may have achieved more in medical school for people who may have achieved less.

That said, I accept that this is the way things are, and its up to the PD to do this, just don't try to argue that it makes perfect sense.





Honestly, I don't think anyone is comparing DO schools to top 10 or 20 MD schools. As you said their is no comparison. In addition, I don't think anyone is particularly offended by top tier residencies not taking DOs, because they are just as picky when it comes to picking the pedigree they want from MD schools.

That said, there are MD schools with averages around 3.5/29 and 3.6/30 (lower tier and newer schools). Comparing the lower quartile of those schools to the averages at many (not just the top 3) DO schools will likely show a lot of overlap. Even the national average for MD matriculants of 3.69/31 isn't that far off from the upper quartile of DO school matriculants, especially those at the higher tier DO schools.

Generally speaking, average DO school matriculant stats (3.51/27) are essentially 1 SD below average US MD school matriculant stats (3.69/31).

The truth is if many DOs lived in states that had mediocre or slightly lower public MD schools, they'd be MDs. This fact makes it hard to justify say a mediocre or middle tier IM program's complete exclusion of DOs when they regularly accept lower tier MDs.

Now, we certainly aren't talking about all DOs, and there are also many that would have never made it into a US MD school, but you are the one that brought up lower quartile MD to average DO. Let's not exaggerate the difference to justify the outdated practices of a handful of PDs.

I somewhat agree with what you are saying but...
1- there are a pretty limited number of 3.5/29-3.6/30 MD schools, and many of them are extremely mission focused so it's not like most 3.5/27 students have any kind of shot there
2- some DOs would be MDs as there is some type of overlap in the applicants/matriculants, but "many" is vague enough to give room for every average matriculant to think they were just unlucky (many of those sub 30 mcat MDs had a stellar app otherwise and that's how they got the seat)
3- from scatterplots/histograms and SDs with mean from schools that I've seen there are pretty small pools at most DO schools with MD stats, there was always a congregation around 27-29 on the MCAT and 3.5-3.7 (the high end tends to be very tightly clustered around the mean) at the DO schools
3- yes there will be overlap between the bottom quartile of low tier MD schools and the average-2nd quartile of some DO schools, and more overlap between the top quartile of some DO and 3rd/4th quartile at some MD --> this is exactly why class rank probably doesn't mean much coming from a DO school, best case scenario you are competing against the bottom half of a low tier MD class and worst case scenario (top schools) you aren't even competing with the bottom quartile, it is more like the bottom few percent
4- with questionable clinical training at many sites it is also hard to put a lot of weight on those evals, undermining the credibility of DO schools

Lastly, I don't think it's right for less competitive academic ACGME residencies to simply exclude DOs regardless of their achievements. But with all the factors above and the plethora of solid US trained MDs to choose from it isn't hard to see how/why they do it. It would be nice to have more standardization across the two to open doors and let the superstars rise to the top regardless of degree.

 

[hallowmann]

I somewhat agree with what you are saying but...
1- there are a pretty limited number of 3.5/29-3.6/30 MD schools, and many of them are extremely mission focused so it's not like most 3.5/27 students have any kind of shot there
2- some DOs would be MDs as there is some type of overlap in the applicants/matriculants, but "many" is vague enough to give room for every average matriculant to think they were just unlucky (many of those sub 30 mcat MDs had a stellar app otherwise and that's how they got the seat)
3- from scatterplots/histograms and SDs with mean from schools that I've seen there are pretty small pools at most DO schools with MD stats, there was always a congregation around 27-29 on the MCAT and 3.5-3.7 (the high end tends to be very tightly clustered around the mean) at the DO schools
3- yes there will be overlap between the bottom quartile of low tier MD schools and the average-2nd quartile of some DO schools, and more overlap between the top quartile of some DO and 3rd/4th quartile at some MD --> this is exactly why class rank probably doesn't mean much coming from a DO school, best case scenario you are competing against the bottom half of a low tier MD class and worst case scenario (top schools) you aren't even competing with the bottom quartile, it is more like the bottom few percent
4- with questionable clinical training at many sites it is also hard to put a lot of weight on those evals, undermining the credibility of DO schools

Lastly, I don't think it's right for less competitive academic ACGME residencies to simply exclude DOs regardless of their achievements. But with all the factors above and the plethora of solid US trained MDs to choose from it isn't hard to see how/why they do it. It would be nice to have more standardization across the two to open doors and let the superstars rise to the top regardless of degree.

I certainly don't disagree with a lot of what you're saying, but for clarity:

Many is absolutely vague. We really don't have reliable stats in that range to be more specific. I would love it if we did.

I for one did very well on the MCAT after a relatively short time of studying. I also had a very solid if not great CV (besides GPA), but I didn't get off of MD waitlists most likely because of my very low GPA, which is fair, and I'm not suggesting that there is no difference between all MD students and DO students.

Seeing the composition of my own class (to the best of my ability), I agree that there tends to be a cluster around the average, but I certainly know of people with 3.4s and 30s or 3.8s and 29s, and those tend to be the people around the top of the class. That said, I also think that GPA depends heavily on where you're coming from, and while a range is a good indicator of success, I doubt you can really compare a 3.7 from one undergrad with a 3.6 from another. But that's probably a debate for the pre-med forums.

I'm not going to make the argument that clinicals are amazing at DO schools, they are essentially unknowns (and are variable in and of themselves). Some may very well be rigorous, but without actually going there and comparing them to other sites, its hard to say, so I'll refrain from making statements one way or another.

 

[SouthernSurgeon]

I'm not going to make the argument that clinicals are amazing at DO schools, they are essentially unknowns (and are variable in and of themselves). Some may very well be rigorous, but without actually going there and comparing them to other sites, its hard to say, so I'll refrain from making statements one way or another.

I think this is the biggest legitimate concern program directors have. The training is so variable it is essentially an unknown quantity, often even within the same school. In an era where graduate preparedness for intern year is receiving increased scrutiny, this is only going to become more important to PDs.

 

[laconfidential]

I think this is the biggest legitimate concern program directors have. The training is so variable it is essentially an unknown quantity, often even within the same school. In an era where graduate preparedness for intern year is receiving increased scrutiny, this is only going to become more important to PDs.

Very true. I was baffled when I heard from a friend at a different DO school that all of his IM rotations were outpatient. All three months were in a 9-5 type PCP clinic. How would I ever trust that person to be a competent intern on medicine wards? Crazy.

I think, perhaps, this is why some programs prefer to take DO students from select schools. At least they know what they're getting then.

 

[user3]

I think this is the biggest legitimate concern program directors have. The training is so variable it is essentially an unknown quantity, often even within the same school. In an era where graduate preparedness for intern year is receiving increased scrutiny, this is only going to become more important to PDs.

that is what I do not understand...poor quality control of DO school clinical rotations has been a serious complaint here for a long long time. It is a big reason why many look questionably upon our training. But for whatever reason, schools don't seem to want to improve this.

 

[SouthernSurgeon]

But for whatever reason, schools don't seem to want to improve this.

I don't think it's that schools don't want to improve it - it's that it is really hard to improve. When you don't have an attached medical school and are reliant on many multiple parties to farm out your clinical rotations, quality control becomes much more difficult.

 

[hallowmann]

I don't think it's that schools don't want to improve it - it's that it is really hard to improve. When you don't have an attached medical school and are reliant on many multiple parties to farm out your clinical rotations, quality control becomes much more difficult.

This really is a problem. There's barely any standardization in regards to rotations, and that's frustrating to me even as a student. I wish I could just be confident that any school affiliate I go to will be a good/valuable experience, but I honestly don't know that.

LECOM even has an attached osteopathic teaching hospital and another newer main site as well, but I've heard repeated problems about volume and the number of students. Each hospital also only takes like 16% of students, and they're the sites that takes the most.

Here we're trying to move towards every student going to a core regional teaching hospital where they do all their core rotations. 52 students go to one hospital, 52 to another, 26 to another, 26 to another, 26 to a health network, and then groups of 13 to all the other hospitals. Most are established teaching hospitals and what not, but that ends up being like 15-20 different sites for the whole class. There is no real way to standardize that experience for everyone. Some are at really great sites where MD students and other DO students rotate at regularly, but still how can that be standardized across so many different hospitals and cities.

On top of that, I really wonder if people want it to change. There's this idea perpetuated by some in our leadership that in order to train community hospital and rural docs, they need to learn at a small outpatient site. That's fine if someone wants to do electives in rural medicine and at a PCP office, but that shouldn't be where we exclusively learn IM during 3rd year.

Sorry...rant went on a little long...

 

[ChrisGriffen]

Guys. This horse has been dead for years.

 

[MLT2MT2DO]

This really is a problem. There's barely any standardization in regards to rotations, and that's frustrating to me even as a student. I wish I could just be confident that any school affiliate I go to will be a good/valuable experience, but I honestly don't know that.

LECOM even has an attached osteopathic teaching hospital and another newer main site as well, but I've heard repeated problems about volume and the number of students. Each hospital also only takes like 16% of students, and they're the sites that takes the most.

Here we're trying to move towards every student going to a core regional teaching hospital where they do all their core rotations. 52 students go to one hospital, 52 to another, 26 to another, 26 to another, 26 to a health network, and then groups of 13 to all the other hospitals. Most are established teaching hospitals and what not, but that ends up being like 15-20 different sites for the whole class. There is no real way to standardize that experience for everyone. Some are at really great sites where MD students and other DO students rotate at regularly, but still how can that be standardized across so many different hospitals and cities.

On top of that, I really wonder if people want it to change. There's this idea perpetuated by some in our leadership that in order to train community hospital and rural docs, they need to learn at a small outpatient site. That's fine if someone wants to do electives in rural medicine and at a PCP office, but that shouldn't be where we exclusively learn IM during 3rd year.

Sorry...rant went on a little long...

To be fair this is becoming more frequent with allopathic schools as well, especially the newer ones. Unfortunately it's the norm for DO schools instead of the exception.

 

[meliora27]

To be fair this is becoming more frequent with allopathic schools as well, especially the newer ones. Unfortunately it's the norm for DO schools instead of the exception.

Good point.

I wonder though what sort of "discrimination" an MD grad of say Quinnipiac or Hofstra-LIJ or Florida Atlantic or Florida International or any of the other new MD schools face if any. I saw that the average MCAT/GPA of the entering class at Quinnipiac was 29.5/3.67 which is comparable to the more competitive DO schools.

 

[hallowmann]

To be fair this is becoming more frequent with allopathic schools as well, especially the newer ones. Unfortunately it's the norm for DO schools instead of the exception.

It is starting to be more common, especially with newer MD schools, but if anything that worries me more.