Is there really a difference between MD and DO?

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Abby_Normal16

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I'm wondering if there is really a difference between MD and DO programs in modern times as far as being holistically focused. Anyone with personal experience or knowledge have any thoughts? I'm sure that this may depend on the specific school one attends. At the moment I'm interested in Attending UCSF, as they seem to embrace the best of both worlds approach. I'm skeptical that I would need to attend a DO program, just to have some training in treating root causes of disease and the whole person. I'm sure there are some MD programs that are not as "integrated" as others, but in general it seems that there are many MD programs which are more than willing to embrace natural approaches such as lifestyle change that actually has some scientific validity to it, such as Dr. Dean Ornish's work.

Not that I doubt OMM may work in some scenarios, but its not something I really care to have 200 hours of training in, and if this is really the only major difference as far as the education is concerned, I think I'd much rather attend a good MD program. Any thoughts will be much appreciated.
 
God damn it, another one of these threads.

The only real differences:

1. Their pre-clinical curriculum is the same, with the exception of OMM.
2. Some DO programs may have poor clerkships/clinical rotations. This is due to how stringent COCA is vs. LCME, but I'm not an expert on this matter.
3. They take different boards (COMLEX vs. USMLE). DO students can take the USMLE to participate in the NRMP match for ACGME residencies, however.
4. There is a bias against DO students matching into ACGME residencies; for the most part, it is very very difficult for a DO grad to match into a non-AOA competitive specialty.
5. At the end of the day, you'll be a doctor whether you went to a DO school or a MD school.

Edit:
6. There is a DO and MD merger happening. Things will be different in the future. I just don't know what will happen/how different it will be.

I think that about sums it up.
 
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medic86 said:
God damn it, another one of these threads.

The only real differences:

1. Their pre-clinical curriculum is the same, with the exception of OMM.
2. Some DO programs may have poor clerkships/clinical rotations. This is due to how stringent COCA is vs. LCME, but I'm not an expert on this matter.
3. They take different boards (COMPLEX vs. USMLE). DO students can take the USMLE to participate in the NRMP match for ACGME residencies, however.
4. There is a bias against DO students matching into ACGME residencies; for the most part, it is very very difficult for a DO grad to match into a non-AOA competitive specialty.
5. At the end of the day, you'll be a doctor whether you went to a DO school or a MD school.

Edit:
6. There is a DO and MD merger happening. Things will be different in the future. I just don't know what will happen/how different it will be.

I think that about sums it up.
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LOL. Yup. These types of post do recur frequently on SDN. Almost as numerous as Am I Too Old for Medicine or RN to MD...etc.
 
Counter-question, why do people who post this usually join the day of / before?
 
As far as actual practice they are both the exact same.

As far as residency opportunities and how the DO graduate is perceived by Residency Program directors, DOs are at a severe disadvantage.
 
I personally chose DO over an MD acceptance, but I chose the situation that I felt was best for my family with no consideration of allopathic vs osteopathic.

Good students match into good residencies regardless of the school you attend. There seems to be a stigma on SDN that DO = harder to get a job for reduced pay/prestige. Just not true.

Is it harder to match into MD residencies as a DO? For sure. I think people forget, though, that there are some very good DO residencies available as well. Do a quick AOA search in your zip code; plenty of DO cardiologists, derms, neuros, etc. that are equal with their MD counterparts in pay/prestige.

Choose a school in a location you love, with great first choice match rates, and a faculty dedicated to supporting your pursuit of medicine. That may be MD or it may be DO, but don't let the title cloud your judgment.
 
Azete said:
I personally chose DO over an MD acceptance, but I chose the situation that I felt was best for my family with no consideration of allopathic vs osteopathic.

Good students match into good residencies regardless of the school you attend. There seems to be a stigma on SDN that DO = harder to get a job for reduced pay/prestige. Just not true.

Is it harder to match into MD residencies as a DO? For sure. I think people forget, though, that there are some very good DO residencies available as well. Do a quick AOA search in your zip code; plenty of DO cardiologists, derms, neuros, etc. that are equal with their MD counterparts in pay/prestige.

Choose a school in a location you love, with great first choice match rates, and a faculty dedicated to supporting your pursuit of medicine. That may be MD or it may be DO, but don't let the title cloud your judgment.
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But with the merger there will be no separate DO residencies left.
 
Gandyy said:
But with the merger there will be no separate DO residencies left.
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Still enough residencies for everybody. DO residencies aren't going to start taking MD students with worse board scores just because they went to allopathic schools.

Good scores will match into good residencies, just like they do now.
 
Azete said:
Still enough residencies for everybody. DO residencies aren't going to start taking MD students with worse board scores just because they went to allopathic schools.

Good scores will match into good residencies, just like they do now.
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Yes, still enough residencies for both, but probably much less competitive residencies for DO. Considering how strong the bias is against DO (Which I think is ridiculous), what you are describing might happen.
 
MarylandMatt said:
MDs don't want to DO it.
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giphy.gif
 
Azete said:
DO residencies aren't going to start taking MD students with worse board scores just because they went to allopathic schools.
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True but MD students with excellent board scores and great ECs will be more competitive for in demand DO programs in neurosurg, ortho, etc etc. I'm sure there's piles of allo grads interested in osteo residencies if it means getting into one of these specialties.

Which is bad news for DO grads interested in "top" fields.
 
md-2020 said:
True but MD students with excellent board scores and great ECs will be more competitive for in demand DO programs in neurosurg, ortho, etc etc. I'm sure there's piles of allo grads interested in osteo residencies if it means getting into one of these specialties.

Which is bad news for DO grads interested in "top" fields.
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So if they score competitively with MD students, what difference should DO make? Either they are fundamentally the same or they are not.
 
jl lin said:
So if they score competitively with MD students, what difference should DO make? Either they are fundamentally the same or they are not.
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Allo schools have more research opportunities, for one.

Also it's not MD vs. DO in the sense that residency programs would be choosing one or the other, but having more quality stats MD applicants to a formerly DO-only program will by definition increase the competition.
 
jl lin said:
So if they score competitively with MD students, what difference should DO make? Either they are fundamentally the same or they are not.
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The differences are in the reputation of the school (MD schools in general have strong regional reputation in their respective areas), research opportunities (MD schools focus much more on research and have the resources for it), and less doubts in their abilities (not a justified bias but it exist due to lower admission standard for DO students)
 
Dr.Smexy said:
less doubts in their abilities (not a justified bias but it exist due to lower admission standard for DO students)
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Yeah, I have a problem with this. These same residency directors don't discriminate against other groups with lower stats on average (nor should they.) So universally saying "we don't look at DO applicants" is very problematic imo.
 
ZedsDed said:
Yeah, I have a problem with this. These same residency directors don't discriminate against other groups with lower stats on average (nor should they.) So universally saying "we don't look at DO applicants" is very problematic imo.
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Exactly, which is my original point when saying that there is no discrimination or bias against students from low tier MD schools/mission based schools, but all DO schools are thrown into the "must have scored a 24 MCAT/3.3 GPA" pool.
 
Gandyy said:
Exactly, which is my original point when saying that there is no discrimination or bias against students from low tier MD schools/mission based schools, but all DO schools are thrown into the "must have scored a 24 MCAT/3.3 GPA" pool.
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Not to throw a grenade into the thread, but I was thinking of URMs as well, who also have lower scores on average (not universally of course.) Yet if a URM MD has high scores no one is going to be like "oh, but statistically they have lower scores on average. Reject!" It's unjustifiable.
 
ZedsDed said:
Not to throw a grenade into the thread, but I was thinking of URMs as well, who also have lower scores on average (not universally of course.) Yet if a URM MD has high scores no one is going to be like "oh, but statistically they have lower scores on average. Reject!" It's unjustifiable.
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Yea, which is why its so ridiculous. Take an AZCOM grad for example.. the average matriculant stats there are 29 MCAT and 3.5 GPA. There are various low tier MD schools with stats in the 30/3.6 range who would have students that are not discriminated against in the match.

But it is what it is I guess.
 
ZedsDed said:
Not to throw a grenade into the thread, but I was thinking of URMs as well, who also have lower scores on average (not universally of course.) Yet if a URM MD has high scores no one is going to be like "oh, but statistically they have lower scores on average. Reject!" It's unjustifiable.
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The thing is the whole "affirmative action" thing works differently for residency programs. You can have URMs with 3.8/28's with MCATs 3-4 points below the MD matriculant average be competitive for top 20 MD programs potentially. If the average Step 1 score is a 227, even if you are a URM with a score like 215-220, you probably aren't going to be competitive for the highest end of the competitive residencies as a general thing. Affirmative action works rather differently when talking about residency admissions.

But yeah, I see your point. A URM who does well in MD med school but was a mediocre student in undergrad doesn't take nearly as much of a hit as your ORM who did better in undergrad but couldn't sneak into an MD program and also does well in med school.

I should note I personally don't have that big of a problem with DO discrimination as others(and I'm a rather borderline applicant wholl apply to both MD and DO programs when I apply) but this is one of the side effects.
 
GrapesofRath said:
The thing is the whole "affirmative action" thing works differently for residency programs. You can have URMs with 3.8/28's with MCATs 3-4 points below the MD matriculant average be competitive for top 20 MD programs potentially. If the average Step 1 score is a 227, even if you are a URM with a score like 215-220, you probably aren't going to be competitive for the highest end of the competitive residencies as a general thing. Affirmative action works rather differently when talking about residency admissions.
Click to expand...

I think Zed's point was that URM MD's are still at an allopathic school where they are not discriminated against like DO's are.
 
GrapesofRath said:
But yeah, I see your point. A URM who does well in MD med school but was a mediocre student in undergrad doesn't take nearly as much of a hit as your ORM who did better in undergrad but couldn't sneak into an MD program and also does well in med school.
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Yeah this is my point. One can go to a DO school (presumably because they didn't have MD-worthy stats), kill it, and still not get accepted to certain MD programs purely on the basis of being a DO med student.

The truth is orthodoxy trumps logic in this case. Some older doctors are always going to equate DO with chiropractic.
 
ZedsDed said:
Yeah this is my point. One can go to a DO school (presumably because they didn't have MD-worthy stats), kill it, and still not get accepted to certain MD programs purely on the basis of being a DO med student.

The truth is orthodoxy trumps logic in this case. Some older doctors are always going to equate DO with chiropractic.
Click to expand...

That's not how it works at all. Let's say you have 1000 applicants competing for 100 interview slots to match into 10 positions. You don't have time to read 1000 applications or even skim them. So how do you cull the herd? If you have 600 US MDs, then an easy first step is to cut applications from DO and abroad automatically. It has nothing to do with orthodoxy and is actually very logical. So now you don't have to read those 400 applications. If you put a step 1 cutoff at 220, then you get rid of all the people who haven't taken step 1 that gets rid of many DOs too as they are only required to take comlex. Now you have 300 applications for 100 slots instead of 1000. All 300 are very qualified and excellent candidates. Do you miss a few diamonds? Maybe. But you still have three times as many applicants as you have slots to interview them in and they are all good candidates.
 
ZedsDed said:
Yeah this is my point. One can go to a DO school (presumably because they didn't have MD-worthy stats), kill it, and still not get accepted to certain MD programs purely on the basis of being a DO med student.

The truth is orthodoxy trumps logic in this case. Some older doctors are always going to equate DO with chiropractic.
Click to expand...

Yeah I mean I in general don't particularly support/agree with how affirmative action is used in med school admission and all that it leads to so I'm not really going to throw a fit here over this situation. But DO bias is a real thing no matter how much there will be some on this site who want to try to mitigate/neglect its presence.

The thing is DO bias doesn't necessarily work the way people always discuss it as. Most of the time, a DO isn't what stops one from a neurosurgery or plastics residency or a program like that in itself. Having talked to a few RD's myself and hearing many others on this site in the know, not all of these programs are necessarily 100% against the idea of ever interviewing or considering a DO. It's just that they don't ever come across a DO that has the qualifications to seriously consider them. And really that should make sense; the odds of a DO who on average has a 3.5/27 in undergrad doing well enough on Step 1 and in other measures than the vast majority of MD's is not particularly high. The type of DO who has this success is making major major changes and showing huge huge improvement upon what they were able to accomplish and show in undergrad. These are in the small minority. Now do DO's with these 250+ step 1 scores and other top qualifications still face discrimination? You bet. But it's more complicated than that.

It's also worth noting, a large number of these borderline MD candidates who sneak into a lower tier school aren't going to be gunning for these high end competitive specialties. Many lower end MD programs have a primary care based mission. That's where many of their grads will end up in.

Where DO bias comes into play more for many is with specialties that take DO's with greater frequency. DO bias has its impact in fields like general surgery that take DO's but for whom it's harder to land a spot. And it especially start showing itself with residencies that are open to DOs generally speaking: Emergency Medicine, Anesthesiology, Pathology, Neurology etc. Here it's not just an issue of matching; it's WHERE you are able to match where DO's will start seeing limitations. Even for traditional DO fields like Family Medicine, where you match is impacted by your initials at the end of your name.
 
Psai said:
That's not how it works at all. Let's say you have 1000 applicants competing for 100 interview slots to match into 10 positions. You don't have time to read 1000 applications or even skim them. So how do you cull the herd? If you have 600 US MDs, then an easy first step is to cut applications from DO and abroad automatically. It has nothing to do with orthodoxy and is actually very logical. So now you don't have to read those extra 400 applications. If you put a step 1 cutoff at 220, then you get rid of all the people who haven't taken step 1 that gets rid of many DOs too as they are only required to take comlex. Now you have 300 applications for 100 slots instead of 1000. All 300 are very qualified and excellent candidates. Do you miss a few diamonds? Maybe. But you still have three times as many applicants as you have slots to interview them in and that is 300 x however many pages in the applications that you have to read.
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By that logic they should cut out a large chunk of lower-tier schools on the assumption that they will have lower stats.

I have a hard time believing that automatically cutting out all DO applicants has nothing to do discrimination. Are you seriously telling me that they would be happy to take DO applicants over MD applicants with lower stats if they just had a little more time to review applications?
 
Psai said:
That's not how it works at all. Let's say you have 1000 applicants competing for 100 interview slots to match into 10 positions. You don't have time to read 1000 applications or even skim them. So how do you cull the herd? If you have 600 US MDs, then an easy first step is to cut applications from DO and abroad automatically. It has nothing to do with orthodoxy and is actually very logical. So now you don't have to read those 400 applications. If you put a step 1 cutoff at 220, then you get rid of all the people who haven't taken step 1 that gets rid of many DOs too as they are only required to take comlex. Now you have 300 applications for 100 slots instead of 1000. All 300 are very qualified and excellent candidates. Do you miss a few diamonds? Maybe. But you still have three times as many applicants as you have slots to interview them in and they are all good candidates.
Click to expand...
While you raise some good points, I find it hard to believe that orthodoxy/snobbery have nothing to do with it. IIRC, other med students/physicians have confirmed that there's an inherent bias against DOs at some programs.

Edit: Zedsded beat me to it.
 
ZedsDed said:
Not to throw a grenade into the thread, but I was thinking of URMs as well, who also have lower scores on average (not universally of course.) Yet if a URM MD has high scores no one is going to be like "oh, but statistically they have lower scores on average. Reject!" It's unjustifiable.
Click to expand...
You know one of these is a federally protected class and the other is an educational choice right?
 
Cyberdyne 101 said:
While you raise some good points, I find it hard to believe that orthodoxy/snobbery have nothing to do with it. IIRC, other med students/physicians have confirmed that there's an inherent bias against DOs at some programs.

Edit: Zedsded beat me to it.
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Snobbery? lol. There's nothing snobby about wanting to train the best physicians. Orthodoxy has nothing to do with it. Do you really think that programs will pass on an excellent candidate because they had a little exposure to OMM? Of course not. First of all, allopathic residencies are for allopathic grads. They have absolutely no obligation to take any DOs at all. And of course DOs face a lot of bias. People who go DO are generally there because they were not competitive for MD. Yes, some people have geographic limitations, etc. but this is the reality. DO programs admit with lower MCATs and GPAs even with grade replacement. Prestige matters because people who go to better schools are there because they have proven themselves in an earlier step.

I'm not even going to touch the URM argument as it is not relevant whatsoever. It is not like you were born a DO student. You chose it.

ZedsDed said:
By that logic they should cut out a large chunk of lower-tier schools on the assumption that they will have lower stats.

I have a hard time believing that automatically cutting out all DO applicants has nothing to do discrimination. Are you seriously telling me that they would be happy to take DO applicants over MD applicants with lower stats if they just had a little more time to review applications?
Click to expand...

Sometimes they do take DO applicants over MD applicants. Just look at Hopkins anesthesiology. They have a few DOs in there but I'm sure there is no shortage of MD applicants. And discrimination happens for a legitimate reason. DOs are not discriminated against for being DOs. DOs are just weaker applicants in general, coming from a weaker pool of students. Prestige does play a role within allopathic schools as well. If you have 100 spots and 200 people, all with great stats, great letters, etc. but 100 are from top schools and 100 are not, the top schools are much more likely to get those interviews. You just have to deal with the fact that there are people that are much better than you and there are easy ways to differentiate between people.
 
Psai said:
Snobbery? lol. There's nothing snobby about wanting to train the best physicians. Orthodoxy has nothing to do with it. Do you really think that programs will pass on an excellent candidate because they had a little exposure to OMM? Of course not. First of all, allopathic residencies are for allopathic grads. They have absolutely no obligation to take any DOs at all. And of course DOs face a lot of bias. People who go DO are generally there because they were not competitive for MD. Yes, some people have geographic limitations, etc. but this is the reality. DO programs admit with lower MCATs and GPAs even with grade replacement. Prestige matters because people who go to better schools are there because they have proven themselves in an earlier step.

I'm not even going to touch the URM argument as it is not relevant whatsoever. It is not like you were born a DO student. You chose it.



Sometimes they do take DO applicants over MD applicants. Just look at Hopkins anesthesiology. They have a few DOs in there but I'm sure there is no shortage of MD applicants. And discrimination happens for a legitimate reason. DOs are not discriminated against for being DOs. DOs are just weaker applicants in general, coming from a weaker pool of students. Prestige does play a role within allopathic schools as well. If you have 100 spots and 200 people, all with great stats, great letters, etc. but 100 are from top schools and 100 are not, the top schools are much more likely to get those interviews. You just have to deal with the fact that there are people that are much better than you and there are easy ways to differentiate between people.
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Snob: one who tends to rebuff, avoid, or ignore those regarded as inferior.

As you pointed out, some programs clearly don't look at DO applicants because they regard them as inferior. And I'm not arguing about the merits of this practice, but it is snobbery, especially since DOs have succeeded at certain ACGME programs.

That said, I understand the reservations that a PD would have about a DO applicant with high scores, but who rotated at sub-par sites.
 
As Psai said, PDs (at this point of time) can honeslty remove DOs from the app cycle for their program with a simple click of a button that excludes anyone who is not an internal ERAS applicant (that is a newly MD grad). On top of that, you have PDs who simply ignore DO applications because they truly feel that accepting them will drop the tier and prestige of their program. This is shown time and time again when you look at mid and top tier Academic IM programs (BMC, MGH, BWH, UCSF NOT UCSF Fresno, Northwestern, UMich, UCSD, UCLA-RR, Duke, Yale, Stanford, Cornell, Jefferson, Stony Brook, UPenn, lIJ).

Many of the competitive programs are looking for much more than decent step scores to choose their potential invterviewees, they want to see scholarly activity and unfortunately, DO schools are not even on the map in the research realm than MD schools. There are DO schools however that are headed down the right path (Rowan, OUHCOM, KCU, MSU) to expand institutional research activities.

The thing here is that it is better to inform you of the reality of choosing the DO path then trick you into thinking you will waltz into a cardiovascular surgery program. MDs and DOs are both well trained physicians. The differences between the two should one want to pursue a medical academic career is profound.
 
ZedsDed said:
By that logic they should cut out a large chunk of lower-tier schools on the assumption that they will have lower stats.

I have a hard time believing that automatically cutting out all DO applicants has nothing to do discrimination. Are you seriously telling me that they would be happy to take DO applicants over MD applicants with lower stats if they just had a little more time to review applications?
Click to expand...
If you think there is no bias against MDs from lower tier schools when they apply to "higher tier"residency programs you are mistaken.
 
DrBowtie said:
You know one of these is a federally protected class and the other is an educational choice right?
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I'm aware. The only parallel I'm drawing is for the lower undergraduate grades obtained by both groups.
Psai said:
Snobbery? lol. There's nothing snobby about wanting to train the best physicians. Orthodoxy has nothing to do with it. Do you really think that programs will pass on an excellent candidate because they had a little exposure to OMM? Of course not. First of all, allopathic residencies are for allopathic grads. They have absolutely no obligation to take any DOs at all. And of course DOs face a lot of bias. People who go DO are generally there because they were not competitive for MD. Yes, some people have geographic limitations, etc. but this is the reality. DO programs admit with lower MCATs and GPAs even with grade replacement. Prestige matters because people who go to better schools are there because they have proven themselves in an earlier step.
Click to expand...
As I said, we are specifically talking about the hypothetical high-stats DO applicant.
Psai said:
Sometimes they do take DO applicants over MD applicants. Just look at Hopkins anesthesiology. They have a few DOs in there but I'm sure there is no shortage of MD applicants. And discrimination happens for a legitimate reason. DOs are not discriminated against for being DOs. DOs are just weaker applicants in general, coming from a weaker pool of students.
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Fair enough, but see above.
Psai said:
Prestige does play a role within allopathic schools as well. If you have 100 spots and 200 people, all with great stats, great letters, etc. but 100 are from top schools and 100 are not, the top schools are much more likely to get those interviews. You just have to deal with the fact that there are people that are much better than you and there are easy ways to differentiate between people.
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I'm not sure what my specific situation has to do with anything but I am not an osteopathic med student, nor do I plan on becoming one.
SouthernSurgeon said:
So what? "Killing it" just means good grades and board scores. It doesn't fully reflect the preparation and training you get in medical school.

A lot of programs, particularly inpatient heavy specialties like medicine/surgery at large hospitals, have concerns about the quality of the rotations at some/many DO schools. Doesn't particularly matter if you "killed it" on your medicine clerkship if it was a preceptor office based rotation with no real hospital experience.

It's not just the academic qualifications, it's the educational program that they are evaluating. They want interns who can walk in on day one ready to take care of patients at at least a baseline level.
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I am in no way qualified to talk about the quality of education (or lack thereof) at DO schools. Assuming it is lacking, discrimination against DO's for that reason makes a lot more sense than vague concerns about undergraduate performance. At the end of the day, I'm just a premed going off of conjecture. I'll bow to those with greater wisdom and experience than myself.
Donald Juan said:
If you think there is no bias against MDs from lower tier schools when they apply to "higher tier"residency programs you are mistaken.
Click to expand...
It's not an automatic screening-out though, no?
 
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