M.D. Vs. D.O. for Ortho Residency

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M.D. Vs. D.O. for Ortho Residency. Which would be more well-rounded Orthopaedic Surgeons?

  • M.D.

    Votes: 48 55.8%
  • D.O.

    Votes: 38 44.2%

  • Total voters
    86

OrthoVukes

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I want to be an orthopaedic Surgeon, but I've been told by many that being a D.O. or an M.D. has their pros and cons for specializing in orthopaedic surgery from those paths. So tell me, what do you think would overall be the better pathway?

From what I've heard, because of the specialty in musculoskeletal system manipulation from D.O.'s, it would be better if D.O. doctors become orthopaedic surgeons vs. being an ortho surgeon from the M.D. path because of the intuitive sense and better understanding of the musculoskeletal functions as well as better recognition of anatomy for D.O.'s

There is a poll, please use it.

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I want to be an orthopaedic Surgeon, but I've been told by many that being a D.O. or an M.D. has their pros and cons for specializing in orthopaedic surgery from those paths. So tell me, what do you think would overall be the better pathway?

From what I've heard, because of the specialty in musculoskeletal system manipulation from D.O.'s, it would be better if D.O. doctors become orthopaedic surgeons vs. being an ortho surgeon from the M.D. path because of the intuitive sense and better understanding of the musculoskeletal functions and anatomy practice with D.O.s.

There is a poll, please use it.

Your poll ignores too many factors that should go into this decision. You can't just base it on better understanding of musculoskeletal anatomy and functional relationships. You have to consider what type of orthopedics you'd like to practice: general? sports? spine? shoulder? hand? You also have to consider what type of program you're seeking: rural? community? university system based?

You'll have to be a top 20% student minimum on both sides DO or MD. Even higher on the MD side most likely for the prestigious university based residencies. You'll more than likely have to do research to get to those upper tier residencies on the MD side, while DO residencies are very much about personality and fit, board scores/grades/research will only get you so far on the DO side. I'm sure it's quite similar on the MD side.

MD overall will give you more opportunities for connections/research/access to academic institution based residencies and for rotations during 3rd/4th year. You'll have to put in more work on the DO to get those same opportunities and connections.

DO will undoubtedly give you an upper hand when it comes anatomy and the functional relationships of the body, but that's not going to score your residency for you.

Overall MD, but don't take the ortho path lightly, you will have to be an extraordinary student inside and outside the classroom for both MD and DO.
 
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You'll probably change your mind many times re: which specialty you want to enter. The best answer is try to get into the best medical school for you and do your best when you get there.

There are lots of DOs and MDs in orthopedics.
 
One of our Deans (a DO) was an Orthopod.

A cousin of mine is an MD Orthopod. He once told me that that it's all "pins and plaster, with power tools."

I want to be an orthopaedic Surgeon, but I've been told by many that being a D.O. or an M.D. has their pros and cons for specializing in orthopaedic surgery from those paths. So tell me, what do you think would overall be the better pathway?

From what I've heard, because of the specialty in musculoskeletal system manipulation from D.O.'s, it would be better if D.O. doctors become orthopaedic surgeons vs. being an ortho surgeon from the M.D. path because of the intuitive sense and better understanding of the musculoskeletal functions as well as better recognition of anatomy for D.O.'s

There is a poll, please use it.
 
Either one is fine. I suggest doing a rotation at a teaching hospital with some orthopedic residents before making this decision. I worked at a Orthopaedic residency and it seem like it sucked to me. I mean, you have to LOVE orthopaedics to make it through there cause you will be in surgery every single weekend and most weekdays. The guys who make it are crazy about trauma, and bones and are just generally crazy for wanting to do surgery that much. They never missed a single holiday (i.e. they did surgery on every one of them).

But some folks love it. Make sure your one of them before you commit tho.
 
I'm not sure you understand what orthopaedic surgeons do.
 
If you want Ortho its better to go MD. Ortho is possible as a DO. Either route is going to require you to kill the boards (Step 1 250+ Step 2 250+), pursue lots of research, be actively involved with med school organizations, get excellent letters of rec, audition well, etc...
 
If you want Ortho its better to go MD. Ortho is possible as a DO. Either route is going to require you to kill the boards (Step 1 250+ Step 2 250+), pursue lots of research, be actively involved with med school organizations, get excellent letters of rec, audition well, etc...

In 2014, 52% and 72% of USMDs applying to ortho with scores between 220-230 matched and scores between 231-240, respectively, matched.
 
Your poll ignores too many factors that should go into this decision. You can't just base it on better understanding of musculoskeletal anatomy and functional relationships. You have to consider what type of orthopedics you'd like to practice: general? sports? spine? shoulder? hand? You also have to consider what type of program you're seeking: rural? community? university system based?

You'll have to be a top 20% student minimum on both sides DO or MD. Even higher on the MD side most likely for the prestigious university based residencies. You'll more than likely have to do research to get to those upper tier residencies on the MD side, while DO residencies are very much about personality and fit, board scores/grades/research will only get you so far on the DO side. I'm sure it's quite similar on the MD side.

That statement is just wrong. While you typically do have to have a decent class rank (top 1/3 to 40%) you definitely don't need to be in the top 20% to land ortho. Heck, we have a current 4th year who is in the bottom quarter of the class and matched ortho at a decent program. From what I've gathered, MD prefers you to have a higher class rank and solid boards. For DO, class rank doesn't matter nearly as much but you've got to get strong boards.

However, the thing both types of programs want are people that are a) going to be a solid fit with the rest of the team and b) going to be willing to come in at 6 am and stay until 7 or 8 every day and almost constantly be on call. Ortho programs want to see commitment. Period. They need decent boards and class rank to know you're competent, but the LORs from preceptors saying you're the first one in and last one out and are always willing to do the work are the things that really impress the programs. Or so I've been told by our deans and 95% of the 12+ orthos I've shadowed.

Either one is fine. I suggest doing a rotation at a teaching hospital with some orthopedic residents before making this decision. I worked at a Orthopaedic residency and it seem like it sucked to me. I mean, you have to LOVE orthopaedics to make it through there cause you will be in surgery every single weekend and most weekdays. The guys who make it are crazy about trauma, and bones and are just generally crazy for wanting to do surgery that much. They never missed a single holiday (i.e. they did surgery on every one of them).

But some folks love it. Make sure your one of them before you commit tho.

That's a bit of an exaggeration. The residency programs I've looked at give you between 12 and 20 vacation days/year and people can definitely take holidays off. The hospital/clinic still needs to be staffed on holidays though, so not everyone can get every holiday off. You also don't have to be in there every single weekend. The few residents I talked to said they rotate, so they work one weekend then take call for 2 weekends. Some weekends they didn't have to go in at all, some weekends call sucked. That's true for anyone on call though. It is a rough lifestyle for residency compared to a lot of other fields though. Especially ones like PM&R or Psych where 50 hour work weeks with minimal call aren't uncommon.

If you want Ortho its better to go MD. Ortho is possible as a DO. Either route is going to require you to kill the boards (Step 1 250+ Step 2 250+), pursue lots of research, be actively involved with med school organizations, get excellent letters of rec, audition well, etc...

@cliquesh already got this one, but to add another stat, ~245 was the average step 1 score for MD students that matched ortho in 2014. That means half of them were below 245. You don't need all those things to match ortho, but they certainly help. You'll always need solid letters and evidence that you're gung-ho about ortho (willing to work your ass off as previously stated), however the other stuff is much more variable. If you kill boards and class rank (i.e. top 10% with 260) then the other stuff like research, ECs, etc. becomes less necessary. If you're in that more average range (top 35ish% with a 245ish step 1), then you'll need the research, pubs, relevant ECs, etc. to help give your app the boost to land an interview.


Everyone on SDN seems to think that things are much more cut and dry than they really are. You don't have to hit some specific magical board score or class rank to get into programs (usually), but you do have to provide an application that proves you are a strong candidate for that program.
 
That statement is just wrong. While you typically do have to have a decent class rank (top 1/3 to 40%) you definitely don't need to be in the top 20% to land ortho. Heck, we have a current 4th year who is in the bottom quarter of the class and matched ortho at a decent program. From what I've gathered, MD prefers you to have a higher class rank and solid boards. For DO, class rank doesn't matter nearly as much but you've got to get strong boards.

However, the thing both types of programs want are people that are a) going to be a solid fit with the rest of the team and b) going to be willing to come in at 6 am and stay until 7 or 8 every day and almost constantly be on call. Ortho programs want to see commitment. Period. They need decent boards and class rank to know you're competent, but the LORs from preceptors saying you're the first one in and last one out and are always willing to do the work are the things that really impress the programs. Or so I've been told by our deans and 95% of the 12+ orthos I've shadowed.



That's a bit of an exaggeration. The residency programs I've looked at give you between 12 and 20 vacation days/year and people can definitely take holidays off. The hospital/clinic still needs to be staffed on holidays though, so not everyone can get every holiday off. You also don't have to be in there every single weekend. The few residents I talked to said they rotate, so they work one weekend then take call for 2 weekends. Some weekends they didn't have to go in at all, some weekends call sucked. That's true for anyone on call though. It is a rough lifestyle for residency compared to a lot of other fields though. Especially ones like PM&R or Psych where 50 hour work weeks with minimal call aren't uncommon.



@cliquesh already got this one, but to add another stat, ~245 was the average step 1 score for MD students that matched ortho in 2014. That means half of them were below 245. You don't need all those things to match ortho, but they certainly help. You'll always need solid letters and evidence that you're gung-ho about ortho (willing to work your ass off as previously stated), however the other stuff is much more variable. If you kill boards and class rank (i.e. top 10% with 260) then the other stuff like research, ECs, etc. becomes less necessary. If you're in that more average range (top 35ish% with a 245ish step 1), then you'll need the research, pubs, relevant ECs, etc. to help give your app the boost to land an interview.


Everyone on SDN seems to think that things are much more cut and dry than they really are. You don't have to hit some specific magical board score or class rank to get into programs (usually), but you do have to provide an application that proves you are a strong candidate for that program.

n=1 isn't a good support for that argument, but okay.

My argument is you're not doing yourself any favors by being lower than top quarter when applying for any competitive specialty. Ortho isn't getting any less competitive, people are needing a little more to stand out for higher tier programs, so if you want to make your road to Ortho a little easier, being in the top quarter will only help, but being in the bottom half to bottom quarter is definitely going to be questioned and viewed as a red flag. So no, my statement isn't wrong.
 
n=1 isn't a good support for that argument, but okay.

My argument is you're not doing yourself any favors by being lower than top quarter when applying for any competitive specialty. Ortho isn't getting any less competitive, people are needing a little more to stand out for higher tier programs, so if you want to make your road to Ortho a little easier, being in the top quarter will only help, but being in the bottom half to bottom quarter is definitely going to be questioned and viewed as a red flag. So no, my statement isn't wrong.

^^^ I totally agree with this statement, though for DO you really just need to hit top 40% or so to be realistically competitive for AOA. Your previous statement was "You'll have to be a top 20% student minimum on both sides DO or MD", which is absolutely wrong.

Obviously the better your rank/boards/whatever, the better your chances will be. I didn't say someone shooting for ortho shouldn't aspire to be top 10% in their class or to hit a 260, I just said it's possible to match if you don't. Also, I never said anything about strong vs. weak programs. If you want to end up at a top 10-20 program, then yes, you'll need to be well above average in boards and class rank. If you just want to match ortho then you don't need that. Even with the top programs, the cutoffs still aren't as ridiculous as people would think. Our dean ended up sitting next to head of Rush U's ortho program (a top 10 program) on a flight and they talked about residency. He asked if there was a specific score or class rank they use as a cutoff for people they interview. The director said they rarely interview people with a step 1 below 240 (I think he said they interviewed 2 people in the past 3 years with scores below that), and they didn't have a set class rank, though they preferred interviewees to be in the top quarter. That's from the director of a top tier ortho program, so I'd imagine mid to low-tier programs would be less stringent, especially considering the statistics cliquesh posted.

I realize that my example was n=1, and I personally will not be shooting for ortho if I'm not in at least the top half of my class. However, I've talked to my fair share of orthos (I used to work for a group with about 150 of them in it) and many of them were not in the top 25% of their class. Granted some of them graduated in a time where you could pretty much just walk into whatever specialty you wanted after med school, but many of them were also more recent grads. I just disagree with generalized blanket statements that convey messages along the lines of "don't apply to this specialty unless you can hit these exact statistics"...
 
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Fact: Most ortho programs are currently ACGME.
Fact: If you go to medical school, by the time you graduate and in the absence of any major change in course, all ortho programs will be ACGME.
Fact: In the 2014 NRMP Program Director Survey (at this link on page 73), only 27% of ACGME ortho PD's indicated that they typically interview and rank DO's.

Make no mistake - you can get an ortho spot if you go DO, but you are absolutely fighting an uphill battle against discrimination. You can hope that this will somehow, magically change in the next few years but I wouldn't hang my hat on it if I were you.
 
That's a bit of an exaggeration. The residency programs I've looked at give you between 12 and 20 vacation days/year and people can definitely take holidays off. The hospital/clinic still needs to be staffed on holidays though, so not everyone can get every holiday off. You also don't have to be in there every single weekend. The few residents I talked to said they rotate, so they work one weekend then take call for 2 weekends. Some weekends they didn't have to go in at all, some weekends call sucked. That's true for anyone on call though. It is a rough lifestyle for residency compared to a lot of other fields though. Especially ones like PM&R or Psych where 50 hour work weeks with minimal call.
Maybe alittle but not much. It was my personal experience when I was there. Now granted, any surgery specialty has a lot of call and weekends. But at the particular residency I was at, which was a level 1 trauma, they worked all the time. There was a point were I did every sunday and the same attending/residents were always there running 3 flip rooms going crazy. I believe they will all be excellent orthopaedic surgeons, but the residency was brutal IMO. And they were there thanksgiving and Christmas, just like I was. I am sure they had vacation days, but some places dont really encourage their use, and it didnt seem like they ever did.

Now on the flip side I did a ACLS renewal class with a 5th year who was gonna graduate soon. I mentioned his attending as being crazy busy and working them like crazy. He replied that the attending was a really good friend and he was a little sad to be leaving even tho it was so busy. That probably tells you more about the residency than anything else IMO. Yeah you are down in the crap hole, but your there together, and a certain camraderie develops that you just wont get outside of the hospital IMO.
 
Fact: Most ortho programs are currently ACGME.
Fact: If you go to medical school, by the time you graduate and in the absence of any major change in course, all ortho programs will be ACGME.
Fact: In the 2014 NRMP Program Director Survey (at this link on page 73), only 27% of ACGME ortho PD's indicated that they typically interview and rank DO's.

Make no mistake - you can get an ortho spot if you go DO, but you are absolutely fighting an uphill battle against discrimination. You can hope that this will somehow, magically change in the next few years but I wouldn't hang my hat on it if I were you.

More people need to read and understand this. Going ortho as a DO is not a practical move. You'll end up working extremely hard at a HUGE risk.
 
More people need to read and understand this. Going ortho as a DO is not a practical move. You'll end up working extremely hard at a HUGE risk.
There are also DO Orthopaedic Residencies tho. Just because they are merging doesn't mean they will suddenly not consider DO's anymore (in fact, due to their Osteopathic focus, I would bet one would have a very hard time getting in as an MD to a former AOA Orthopaedic residency). 2014 ACGME does not equal 2020 ACGME with the AOA residencies rolled in.
 
Maybe alittle but not much. It was my personal experience when I was there. Now granted, any surgery specialty has a lot of call and weekends. But at the particular residency I was at, which was a level 1 trauma, they worked all the time. There was a point were I did every sunday and the same attending/residents were always there running 3 flip rooms going crazy. I believe they will all be excellent orthopaedic surgeons, but the residency was brutal IMO. And they were there thanksgiving and Christmas, just like I was. I am sure they had vacation days, but some places dont really encourage their use, and it didnt seem like they ever did.

Now on the flip side I did a ACLS renewal class with a 5th year who was gonna graduate soon. I mentioned his attending as being crazy busy and working them like crazy. He replied that the attending was a really good friend and he was a little sad to be leaving even tho it was so busy. That probably tells you more about the residency than anything else IMO. Yeah you are down in the crap hole, but your there together, and a certain camaraderie develops that you just wont get outside of the hospital IMO.

Keep in mind that's a level 1 trauma center. Their program is going to be more rigorous than at many other hospitals. They will also be more likely to get better funding because of it and see cases they wouldn't see elsewhere, so they may very well end up being much better physicians in the long run. Any ortho residency is going to be more difficult/intense than most other fields, but I don't think it's too common to be at a program where you literally get no holidays off and work every single weekend without getting days off during the week.

Fact: Most ortho programs are currently ACGME.
Fact: If you go to medical school, by the time you graduate and in the absence of any major change in course, all ortho programs will be ACGME.
Fact: In the 2014 NRMP Program Director Survey (at this link on page 73), only 27% of ACGME ortho PD's indicated that they typically interview and rank DO's.

Make no mistake - you can get an ortho spot if you go DO, but you are absolutely fighting an uphill battle against discrimination. You can hope that this will somehow, magically change in the next few years but I wouldn't hang my hat on it if I were you.

Source? Unless you're saying that everything will be ACGME because AOA programs will have the same accreditation after the merger then Idk where you would get that idea.

I've tried to find a complete list of all the AOA ortho programs, but the only thing I've been able to find is state by state breakdowns, and I don't feel like going through 40 some lists to count all the programs and slots available. If anyone can find that list/information it would be awesome. I did find this though:

http://data.aacom.org/media/DO_GME_match_2012.pdf

According to this, in 2012 there were 160 people who listed ortho as their first choice and 92 people matched for 94 spots. 2 spots went unfilled. Those odds aren't bad. They're not as good as the MD odds, but I'd still be happy going in with them. Also, any DO fights an uphill battle when trying to specialize or enter an ACGME program, that's just how it is right now.
 
Source? Unless you're saying that everything will be ACGME because AOA programs will have the same accreditation after the merger
I am saying that all programs will be ACGME precisely because all programs will be ACGME. There will be no AOA programs after the takeover, which will be complete by 2020.
This is useful information for people applying now. It would be inappropriate to assume that this information would be relevant in 2020 and beyond.
 
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I am saying that all programs will be ACGME precisely because all programs will be ACGME. There will be no AOA programs after the takeover, which will be complete by 2020.

Fair enough

This is useful information for people applying now. It would be inappropriate to assume that this information would be relevant in 2020 and beyond.

That's true assuming that the unified match starts in 2020. I doubt things will change too much until there is one match, but once there is I would expect there to be some major changes.
 
I am saying that all programs will be ACGME precisely because all programs will be ACGME. There will be no AOA programs after the takeover, which will be complete by 2020.
This is useful information for people applying now. It would be inappropriate to assume that this information would be relevant in 2020 and beyond.



Wait so there won't be AOA ortho residencies???? Won't DOs get screwed if they want ortho then.

Can someone explain this further pls. This merger is troubling.
 
I want to be an orthopaedic Surgeon, but I've been told by many that being a D.O. or an M.D. has their pros and cons for specializing in orthopaedic surgery from those paths. So tell me, what do you think would overall be the better pathway?

From what I've heard, because of the specialty in musculoskeletal system manipulation from D.O.'s, it would be better if D.O. doctors become orthopaedic surgeons vs. being an ortho surgeon from the M.D. path because of the intuitive sense and better understanding of the musculoskeletal functions as well as better recognition of anatomy for D.O.'s

There is a poll, please use it.

If you want to become an Orthopedic Surgeon, going to an MD school will be a big advantage over a DO school by a very wide margin. Most Orthopedic Surgery residencies are ACGME and its hard for a DO to get into these residencies.
 
Wait so there won't be AOA ortho residencies???
Correct.
Won't DOs get screwed if they want ortho then.
Possibly. But many people hope (and some believe) that won't happen. These people are counting on current ACGME programs to accept more DOs to completely offset the loss of AOA positions from the GME transition. I have some doubts that this will happen but only time can really tell, assuming that the involved parties keep good statistics of DO matches to specific specialties such as orthopedic surgery before and after the merger.
 
Wait so there won't be AOA ortho residencies???? Won't DOs get screwed if they want ortho then.

Can someone explain this further pls. This merger is troubling.

Even after the merger, for imminent future (think next decade), it will still maintain the status quo. PDs accepting MDs will continue to do so and PDs who's been accepting DOs won't suddenly change his mind and flip back...This goes the same for DO PDs...it goes both way, not one way street. If the said program applies for an osteopathic focus, it will be even harder for MDs because they will have to be OMM competent.

As for the futures head (think decades), nobody knows for sure but if anything, AOA&AACOM being 28% of the ACGME's governing body has to mean something.
 
Wait so there won't be AOA ortho residencies???? Won't DOs get screwed if they want ortho then.

Can someone explain this further pls. This merger is troubling.

Due to the merger, AOA will not accredit programs anymore so by default all AOA residency will be under ACGME, most (not all) former AOA programs will have an osteopathic focus. So this will mean that physicians with osteopathic training will be preferred over non-osteopathic students.

I maybe wrong but I remember reading a thread about how in the future, they are planning to offer osteopathic training to MD students that want to apply to osteopathic-focused programs so they can be competent in OMM before starting.

Obviously, the # of MD's willing to learn OMM will be low but in theory they will be able to learn OMM if they want.
 
PDs accepting MDs will continue to do so and PDs who's been accepting DOs won't suddenly change his mind and flip back...This goes the same for DO PDs...it goes both way, not one way street. .
This is not entirely true. Here is a classic example - https://www.mercydesmoines.org/Portals/0/media/documents/residencydocuments/2015-2016 GS Program.pdf
Mercy General Surgery program in Iowa was a one of the top AOA programs and it is now ACGME accredited. Notice how first year class is all MD? Many of these places are going to interview the best candidates that they think they can get. They will not decline to rank applicants and risk going unmatched just to stay loyal to the DO schools.
If the said program applies for an osteopathic focus, it will be even harder for MDs because they will have to be OMM competent.
Doesn't matter for ortho programs. Ortho applicants (MDs) will crush any requirement in order to match ortho. You'll see these ppl will complete an OMM rotation or whatever the osteopathic focus is, just so they can match in ortho. Furthermore, many orthopods I know completed a fellowship right after residency, so you can bet that MDs will jump to current AOA ortho programs. Matching to ortho will be a major problem for DO applicants in near future.
 
You are seriously underestimating the hoops people will jump through to get their dream specialty.

I wasn't referring to MD applying ortho, just in general. IMO, the average MD student will not learn OMM just to have a better chance at a small number of programs when there are dozens of programs in their desired field that don't have an osteopathic emphasis.
 
When will AOA ortho programs switch over to participating in the MD match? As soon as they get accredited, or will they still be in the DO match until 2020?
 
When will AOA ortho programs switch over to participating in the MD match? As soon as they get accredited, or will they still be in the DO match until 2020?

If they are seeking to continue the program, to meet the deadline 2020, all 5 year AOA residencies have to apply for ACGME accreditation starting this year.

This is not entirely true. Here is a classic example - https://www.mercydesmoines.org/Portals/0/media/documents/residencydocuments/2015-2016 GS Program.pdf
Mercy General Surgery program in Iowa was a one of the top AOA programs and it is now ACGME accredited. Notice how first year class is all MD? Many of these places are going to interview the best candidates that they think they can get. They will not decline to rank applicants and risk going unmatched just to stay loyal to the DO schools.

Doesn't matter for ortho programs. Ortho applicants (MDs) will crush any requirement in order to match ortho. You'll see these ppl will complete an OMM rotation or whatever the osteopathic focus is, just so they can match in ortho. Furthermore, many orthopods I know completed a fellowship right after residency, so you can bet that MDs will jump to current AOA ortho programs. Matching to ortho will be a major problem for DO applicants in near future.

The said program's PD is an MD.
 
If they are seeking to continue the program, to meet the deadline 2020, all 5 year AOA residencies have to apply for ACGME accreditation starting.
Does that mean they will switch over to the MD match once they apply for accreditation or only once they are accredited? Essentially, for those matching in 2019, will all ortho positions only be through the MD match?
 
Does that mean they will switch over to the MD match once they apply for accreditation or only once they are accredited? Essentially, for those matching in 2019, will all ortho positions only be through the MD match?
Pretty much. Most programs aren't even bothering to apply for osteopathic recognition.
 
Nobody knows what will happen.

Get into med school first.

/thread.
 
At the end of the day going ortho is very difficult whether you are a MD or DO. Yes MD is the more preferable if you are looking to specialize in something super competative, but don't think that the MD will allow you to just waltz into an ortho residency. Those guys really earn their matches either way.
 
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