Lecom forces me into DO only residency

[hckyplyr]

Heres the long and short of it:
I'm a PA student that is applying to Lecom PA to DO bridge program. Here's how it works. There are 12 spots, 6 are designated for primary care, and the other 6 can choose the specialty of their choice. However, you MUST do an osteopathic residency. I understand the orginal ACGME merger was intended for 2015, but it looks to be atleast 2018 now (from rumors).
I have a very close MD ortho surgeon that is very high up in a specific residency program that I wanted to apply to, he said he would pretty much guarantee me a residency with them (I still take this with a grain of salt). Since I'm not a medical student, I'm very unfamiliar with how the residency works. By LECOM forcing me to do an osteopathic residency, wouldn't that significantly reduce my chances of getting a residency in the specailty of my choice? I know I don't want primary care, and want a surgery residency or anes, EM.
So again, here is my simple question: By forcing me to do an osteopathic residency, would that lower my chances of getting into the specialty I want, because it takes away all the MD residencies that I could be applying to, and only limiting me to osteo ones? Thanks for your help.

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[PeepsLove]

Is that contractually obligated or is it strongly suggested like OUCOM staying in Ohio

 

[DrBowtie]

Solution: Dont do the bridge program.

 

[BinderClip]

I'm confused - If you are so worried about your chances at an Ortho residency, why would you choose to enter the PA to DO Bridge program?

Regardless, MD Ortho programs tend to be a reach for most DO students. The statistics generated by the NRMP support this (only 6 DO students matched into MD Ortho programs in 2013; usually, only 2 or so DO students match into MD Ortho programs). As of 2013, there were 693 spots available for MD Ortho. The math is simple - If you're interested in Ortho, you're most likely going to have greater success matching into a DO program.

Now, having someone in an influential position in a residency program may give you the edge to be one of the few, but you're going to have to weigh how important that program is and how much influence this physician has over the program director. Those are the factors you're going to want to first look into before committing to this Bridge program.

 

[hckyplyr]

I believe it is now contractually obligated. I heard they tried to impose this rule on the first bridge class, and they fought it tooth and nail, because it wasn't part of the original agreement, and they were able to repeal it. But for the current class, its a must.
It's not just as easy as the other guy who posted "Don't do the bridge program." If I have the opportunity to save a year of tuition, and get in the working world a year earlier (additional year of income), it's something to strongly consider. I just didn't know how significantly it would hurt me if I only have the opportunity to apply to DO residencies, since I haven't been through the match process before.

 

[DrBowtie]

I believe it is now contractually obligated. I heard they tried to impose this rule on the first bridge class, and they fought it tooth and nail, because it wasn't part of the original agreement, and they were able to repeal it. But for the current class, its a must.
It's not just as easy as the other guy who posted "Don't do the bridge program." If I have the opportunity to save a year of tuition, and get in the working world a year earlier (additional year of income), it's something to strongly consider. I just didn't know how significantly it would hurt me if I only have the opportunity to apply to DO residencies, since I haven't been through the match process before.

The point is short cuts come with consequences. Being restricted obviously removes the opportunity to use your contact.

Read more on the quality and locations of the DO residencies in the fields you want and make the value judgement if its worth it.

 

[pattr]

I don't really get it either...

But I will echo the sentiments above in that as a DO you have a much higher probability of matching ortho in the AOA match, so going this route would work out for you either way, if you decide on the bridge program or not.

If you would rather try to get into this specific ACGME ortho residency, then you should not do the bridge program so you will be eligible to apply for the ACGME match.

If you are really set on ortho, though, it actually behooves you in many aspects to do the bridge program (citing the reasons you've stated above in terms of saving a year of time and tuition), do well in school and take your chances in the AOA ortho match with a strong LOR/connection in your ortho surgeon friend.

Have you worked in ortho before? Why are you so interested in it? You're only a student now though... I guess I'm still confused.

 

[sylvanthus]

It was already a waste of time to do PA and then DO, taking another year to go through a normal DO program and keeping your options more open seems like a no brainer to me. I would not want to start medical school knowing I was limited right off the bat.

 

[sylvanthus]

Also, the above discussion specifically about ortho is premature since most people change their minds about specialty in medical school anyhow. Keep your options open.

 

[gators21]

It doesn't matter what you think you want to do, how much money you want to save, or less schooling you want to do. The program is a bridge program. This has clearly been outlined to you. You have no choice once YOU decide on the program. The program is for primary care. LECOM isn't forcing you to do anything
It's almost like saying that you don't like the the practice rights of being a PA, so can you just call yourself a Doctor? No, you are a PA. Is the AOA forcing you to be a PA? No. If you don't like it then too bad, you knew what you were signing up for/don't sign up for it.

 

[pattr]

OP, it really depends what you want.

After re-reading your original post, it seems you really don't know what you want to do, aside from something outside of primary care. So you're like most entering medical students.

In this case you should just weigh your options. In many cases, an AOA residency in surgical subspecialties such ortho will be much more obtainable than an ACGME. However, should you decide later on that you prefer gen surg, anesthesia, or EM then ACGME programs are much more "DO friendly" in these fields.

So I agree with sylvanthus and say you should go whatever route gives you the most options, which would seem to be the normal DO program. I also agree that LECOM isn't "forcing" you and that word isn't appropriate in this situation, because the bridge program was specifically set up to get more people into primary care and osteopathic residencies.

 

[Mosonik]

I don't know why someone hasn't mentioned this yet (unless my quick scan missed it) but your chances of matching ACGME ortho as a DO are statistically minimal. I wouldn't make any decision based on an assumption that you are/will be the exception to the rule before you even start your med education.
If i were in your shoes I would worry less about matching to an AOA vs ACGME program and more about getting into the position to compete for any spot in a cut-throat competitive field. Just my two cents

 

[Druggernaut]

I don't know anything about being forced to do an osteopathic residency (though if you're trying for ortho, you'll probably have to do that anyway unless your personal connection really comes through for you), but I've heard that there isn't much freedom in setting up your rotations in the PA-DO bridge program, as they're working with a condensed schedule. This creates a lot of anxiety when it comes to trying to get your LORs and do audition rotations. If I remember correctly, they don't give you as much time off to interview either.

There's a poster on here who's enrolled in that program now, so she'll probably chime in before too long, but that's something to think about. I don't think I'd be willing to shave off one year for these conditions. My classmate in this pathway is a rockstar, probably both because he's a smart guy and because he's already had "medical school lite" as a practicing PA, and while I'm sure he'll do well in whatever he chooses, I'm sure he could create a really stacked resume come residency application season if he was on the same schedule as the rest of us.

 

[hckyplyr]

Thank you to all that have answered so quickly. After reading all of the responses, it's quite obvious that I've made an elementary question seem very confusing, which I apologize for. What I should have said, is that I'm interested in specialties other than primary care (based off my PA rotations for the past 18 months). Some of these include general surg, anes, EM. Since 6 spots in the bridge program can apply to specialties, how much would I be hurting myself (from getting my desired residency standpoint) if I'm only allowed to apply to DO residencies?
As stated before, I understand not everyone gets the specialty of their choice, I just feared that if I am limited to only osteo residencies, I didn't know how much of a disadvantage I'd be putting myself at from the get go, if any at all. But as I thought, and from some responses, I will have many more doors open to me if I do not do the bridge, because I'll have the chance to apply to both residencies. I just fear not matching and being forced to scramble. So obviously I want to keep the most doors open I can. Again, thanks for the responses.

 

[cliquesh]

You'll be fine if you end up doing general surgery or emergency medicine. There were 135 general surgery spots offered last year and 231 EM spots.

There were, however, only 30 AOA anesthesia spots offered last year.


https://www.natmatch.com/aoairp/stats/2013prgstats.html here's a list of the total number of AOA spots.

Most DOs who do surgery of any sort (general surgery, ortho, urology, etc.) do AOA residencies. The only acgme surgical field that is remotely DO friendly is general surgery. 47 DOs matched Acgme general surgery this year.

It's unlikely, as a DO, you'd be able to match Acgme orthopedics, urology, ENT, neurosurgery, derm, or rad onc, so it wouldn't matter if you could apply to them anyway.

I personally wouldn't do the bridge program. It's realistic, as a DO, to go to a decent Acgme university based EM, anesthesia, or general surgery residency. Additionally, anesthesiology is very DO friendly, and it's not unrealistic to match at a top program.

 

[user3]

What is the status of the merger anyway?

 

[sonofva]

the word i got from high ups at my rotation site are "don't hold your breath on the merger."

they also passed down that they are looking to start a program in the DO world that would allow you to practice primary care after a 5 year combined medical school/residency. not even trolling (wish i was)...

 

[JRjcu08]

Thank you to all that have answered so quickly. After reading all of the responses, it's quite obvious that I've made an elementary question seem very confusing, which I apologize for. What I should have said, is that I'm interested in specialties other than primary care (based off my PA rotations for the past 18 months). Some of these include general surg, anes, EM. Since 6 spots in the bridge program can apply to specialties, how much would I be hurting myself (from getting my desired residency standpoint) if I'm only allowed to apply to DO residencies?
As stated before, I understand not everyone gets the specialty of their choice, I just feared that if I am limited to only osteo residencies, I didn't know how much of a disadvantage I'd be putting myself at from the get go, if any at all. But as I thought, and from some responses, I will have many more doors open to me if I do not do the bridge, because I'll have the chance to apply to both residencies. I just fear not matching and being forced to scramble. So obviously I want to keep the most doors open I can. Again, thanks for the responses.

I would add that your rotations in the PA-DO program will not really allow you to do many auditions, which are almost a requirement if you're applying AOA ortho, and if you're applying ACGME to something that competitive you for sure need to audtion (and don't bank on a connection). In APAP, you'll have a couple of enrichment rotations in primary care between MS1 and 2, but basically you will be starting rotations in July after MS2, and starting to apply for residency at the same time.

Another question I would have if I was a PD would be why you went straight from graduating PA to starting DO school, specifically in a bridge program for PA's? I was always under the impression that the APAP program was designed for PA's who were in practice, but desired more independence/professional growth, so were changing courses. For your specific case, I did meet a guy on rotations who matched this year to an AOA ortho program, and was previously a PA; but he went through a traditional 4-year DO program, and he had also practiced as a PA with an ortho office for a few years prior to med school.

 

[cliquesh]

the word i got from high ups at my rotation site are "don't hold your breath on the merger."

they also passed down that they are looking to start a program in the DO world that would allow you to practice primary care after a 5 year combined medical school/residency. not even trolling (wish i was)...

Those programs do exist in MD world, sort of. They are usually 6 years total, though.

 

[NYEMMED]

What is the status of the merger anyway?

On paper its on track for 2015... In reality, I dont think anyone could tell you for sure.

 

[Bacchus]

Are they requiring an AOA residency because you're not doing as much time at LECOM? How many years are you in the DO program? If you're doing a shortened schedule maybe they want you to enter their AOA programs because nowhere else will take a student who did a bridge program and shortened schedule?

 

[WDeagle]

Honestly I don't know that a program in anything other than primary care would be willing take someone who only did 3 years of med school anyway. Plus, when are you going to have time to do audition rotations?

 

[hckyplyr]

Are they requiring an AOA residency because you're not doing as much time at LECOM? How many years are you in the DO program? If you're doing a shortened schedule maybe they want you to enter their AOA programs because nowhere else will take a student who did a bridge program and shortened schedule?

Curriculum wise, everything is identical the first two years. However, the bridge students go on additional rotations when the other students have breaks. I do not know the full extent to this, but in the end, I don't think the traditional students end up doing many more rotations than the bridge students. But somehow, bridge students are waived from the 4th year rotations, because they are given credit for having done so many rotations as a PA/clinical hours over the years. I believe there is some time to audition, but honestly it all seems very crammed, considering the comlex/usmle, interviews, etc.
As others have stated, I too worry how favorably the student will be looked at when applying for residency, considering they did only 3 years opposed to the traditional 4. Which may even make it more difficult to match. As good as I initially thought this program may be (saving a year of tuition, working a year earlier), it seems like the negatives may outweigh the positives, and I may be better served by just doing the traditional route.

 

[group_theory]

I would add that your rotations in the PA-DO program will not really allow you to do many auditions, which are almost a requirement if you're applying AOA ortho, and if you're applying ACGME to something that competitive you for sure need to audtion (and don't bank on a connection). In APAP, you'll have a couple of enrichment rotations in primary care between MS1 and 2, but basically you will be starting rotations in July after MS2, and starting to apply for residency at the same time.

Another question I would have if I was a PD would be why you went straight from graduating PA to starting DO school, specifically in a bridge program for PA's? I was always under the impression that the APAP program was designed for PA's who were in practice, but desired more independence/professional growth, so were changing courses. For your specific case, I did meet a guy on rotations who matched this year to an AOA ortho program, and was previously a PA; but he went through a traditional 4-year DO program, and he had also practiced as a PA with an ortho office for a few years prior to med school.

Bingo!!!

Here's LECOM APAP Curriculum Overview

http://lecom.edu/college-medicine.php/APAP-Curriculum-Overview/49/2205/612/2788

ERAS opens in July

https://www.aamc.org/students/medstudents/eras/residency/343926/timeline.html

The AOA Match Service opens June/July

https://natmatch.com/aoairp/aboutdates.html


So basically by the time you start clinical rotation, and have just finished COMLEX 1, you will be getting your application together to apply for residency. If you do the bridge, the downside is ... you won't have any clinical rotation scores or grades. Your dean's letter (MSPE) will talk about your preclinical grades, but nothing about your clinical rotations (as a DO student, not as a PA student). Basically you will be applying without any significant core rotations to a competitive field (surgery, anesthesia, emergency medicine, ortho, etc). And if the program lets you apply to acgme residency - not only are you fighting an uphill battle (as a DO student), but you will be fighting an uphill battle without any relevant core rotations grade.

And you won't have any recent LOR from rotations.



Plus, you will be missing days on rotation for interviews. It will certainly affect your performance, or the perception of your performance (since you will be missing multiple days for your interviews on CORE rotations)


The bridge may let you graduate faster, but the logistics of applying for residency (AOA/ACGME) will be a nightmare (and partly why LECOM's APAP primary care pathway leads to LECOM primary care residency, or why NYU's proposed 3 year program lead to NYU residencies)

Being a former PA with real world experience may overcome some of the logistics that is working against you. But how much it may overcome will likely depend on individual circumstances.

 

[Banned]

Solution: Dont do the bridge program.

This. LECOM isn't forcing you to do anything. If you don't like it, don't apply. Just do the "extra" 1 year for the normal track. ROI, son. You get a huge return on that 1 year by being eligible for ACGME residencies. And 4th year is fun. Don't miss out.

 

[DrBowtie]

Bingo!!!

Here's LECOM APAP Curriculum Overview

http://lecom.edu/college-medicine.php/APAP-Curriculum-Overview/49/2205/612/2788

ERAS opens in July

https://www.aamc.org/students/medstudents/eras/residency/343926/timeline.html

The AOA Match Service opens June/July

https://natmatch.com/aoairp/aboutdates.html


So basically by the time you start clinical rotation, and have just finished COMLEX 1, you will be getting your application together to apply for residency. If you do the bridge, the downside is ... you won't have any clinical rotation scores or grades. Your dean's letter (MSPE) will talk about your preclinical grades, but nothing about your clinical rotations (as a DO student, not as a PA student). Basically you will be applying without any significant core rotations to a competitive field (surgery, anesthesia, emergency medicine, ortho, etc). And if the program lets you apply to acgme residency - not only are you fighting an uphill battle (as a DO student), but you will be fighting an uphill battle without any relevant core rotations grade.

And you won't have any recent LOR from rotations.



Plus, you will be missing days on rotation for interviews. It will certainly affect your performance, or the perception of your performance (since you will be missing multiple days for your interviews on CORE rotations)


The bridge may let you graduate faster, but the logistics of applying for residency (AOA/ACGME) will be a nightmare (and partly why LECOM's APAP primary care pathway leads to LECOM primary care residency, or why NYU's proposed 3 year program lead to NYU residencies)

Being a former PA with real world experience may overcome some of the logistics that is working against you. But how much it may overcome will likely depend on individual circumstances.

If he had experience, but he hasn't ever even worked as a PA, just clinical rotations.

 

[goldenroc]

What is the status of the merger anyway?

http://www.acgme.org/acgmeweb/Portals/0/PDFs/Nasca-Community/NascaLetterGMECommunityJune142013.pdf

 

[MLT2MT2DO]

This. LECOM isn't forcing you to do anything. If you don't like it, don't apply. Just do the "extra" 1 year for the normal track. ROI, son. You get a huge return on that 1 year by being eligible for ACGME residencies. And 4th year is fun. Don't miss out.

+1. Being a LECOM student and hating on many of the schools policies and rules, I have to ask "OP please don't take a positive thing the school does and turn it into a negative".

Your choices are:

#1: 3 year program as a PA, get into a DO residency in where you're obligated to go.
#2: Do a 4 year program and go where your boards/grades take you.

Another positive of LECOM if you pick #2, you'll only be paying the equivalent of 3 years tuition at a more expensive school (most other DO schools), over 4 years.

 

[notbobtrustme]

I believe it is now contractually obligated. I heard they tried to impose this rule on the first bridge class, and they fought it tooth and nail, because it wasn't part of the original agreement, and they were able to repeal it. But for the current class, its a must.
It's not just as easy as the other guy who posted "Don't do the bridge program." If I have the opportunity to save a year of tuition, and get in the working world a year earlier (additional year of income), it's something to strongly consider. I just didn't know how significantly it would hurt me if I only have the opportunity to apply to DO residencies, since I haven't been through the match process before.

penny-wise, pound-foolish

/thread

 

[DrWBD]

I'm surprised that this is even legal (forcing a graduate into an osteopathic residency).

 

[Textbookversion]

I'm surprised that this is even legal (forcing a graduate into an osteopathic residency).

You sign a contract... it's not like they are locking someone up and dropping them off at an AOA program. So, yes, it's legal.

The program saves you a year, but just like the program at NYU there is a trade-off by necessity. The whole reason 4th year exists is so that you can apply to residency with 3rd year grades. No 4th year = no practical way to apply places.

 

[SurgeDO]

heres the long and short of it:

i have a very close md ortho surgeon that is very high up in a specific residency program that i wanted to apply to, he said he would pretty much guarantee me a residency with them

LO-****ing-L

 

[dokmark]

Update
I know this thread is old and hasn't had any postings for over 2 years but wanted to provide an update
1) The requirement for the osteopathic residency has been removed for the last 2 years with the planned unification of residencies
2) There have been 2 years of graduates from this program with excellent residency matches. Residency directors recognize that PAs hit the ground running. According to an article in Academic Medicine - The Accelerated Physician Assistant Pathway: A Three-Year Medical School Curriculum for Physician Assistants to Obtain DO Degrees, they have 5.4 years of clinical experience before going to medical school. This puts them at a distinct advantage when it comes to applying to residencies. John Hopkins anesthesia sounds pretty powerful to me.