Is there really a difference between MD and DO?

[Lawpy]

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to be fair, isn't RVU the only explicitly open for-profit DO right now? And their clinical sites are reportedly reasonably decent, especially for a brand new school.

I believe Burrell is also for profit

 

[Gandyy]

Honest questions.

1. Why do DO schools have COMLEX instead of mandating USMLE?

2. Why do DO schools require very large deposits to hold seats? Even when strictly focusing DO?

3. Why do DO schools have a different application service?

If MD and DO schools are equivalent, why do we have the above three issues? This is not inflammatory, but rather i am lost in this matter

Well it is a separate degree, so I guess thats why. I think asking the question about MD and DO being equivalent is not really applicable.

They both have the same practice privileges in all 50 states. Is that not equivalency>?

 

[235009]

I actually think that Goro ignored MeatTornado a while ago, so thats why hes not responding to any of his posts because he cant see them. Idk, I could be wrong

It's fine if he wants to live in a bubble but it's extremely childish to continue name-calling and making snide remarks directed at me. It's very revealing of his motivations.

Honest questions.

1. Why do DO schools have COMLEX instead of mandating USMLE?

2. Why do DO schools require very large deposits to hold seats? Even when strictly focusing DO?

3. Why do DO schools have a different application service?

If MD and DO schools are equivalent, why do we have the above three issues? This is not inflammatory, but rather i am lost in this matter

The answers:

1. $$

2. $$$$$

3. $$$$

That's fine and all, but part of using "ignore" is that you're essentially saying you won't engage with that person anymore. It's pretty lame to ignore someone and then continue sniping at them constantly. Kind of defeats the whole purpose.

Yup.

 

[Lawpy]

Well it is a separate degree, so I guess thats why. I think asking the question about MD and DO being equivalent is not really applicable.

They both have the same practice privileges in all 50 states. Is that not equivalency>?

But why the redundancy? It is a given that MD and DO physicians have equal practice privileges, but why are there two separate, parallel approaches to medical education? Clearly, there is a striking difference that makes DO schools unique, but what is it? And it isn't OMM since MD physicians can learn and use OMM in practice.

 

[Cyberdyne 101]

We are talking general terms here. On average, US MD is superior to US DO and it's not just the biases/stigma playing a role

Yeah, we're aware of the bolded, but I think these forums would serve a better purpose if people actually knew which schools would shortchange them during the clinical years.

 

[Lawpy]

Yeah, we're aware of the bolded, but I think these forums would serve a better purpose if people actually knew which schools would shortchange them during the clinical years.

I am struggling with the fundamentals. What makes DO schools unique enough for them to be separated from MD and have its own application process and standardized exams? From there, we can see which schools will be affected

 

[WedgeDawg]

I am struggling with the fundamentals. What makes DO schools unique enough for them to be separated from MD and have its own application process and standardized exams? From there, we can see which schools will be affected

Convergent evolution with distinct origins?

 

[deleted407021]

It's fine if he wants to live in a bubble but it's extremely childish to continue name-calling and making snide remarks directed at me. It's very revealing of his motivations.

Maybe so, but you seem awfully self-validated in continuously pointing it out. It makes you feel good, yeah?

I'm with @Cyberdyne 101 re: the the bickering in this thread.

 

[WingedOx]

Convergent evolution with distinct origins?

Bingo.

 

[Lawpy]

Convergent evolution with distinct origins?

Bingo.

So.... eventual convergence to a point?

At this point? Largely history, and the more practical fact that it's hard to dismantle a large machine, especially when money is involved.

Basically you're saying: "Well Burger King and McDonalds are basically the same, so why are they two separate companies?"

I mean DDS/DMD is also largely history with the same education pathway....

 

[WedgeDawg]

So.... eventual convergence to a point?

If the trend continues, I wouldn't be surprised

 

[22031 Alum]

I think people should just cut to the chase and name the schools who have subpar clinical training. I mean that's what these forums are for, right?

It actually doesn't do much good for me to say that student who'd never written an inpatient OB note was from _COM. I'm sure she had classmates who had very different experiences with different preceptors. From an MD faculty point of view it's that variability that's an issue. Although if there are schools that wards-only clinical years, that would be helpful for me to know.

 

[Gandyy]

I am struggling with the fundamentals. What makes DO schools unique enough for them to be separated from MD and have its own application process and standardized exams? From there, we can see which schools will be affected

In truth there is no real difference besides OMM that is taught to every DO student. I think Andrew Still (the only MD, DO) had good intentions when he started off with the DO prospect, but money and lax standards have hurt the name of osteopathic education. In the modern era, its just as @SouthernSurgeon says. Its burger king or mcdonalds. Large machine that is Osteopathic education which probably will not be stopped. I just wish the LCME was governing osteopathic schools too. Thats all I ask for. Equal education because the end intent of every medical school should be to produce competent and compassionate physicians.

 

[AnatomyGrey12]

So.... eventual convergence to a point?



I mean DDS/DMD is also largely history with the same education pathway....

DO/MD are separate because they have different origins. DDS and DMD have always been the same thing. And addressing the clinical rotations issue like @22031 Alum stated above its not really specific schools. The problem is that, even at the same school, the quality varies. For example a student told me that at KCOM having all ward based rotations is possible if that is what you want, but not everyone wants/chooses those. Preceptorships vary dramatically. Some schools have less variance than others. Like was mentioned above Midwestern-Chicago really doesn't have rotations much different than RFU but there is still variance.

FWIW my opinion is in about 20 years you will have complete convergence when the current DO students get into the leadership positions. It is mostly the old school DOs who are all into "DO distinctiveness," which today is just mostly 200 class hours of OMM.. The former DO schools will become MD schools with an emphasis on community health and PC.

And thought I would throw in that "for profit" status has had no bearing on school quality. RVU is for profit and you should go take a look at their match list. They already have a match list on par with the most established DO schools for the most part. I doubt PDs care, it gets way overblown on SDN.

 

[Lawpy]

In truth there is no real difference besides OMM that is taught to every DO student. I think Andrew Still (the only MD, DO) had good intentions when he started off with the DO prospect, but money and lax standards have hurt the name of osteopathic education. In the modern era, its just as @SouthernSurgeon says. Its burger king or mcdonalds. Large machine that is Osteopathic education which probably will not be stopped. I just wish the LCME was governing osteopathic schools too. Thats all I ask for. Equal education because the end intent of every medical school should be to produce competent and compassionate physicians.

If anything, it'd be apt for all schools to adopt OMM into their curriculum in some way since it has been shown to be helpful in many instances. But that would make DO a largely historical degree.

Either way, i don't see the point of having a different application service and additional standardized exams when AMCAS and USMLE suffice

DO/MD are separate because they have different origins. DDS and DMD have always been the same thing. And addressing the clinical rotations issue like @22031 Alum stated above its not really specific schools. The problem is that, even at the same school, the quality varies. For example a student told me that at KCOM having all ward based rotations is possible if that is what you want, but not everyone wants/chooses those. Preceptorships vary dramatically. Some schools have less variance than others. Like was mentioned above Midwestern-Chicago really doesn't have rotations much different than RFU but there is still variance.

FWIW my opinion is in about 20 years you will have complete convergence when the current DO students get into the leadership positions. It is mostly the old school DOs who are all into "DO distinctiveness," which today is just mostly 200 class hours of OMM.. The former DO schools will become MD schools with an emphasis on community health and PC.

And thought I would throw in that "for profit" status has had no bearing on school quality. RVU is for profit and you should go take a look at their match list. They already have a match list on par with the most established DO schools for the most part. I doubt PDs care, it gets way overblown on SDN.

I am completely lost of the history of the DO degree but i won't discuss it because of its potential negative nature. But even if it is largely historical, i don't see why it needs to be completely separate.

I mentioned for-profit DO schools because people were mocking LCME/ACGME for being foolish in accrediting Northstate. RVU may be good but i heard very poor things about BCOM in the osteo school-specific discussions and general forums

 

[Goro]

Bingo.

I actually think that Goro ignored MeatTornado a while ago, so thats why hes not responding to any of his posts because he cant see them. Idk, I could be wrong

Very true.
At this point? Largely history, and the more practical fact that it's hard to dismantle a large machine, especially when money is involved.

I think a more accurate analogy would be to ask: "well, Ford and Mercury (or Chevrolet and Pontiac, or Dodge and Plymouth) are basically the same, so why are there two separate companies?"

Basically you're saying: "Well Burger King and McDonalds are basically the same, so why are they two separate companies?"

 

[WedgeDawg]

If anything, it'd be apt for all schools to adopt OMM into their curriculum in some way since it has been shown to be helpful in many instances. But that would make DO a largely historical degree.

I don't think there's any way anyone is going to convince MD to adopt OMM in the near future given the shaky evidence overall (or at least the perception of it being shaky).

 

[22031 Alum]

For example a student told me that at KCOM having all ward based rotations is possible if that is what you want, but not everyone wants/chooses those.

If I'd been fed the line that I could see real doctors practice real medicine, as opposed to following residents around "doing scut" all day, I probably would have made the same choice. It sounds like a good deal.

 

[Lawpy]

I don't think there's any way anyone is going to convince MD to adopt OMM in the near future given the shaky evidence overall (or at least the perception of it being shaky).

OMM is shown to be incredibly valuable in treating musculoskeletal ailments. It's a good elective to expand and diversify the MD regimen

 

[WedgeDawg]

OMM is shown to be incredibly valuable in treating musculoskeletal ailments. It's a good elective to explore and diversify the MD regimen

I could see it being offered as a 4th year elective, but not as a core class.

 

[AnatomyGrey12]

If I'd been fed the line that I could see real doctors practice real medicine, as opposed to following residents around all day, I probably would have made the same choice. It sounds like a good deal.

As someone who will most likely end up going DO (I consider myself a late bloomer) I can honestly say I am grateful for SDN so I can avoid that trap. I will fight tooth and nail to get ward based rotations with residents. it sounds good but I won't be paying 300,000+ to be a mediocre physician.

 

[jl lin]

I actually think that Goro ignored MeatTornado a while ago, so thats why hes not responding to any of his posts because he cant see them. Idk, I could be wrong

That's why the feature is there. I am sure MT will be fine, but it is a good idea IMHO to review the ignore list every once in a while. I have taken some people off and am fine with that, but then there's a person I took off, and it took just almost no time for him to receive a spot back on the ignore list.
Top reasons I list people to Ignore...if I feel like they are trolling or if I feel they are engaging in bully behavior. Of course if I see a lot of gang-banging type of antics, it's a waste to return to that particular thread. That is the little brat coming out in the online adult. No time for that.
I usually give people a number of chances, and as I said, periodically re-evaluate the Ignore List. In review, I actually found a number of folks were banned or left and haven't been back, so I took them off the list.

Free will. People can do as they please. It's no skin off of anyone's chin either way.

 

[Lawpy]

@SouthernSurgeon @AnatomyGrey12 and @Goro sorry but i fail to see how the analogies make sense. Shouldn't medical education be homogeneous and standardized? This would require only one pathway.

 

[Gandyy]

@SouthernSurgeon @AnatomyGrey12 and @Goro sorry but i fail to see how the analogies make sense. Shouldn't medical education be homogeneous and standardized? This would require only one pathway.

I agree

 

[WedgeDawg]

@SouthernSurgeon @AnatomyGrey12 and @Goro sorry but i fail to see how the analogies make sense. Shouldn't medical education be homogeneous and standardized? This would require only one pathway.

In an ideal, perfectly efficient world? Sure, I could see that argument being made. But the reality is that currently there are two pathways, and the question remains are these pathways different enough in a way that affects outcomes for patients that warrants the expenditure of time and resources to eliminate the distinction.

 

[Lawpy]

In an ideal, perfectly efficient world? Sure, I could see that argument being made. But the reality is that currently there are two pathways, and the question remains are these pathways different enough in a way that affects outcomes for patients that warrants the expenditure of time and resources to eliminate the distinction.

Right and i don't know what differences are there in the first place if MD schools can incorporate OMM as an elective.

This problem isn't seen in dentistry and veterinary medicine, which have different degrees for purely historical reason, but the education pathway is the same.

 

[jl lin]

In an ideal, perfectly efficient world? Sure, I could see that argument being made. But the reality is that currently there are two pathways, and the question remains are these pathways different enough in a way that affects outcomes for patients that warrants the expenditure of time and resources to eliminate the distinction.

Yes, however, it seems more probable to me that the issue is primarily politics and money--the usual stuff that keeps groups from unification.

 

[235009]

Maybe so, but you seem awfully self-validated in continuously pointing it out. It makes you feel good, yeah?

I'm with @Cyberdyne 101 re: the the bickering in this thread.

I don't want to make this thread about me and detract from a very substantive discussion by the attendings and residents I mentioned earlier. I'd just like to point out that I intentionally stayed out of this thread until @Goro called me out by name. Again, very childish behavior and if he insists on doing it I will continue to point out that he's a snake oil salesman whose opinion doesn't count.

 

[WedgeDawg]

Yes, however, it seems more probable to me that the issue is primarily politics and money--the usual stuff that keeps groups from unification.

Political power and money are both scarce resources.

 

[Lawpy]

As said above, in a utopia, sure.

But right now you have a regulatory body (AOA/COCA) that has the legal authority to license schools to confer DO degrees, and dozens of schools full of administrators/staff/etc, all with a business interest in keeping doing what they are doing.

Simply saying it should be standardized would mean eliminating most of the above and (at this point at least) forcing them to follow the dictums of an entirely separate regulatory body (LCME).

There is simply no motivation at present for the parties to do so.

Yes, however, it seems more probable to me that the issue is primarily politics and money--the usual stuff that keeps groups from unification.

Political power and money are both scarce resources.

Well this is disappointing.

 

[ZedsDed]

If anything, it'd be apt for all schools to adopt OMM into their curriculum in some way since it has been shown to be helpful in many instances.

Maybe, if we exclude cranial manipulation and "Chapman's points," which both seem like pseudoscience coupled with a hefty dose of placebo effect.

 

[WedgeDawg]

Well this is disappointing.

To quote Monica Geller: "Welcome to the real world! It sucks! You're gonna love it!"

 

[DrBowtie]

I don't want to make this thread about me and detract from a very substantive discussion by the attendings and residents I mentioned earlier. I'd just like to point out that I intentionally stayed out of this thread until @Goro called me out by name. Again, very childish behavior and if he insists on doing it I will continue to point out that he's a snake oil salesman whose opinion doesn't count.

He's preclinical faculty correct?

 

[22031 Alum]

As someone who will most likely end up going DO (I consider myself a late bloomer) I can honestly say I am grateful for SDN so I can avoid that trap. I will fight tooth and nail to get ward based rotations with residents. it sounds good but I won't be paying 300,000+ to be a mediocre physician.

Well, med school doesn't create physicians- residency does. So I wouldn't worry about coming out of school as a mediocre physician, but as one who was less prepared for the crucible of residency. Can people overcome that difference and excel in residency, becoming excellent physicians?? Of course. It happens every year. Should you want to enter residency as well prepared as possible, anyway?? I think so.

I'll be honest, MS3 was hard. When I was pre-pre-rounding, dealing with intra-team personality conflicts, helping with wound vac changes that took an hour, or feeling like an idiot on teaching rounds, I would've gladly switched formats. But now I'm really glad that my first time doing those things wasn't as an intern- or even a sub-I.

 

[Goro]

A) It's heading in that direction.

B) The mention of separate origin with convergent evolution is a valid point! As I have mentioned previously in other threads, Medicine in 2015 is NOT the same as it was in 1915 or 1890, hence the early proliferation of life-forms, err, doctrines in the practice of Medicine. How many of you know that Drexel start out as a merger between Hahnemann and another failed MD school? And that Hahnemann started out an a homeopathic medical school?? How many of you know that UCI started out as a DO school???? I foresee a time where the two degrees will merge. I'll probably be long retired or dead by that point.

So you see, evolution occurs right in front of our eyes. The negatives in this are two-fold:

1) The AOA persists in opening new schools, thinking that more DO grads is a good thing
2) VCOM, RVU, PCOM, CCOM, Touro and LECOM have realized that opening medical schools is a cash cow, but have no regard to the future of the profession, or the graduates they produce. My learned colleague @22031 Alum's comment above about how one lousy student can poison the well for a school is very telling. It's 100% correct, but the people jumping on the branch campus bandwagon are unaware of this, or simply don't care.

C) By and large, medical education IS standardized for the first two years. The MD schools, since they almost all have access to teaching hospitals, can provide a more standardized 3rd/4th year education, and this is what PDs look for, especially for those beloved and highly lusted after competitive specialties.

D) As for standardized AND homogenous, I don't think that this will be possible given that there are many different avenues to teaching a doctor how to be a doctor, especially in the first two years. Classic Flexner discipline-based? Systems-based? PBL? Competency-based? TBL? Early clinical exposure? Roughly every 10-20 years, some genius at Harvard comes up with a curriculum change, and by Gawd, every medical school in the US has to follow suit! It sure becomes a pain in the ass for us Faculty.

One final note. With the return of the for-profit medical school, it wouldn't surprise me if hospitals or hospital chains get in the act of opening their own med schools. Ready supply of cheap labor and future staff and al that, if they can get over the mania of the "you need to see a patient every 15 minutes" business model.

Discuss.

@SouthernSurgeon @AnatomyGrey12 and @Goro sorry but i fail to see how the analogies make sense. Shouldn't medical education be homogeneous and standardized? This would require only one pathway.

 

[WingedOx]

I also think there's some value in getting some exposure to community hospitals in small quantities while in med school just to see that there's more to medicine than just what goes on at major academic centers. I did a rotation in Reading, PA (almost all the Philly schools + Penn State rotate there in some capacity) and it was actually a great experience.

 

[Gandyy]

Well, med school doesn't create physicians- residency does. So I wouldn't worry about coming out of school as a mediocre physician, but as one who was less prepared for the crucible of residency. Can people overcome that difference and excel in residency, becoming excellent physicians?? Of course. It happens every year. Should you want to enter residency as well prepared as possible, anyway?? I think so.

I'll be honest, MS3 was hard. When I was pre-pre-rounding, dealing with intra-team personality conflicts, helping with wound vac changes that took an hour, or feeling like an idiot on teaching rounds, I would've gladly switched formats. But now I'm really glad that my first time doing those things wasn't as an intern- or even a sub-I.

So basically 1 standardized test called the MCAT has that much impact for the next 10 years of your life in the path of medicine.

Its too much, just way too much

 

[WedgeDawg]

So basically 1 standardized test called the MCAT has that much impact for the next 10 years of your life in the path of medicine.

Its too much, just way too much

I mean, if you really want to go there, one 2-3 millimeter slip of your hand can lacerate the internal carotid artery and cause blindness in one eye for your patient for the next 50 years of their life so all things considered, you have it pretty good considering you still get to practice medicine as a DO even if your MCAT isn't super fantastic.

 

[Gandyy]

I mean, if you really want to go there, one 2-3 millimeter slip of your hand can lacerate the internal carotid artery and cause blindness in one eye for your patient for the next 50 years of their life so all things considered, you have it pretty good considering you still get to practice medicine as a DO even if your MCAT isn't super fantastic.

Ok.... this might the most ridiculous thing I've seen you post.

What are you even talking about? I can interpret this post in so many ways.

Are you saying that somehow MCAT score is correlated to hand dexterity as an ophthalmic surgeon?

 

[DrBowtie]

So basically 1 standardized test called the MCAT has that much impact for the next 10 years of your life in the path of medicine.

Its too much, just way too much

Step 1 probably determines more and you don't get the chance to retake it if you pass.

 

[WedgeDawg]

Ok.... this might the most ridiculous thing I've seen you post.

What are you even talking about? I can interpret this post in so many ways.

Are you saying that somehow MCAT score is correlated to hand dexterity as an ophthalmic surgeon?

No I'm just saying the pressure is only going to get higher. With the MCAT, you have recourse. Later on, you might not. It's a hyperbolic example, but going DO vs. MD is not the end of the world in any sense. In fact, it's really a blessing, because you're not going to have "safety nets" like that in situations later on.

 

[22031 Alum]

I should note that the poor _COM student I mentioned was excellent. A very fast learner and hard worker. She did not poison the well for her school- far from it. But I certainly learned that I can't take for granted what experiences every MS4 has had by the time they get to me.

Are you saying that somehow MCAT score is correlated to hand dexterity as an ophthalmic surgeon?

No, no, no. You lamented that messing up a little bit on the MCAT can have huge consequences. @WedgeDawg was pointing out that it's far from the last time in your career that little errors can have huge consequences. It's an analogy, though a little overblown. It's not a correlation.

 

[Gandyy]

No I'm just saying the pressure is only going to get higher. With the MCAT, you have recourse. Later on, you might not. It's a hyperbolic example, but going DO vs. MD is not the end of the world in any sense. In fact, it's really a blessing, because you're not going to have "safety nets" like that in situations later on.

I should note that the poor _COM student I mentioned was excellent. A very fast learner and hard worker. She did not poison the well for her school- far from it. But I certainly learned that I can't take for granted what experiences every MS4 has had by the time they get to me.



No, no, no. You lamented that messing up a little bit on the MCAT can have huge consequences. @WedgeDawg was pointing out that it's far from the last time in your career that little errors can have huge consequences. It's an analogy, though a little overblown. It's not a correlation.

Ok I see your point.

 

[Lawpy]

A) It's heading in that direction.

B) The mention of separate origin with convergent evolution is a valid point! As I have mentioned previously in other threads, Medicine in 2015 is NOT the same as it was in 1915 or 1890, hence the early proliferation of life-forms, err, doctrines in the practice of Medicine. How many of you know that Drexel start out as a merger between Hahnemann and another failed MD school? And that Hahnemann started out an a homeopathic medical school?? How many of you know that UCI started out as a DO school???? I foresee a time where the two degrees will merge. I'll probably be long retired or dead by that point.

So you see, evolution occurs right in front of our eyes. The negatives in this are two-fold:

1) The AOA persists in opening new schools, thinking that more DO grads is a good thing
2) VCOM, RVU, PCOM, CCOM, Touro and LECOM have realized that opening medical schools is a cash cow, but have no regard to the future of the profession, or the graduates they produce. My learned colleague @22031 Alum's comment above about how one lousy student can poison the well for a school is very telling. It's 100% correct, but the people jumping on the branch campus bandwagon are unaware of this, or simply don't care.

C) By and large, medical education IS standardized for the first two years. The MD schools, since they almost all have access to teaching hospitals, can provide a more standardized 3rd/4th year education, and this is what PDs look for, especially for those beloved and highly lusted after competitive specialties.

D) As for standardized AND homogenous, I don't think that this will be possible given that there are many different avenues to teaching a doctor how to be a doctor, especially in the first two years. Classic Flexner discipline-based? Systems-based? PBL? Competency-based? TBL? Early clinical exposure? Roughly every 10-20 years, some genius at Harvard comes up with a curriculum change, and by Gawd, every medical school in the US has to follow suit! It sure becomes a pain in the ass for us Faculty.

One final note. With the return of the for-profit medical school, it wouldn't surprise me if hospitals or hospital chains get in the act of opening their own med schools. Ready supply of cheap labor and future staff and al that, if they can get over the mania of the "you need to see a patient every 15 minutes" business model.

Discuss.

Convergent evolution is a pretty interesting and accurate description on what's going on. I admit i didn't know Drexel started out as a merger between a teaching hospital and a failed MD school but it does curiously highlight present problems that the school faces (and yes, i strongly believe many DO schools, including PCOM, surpass Drexel and other lower tier MD schools in medical education quality by a long shot). UCI starting out as a DO school is a surprise.

Regarding the explanations you provided, i have a few questions

1. Why does the AOA feel that way? In other words, what possible features does the AOA believe make DO schools unique and essential that having more DO grads is necessary?

2. Why is the need of COMLEX important in preclinical education when USMLE suffices?

It's interesting to know more about the DO structure but i just have this feeling that the two degrees are essentially equivalent that there is no point in having a separate application process and standardized exams

 

[GrapesofRath]

Just to go off the whole MCAT thing I've had more than one person I know fairly well personally in MD admissions tell me a big part of the reason why there are some ADCOMs who just don't like MCAT re-takes and will either a) insist on averaging multiple MCAT scores b) persistently question a very high score if it came after an initial poor attempt is precisely because of what others are talking about. You only get one shot at Step 1 which is a bigger test. You don't get any safety nets later on in the game with mediocre showings. For many people, Step 1 is what will define whether or not they have a chance of going into their life long dream specialty or if they will have to settle for a specialty they never even considered or are that interested in and are stuck with for the next 40 years.

There truly are some ADCOMs from all I've heard and been told who really believe the MCAT should only be taken once, period. The fact people get to re-take MCAT scores and still have the latter score carry alot of weight or have options if they don't do well on the MCAT(ie DO programs) is not a luxury that occurs later on in the medical training process. The MCAT is the only standardized measure there is to compare applicants. In other parts of the world, these type of standardized tests mean a hell of a lot more than an MCAT. Hell, in Canada even a 10 in a section as subjective as Verbal can get you screened out. We got it pretty good in the US of A.

 

[Lawpy]

Just to go off the whole MCAT thing I've had more than one person I know fairly well personally in MD admissions tell me a big part of the reason why there are some ADCOMs who just don't like MCAT re-takes and will either a) insist on averaging multiple MCAT scores b) persistently question a very high score if it came after an initial poor attempt is precisely because of what others are talking about. You only get one shot at Step 1 which is a bigger test. You don't get any safety nets later on in the game with mediocre showings. For many people, Step 1 is what will define whether or not they have a chance of going into their life long dream specialty or if they will have to settle for a specialty they never even considered or are that interested in and are stuck with for the next 40 years.

There truly are some ADCOMs from all I've heard and been told who really believe the MCAT should only be taken once, period. The fact people get to re-take MCAT scores and still have the latter score carry alot of weight or have options if they don't do well on the MCAT(ie DO programs) is not a luxury that occurs later on in the medical training process. The MCAT is the only standardized measure there is to compare applicants. In other parts of the world, these type of standardized tests mean a hell of a lot more than an MCAT. Hell, in Canada even a 10 in a section as subjective as Verbal can get you screened out. We got it pretty good in the US of A.

Well, the MCAT and Step 1 involve completely different scenarios and environments. And people can retake Step 1 if they fail (though that looks very bad on the record). Step 1 prep has a finite deadline based on MS1/2 knowledge, while MCAT prep is infinite. And medical schools serve as a support system to ensure students do well on Step 1, while there is no such support for the MCAT.

 

[WedgeDawg]

Well, the MCAT and Step 1 involve completely different scenarios and environments. And people can retake Step 1 if they fail (though that looks very bad on the record). And medical schools serve as a support system to ensure students do well on Step 1, while there is no such support for the MCAT.

Sure but also remember that

1) people who take Step 1 have already gone through the "weed-out" process by taking the MCAT, so you're supporting people who already are demonstrably strong standardized test takers

2) you can't "fail" the MCAT but you can actually fail Step 1, and if you're aiming to go into ENT or something, getting a 200 is more or less failing (in the same sense as getting a 22 on the MCAT is "failing" if you're trying to get into WashU)

3) Step 1 is more content-based then the MCAT, which requires content knowledge but is also very much a reasoning test, so mastery of the material is a necessary prerequisite for success on step 1, which in most cases would not be possible without going through medical school. In contrast, someone could reasonably self-study for the MCAT in a couple months without having taken the classes and do well enough to get into medical school

4) The MCAT occurs before you've invested hundreds of thousands of dollars into medical school, so the price of not doing well is not as severe as failing step 1, which can lead to you not getting a residency spot and destroying the rest of your life

 

[GrapesofRath]

Well, the MCAT and Step 1 involve completely different scenarios and environments. And people can retake Step 1 if they fail (though that looks very bad on the record). Step 1 prep has a finite deadline based on MS1/2 knowledge, while MCAT prep is infinite. And medical schools serve as a support system to ensure students do well on Step 1, while there is no such support for the MCAT.

Re-taking Step-1 is not something you just do to enhance your credentials. If you need to re-take Step 1; you've dug yourself a real hole. Somebody who passes Step 1 by one point the first time around is clearly in better shape than somebody who fails Step 1 the first time and gets a 250 on the re-take(not that such a thing would happen). A failed Step 1 alone will eliminate you from consideration for a large number of residency programs. The ramifications are much much more serious than a bad MCAT attempt.

MCAT prep really isn't infinite at all. You take it when you are ready; there is simply no need to prep for more than a certain amount of time(usually a few months). It's a skills based test, almost an aptitude test per se. The amount of info on the MCAT pails in comparison to Step 1 by orders of magnitude.

 

[Lawpy]

Sure but also remember that

1) people who take Step 1 have already gone through the "weed-out" process by taking the MCAT, so you're supporting people who already are demonstrably strong standardized test takers

2) you can't "fail" the MCAT but you can actually fail Step 1, and if you're aiming to go into ENT or something, getting a 200 is more or less failing (in the same sense as getting a 22 on the MCAT is "failing" if you're trying to get into WashU)

3) Step 1 is more content-based then the MCAT, which requires content knowledge but is also very much a reasoning test, so mastery of the material is a necessary prerequisite for success on step 1, which in most cases would not be possible without going through medical school. In contrast, someone could reasonably self-study for the MCAT in a couple months without having taken the classes and do well enough to get into medical school

4) The MCAT occurs before you've invested hundreds of thousands of dollars into medical school, so the price of not doing well is not as severe as failing step 1, which can lead to you not getting a residency spot and destroying the rest of your life

I agree with all but it's going a bit too far to dismiss people who retook a bad MCAT score to a very high MCAT as high-risk applicants because a standardized measure isn't available. Step 1 and the boards are obviously on a different level and much harder but using the MCAT as a proxy when it tests different things is a bit off-target

Re-taking Step-1 is not something you just do to enhance your credentials. If you need to re-take Step 1; you've dug yourself a real hole. Somebody who passes Step 1 by one point the first time around is clearly in better shape than somebody who fails Step 1 the first time and gets a 250 on the re-take(not that such a thing would happen). A failed Step 1 alone will eliminate you from consideration for a large number of residency programs. The ramifications are much much more serious than a bad MCAT attempt.

MCAT prep really isn't infinite at all. You take it when you are ready; there is simply no need to prep for more than a certain amount of time(usually a few months). It's a skills based test, almost an aptitude test per se. The amount of info on the MCAT pails in comparison to Step 1 by orders of magnitude.

Step 1 is a one-shot deal because school time is invested into preparing for the exam. Failing Step 1 and having to retake it reduces clinical time which is a death sentence to the residency app. There is no such pressure involved in the MCAT, hence why the exam isn't a one-shot deal. No one is investing resources into your doing well on the MCAT besides you, whereas the medical school is making sure you succeed on Step 1 and on the boards or else they will make you pay severely

 

[WedgeDawg]

@Lawper at that point you can look at the effect of competition. Why look at the guy with a 26 and then a 35 when you can take the guy with a first-time 34 instead? There are plenty of those to go around.

Also although the MCAT is used as a proxy for standardized test taking ability along with a small to medium amount of content mastery, the fact that MCAT retakers can be highly successful in admissions means that not nearly as much emphasis is placed on it as step 1 anyway. So it is a proxy, but it's not a perfect analogue (which I think is obvious to everyone, as well as not the intended purpose of the test) and adcoms know this.

Going back to the original point (or at least one more upstream), this is why complaining about how much the MCAT can change your chances for med school admissions is pointless when you're entering a profession where each successive step is going to be even more high stakes.