MD/DO Separate Matches

[TexPre-Med]

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As I understand it, M.D.'s and D.O.'s can have different matches. M.D.'s must match allopathically while D.O.'s can choose between osteopathic and allopathic residencies.

I'm not asking to debate the issue because this rule is obviously stupid.

I'm not saying that allopathic residencies should exclude osteopathic students. No wait. That is what I am saying if they are going to exclude allopathic students from osteopathic residencies. Either both should exclude or neither. It is perpetuating the incorrect stereotype that osteopathic students need their own match to compete with allopathic students while allopathic students are screwed out of opportunities. Lose/lose situation.

I am really not asking to debate this issue, but asking whether anyone has done anything to change the current status? I would think many allopathic and osteopathic students would be upset by this, but has anybody written letters, called congressmen, etc.? If so, who would you contact? What has been done? When did this go into effect? Thanks for your help.

 

[diosa428]

Allopathic students cannot match into osteopathic residencies because they have not had osteopathic training.

 

[TexPre-Med]

Allopathic students cannot match into osteopathic residencies because they have not had osteopathic training.

And exactly how much osteopathic training is there in anesthesia, EM, etc.?
Not much.

Few Osteopaths ever use OMM/OMT, so there is no excuse.
Allopathic residencies have just as much claim to say, you don't have M.D. after your name so you don't qualify.

It is all the same. Do you want a piece of fruit or a piece of fruit? An allopath or osteopath?

Still, I'd rather just know if anyone has ever cared enough to talk to someone of power about this. Rather than just argue opinions.

 

[diosa428]

And exactly how much osteopathic training is there in anesthesia, EM, etc.?
Not much.

Few Osteopaths ever use OMM/OMT, so there is no excuse.
Allopathic residencies have just as much claim to say, you don't have M.D. after your name so you don't qualify.

It is all the same. Do you want a piece of fruit or a piece of fruit? An allopath or osteopath?

Still, I'd rather just know if anyone has ever cared enough to talk to someone of power about this. Rather than just argue opinions.

😴

 

[San_Juan_Sun]

Perhaps you're under the assumption that the Matches are there for the students. They are not. They are in place to allow an equitable and orderly division of new interns to hospitals. And as long as there are unfilled allo- programs and plenty of DOs and FMGs around wanting to slave away within the system, the Match will exist, and it will include DOs/FMGs.

 

[shortbread9]

I think you are really opening up a can of worms...as a DO who is awaiting the match results on thursday...personally i feel you did not pick the best time to do so.
Id would like to know what makes you think so highly of yourself that you feel DO's are stealing away an MD's spot? On the contrary, i have worked as hard as the next person and my application just happens to be as competitive or more so than my fellow applicants. Unfortunately, osteopathic residency's for some specialities are not adequate in their training...this is the fault of the AOA and their lack of building strong programs...and b/c of this i dont feel DO students should get the brunt of these complaints. I do feel that the ostepathic world should accept allopathic students if they choose....but honestly would u really want that? even though most of those spots have nothing to do with using OMM...they are not strong programs.
You really need to realize as an MD student (if you are one) as long as you are an average student your application "could" be accepted by any MD program...in the sense that some programs wont even consider me b/c im a DO. So im alreayd at a disadvantage. overall....no one is trying to steal spots away from the md world...but we dont make the rules and as long as we can try and get a decent residency (after working our butss off like the rest) we surely deserve one.
It is people like you that make the discrimination stronger and until you really know what its like to be a medical student (you name says premed) and be more knoweledable on the osteopathic world an its one difference its not fair to put us down.

 

[sophiejane]

Do you have a desire to apply to osteopathic residencies? If so, you should have gone to an osteopathic school. But I really don't think that is what this is about.

Let's get to the heart of this...you are a first year student, correct? What are you thinking of going into? Is it something that you feel you will not be on a level playing field with DOs? Are you upset because DOs have spots in ENT, urology, neurology, optho, and derm that aren't open to MDs? If you are going into any other field besides those very competitive ones, there is no reason to think that DOs having a separate match would have any bearing on your future career plans whatsoever.

You have many, many residencies open to you as a future MD. You will very likely match in your chosen field, regardless of whether or not you have osteopathic residencies open to you, and regardless of the DOs you will be competing with for allopathic spots.

So relax, go study...worry about this in a few years. I'd venture that when it's your turn to match, you will care far less about this than you do now.

 

[TexPre-Med]

Yes, I am now a medical student.

I personally have NO problem with osteopaths. I am not worried about them "stealing" my spot in the match (when it comes).

If a residency is a residency, why is it not governed by the same group of people? We have this split b/w us, and I merely wanted to know if anyone had worked to change this.

Once again, thank you for turning this into a hate thread, and blaming me for everything. Your unkind remarks are well noted. I figured working to merge the 2 systems would benefit everyone. But no, go ahead and pull the disadvantaged D.O. card. So touchy.

Does anyone actually have facts as to why the 2 systems? Has anyone actually looked into this? Besides complaining or graciously reassuring my lovely behind, is anyone aware of past attempts to merge the 2 systems. Thank you in advance for your FACTS.

 

[msu_scutmonkey]

Yes, I am now a medical student.

I personally have NO problem with osteopaths. I am not worried about them "stealing" my spot in the match (when it comes).

If a residency is a residency, why is it not governed by the same group of people? We have this split b/w us, and I merely wanted to know if anyone had worked to change this.

Once again, thank you for turning this into a hate thread, and blaming me for everything. Your unkind remarks are well noted. I figured working to merge the 2 systems would benefit everyone. But no, go ahead and pull the disadvantaged D.O. card. So touchy.

Does anyone actually have facts as to why the 2 systems? Has anyone actually looked into this? Besides complaining or graciously reassuring my lovely behind, is anyone aware of past attempts to merge the 2 systems. Thank you in advance for your FACTS.

No I have done nothing to change this because as you will soon find out, the further you get in your education the less you will care about trivial issues like this. Instead you will care more about learning what you need to know so that you don't kill someone during internship/residency.

 

[TexPre-Med]

No I have done nothing to change this because as you will soon find out, the further you get in your education the less you will care about trivial issues like this. Instead you will care more about learning what you need to know so that you don't kill someone during internship/residency.

haha. Well noted. Pay less attention to politics, more attention to not killing patients.

 

[Faebinder]

I think TexPre-Med makes a good point and it is a problem that needs to be addressed if in the future DOs and MDs are to be made fully equal in terms of residency acquisition, cause lets be honest, it seems there are inequalities in residency acquisition (DOs dont get some allopathic residency and MDs dont get into all osteopathic residencies.)

 

[lsres]

I think you are really opening up a can of worms...as a DO who is awaiting the match results on thursday...personally i feel you did not pick the best time to do so.
Id would like to know what makes you think so highly of yourself that you feel DO's are stealing away an MD's spot? On the contrary, i have worked as hard as the next person and my application just happens to be as competitive or more so than my fellow applicants. Unfortunately, osteopathic residency's for some specialities are not adequate in their training...this is the fault of the AOA and their lack of building strong programs...and b/c of this i dont feel DO students should get the brunt of these complaints. I do feel that the ostepathic world should accept allopathic students if they choose....but honestly would u really want that? even though most of those spots have nothing to do with using OMM...they are not strong programs.
You really need to realize as an MD student (if you are one) as long as you are an average student your application "could" be accepted by any MD program...in the sense that some programs wont even consider me b/c im a DO. So im alreayd at a disadvantage. overall....no one is trying to steal spots away from the md world...but we dont make the rules and as long as we can try and get a decent residency (after working our butss off like the rest) we surely deserve one.
It is people like you that make the discrimination stronger and until you really know what its like to be a medical student (you name says premed) and be more knoweledable on the osteopathic world an its one difference its not fair to put us down.

Perhaps I am misunderstanding the situation but the Program Director of a D.O. Program in family medicine told me last week his program did not fill again and that the match for D.O.'s was before the M.D. match. He said that many D.O. family medicine positions go unfilled while D.O. students try to get into M.D. positions. Then those who do not match in an M.D. spot go back and try to get into the unfilled D.O. spots. But even after that there are unfilled primary care D.O. spots. While D.O.'s can take M.D. residencies M.D.'s cannot currently go into D.O. residencies becuase they do not have the training in manipulative therapy (which is the current arguement).

 

[sophiejane]

Does anyone actually have facts as to why the 2 systems? Has anyone actually looked into this? Besides complaining or graciously reassuring my lovely behind, is anyone aware of past attempts to merge the 2 systems. Thank you in advance for your FACTS.

Here are some facts for you.

Osteopathic students have been working hard within the AOA to get them to approve a combined match for several years now. I have spoken personally with the AOA president and tried to get somewhere with this. It's like talking to a brick wall.

The issue is very complex, and there are many reasons why the current AOA administration is against the combined match. But I can tell you the majority of osteopathic students are for it.

I personally agree with you--I think we should combine the matches. But I don't agree with you for the same reasons that you state. I hardly think that most allopathic students feel they are being "screwed" out of opportunities by not being able to apply to osteopathic residencies. Unfortunately, the quality of a number of osteopathic residencies have slid downhill in recent years, while more DO schools are being opened. It is a matter of great concern to most DO students, and something we debate regularly.

 

[Boxer1]

As I understand it, M.D.'s and D.O.'s can have different matches. M.D.'s must match allopathically while D.O.'s can choose between osteopathic and allopathic residencies.

I'm not asking to debate the issue because this rule is obviously stupid.

I'm not saying that allopathic residencies should exclude osteopathic students. No wait. That is what I am saying if they are going to exclude allopathic students from osteopathic residencies. Either both should exclude or neither. It is perpetuating the incorrect stereotype that osteopathic students need their own match to compete with allopathic students while allopathic students are screwed out of opportunities. Lose/lose situation.

I am really not asking to debate this issue, but asking whether anyone has done anything to change the current status? I would think many allopathic and osteopathic students would be upset by this, but has anybody written letters, called congressmen, etc.? If so, who would you contact? What has been done? When did this go into effect? Thanks for your help.

I was going to write a lengthy response but I'll let that go. It's complex. The problem can be circumvented by every residency program seeking dual accreditation from both the ACGME and the AOA. Because a minority of residency programs in the US have sought this option, the majority of program directors must prefer the current situation to the hassle of dual accreditation.

 

[shortbread9]

Its always funny when these threads pop up b/c I have yet to hear one MD student who is just dying for that osteopathic DO FP residency or an MD who really wants to do OMM.

Although I do think it would be kinda funny to watch MD students try to interview @ a competive osteopathic residency. Watching them study for the COMLEX and hearing program directors ask them "Why did you choose an MD school over a DO school?" or "Why didn't you take the comlex, I haven't really seen USMLE scores in a while so I just don't know how to inerpret them"

 

[sophiejane]

Its always funny when these threads pop up b/c I have yet to hear one MD student who is just dying for that osteopathic DO FP residency or an MD who really wants to do OMM.

My point exactly. That's why I think people who bring up this topic have other motivations, like those few extra coveted spots in competitive specialties that might open up to them in a combined match.

 

[NotAProgDirector]

Warning: This post is somewhat off topic.

I would like to disagree strongly with the post above that states that the match is for programs, not for students. The match has been around so long that few remember what life was like pre-match. Here's a true story:

GI fellowships recently entered the match. Several years ago, one of the top residents in my program (selected for a chief spot) was looking for a GI spot. There was no question in my mind that this guy was going to get a spot.

His first choice was our program -- he was established here, etc. Each year, GI applications were due earlier and earlier as programs tried to get the best residents to sign on. That year, applications were due in the PGY-1 year in many programs -- a full two years before a fellowship would be started. He went on his first interview in a neighboring state. Great program, top notch. He was driving home from the interview, and the PD called himon his cell to tell him they were offering him a spot:

Resident: "Great, I'll let you know when I decide what I want to do"

PD: "No, you misunderstand. I need an answer, now!"

Res: "Well, I really should talk about this with my wife."

PD: "Why don't you just call her on your cell phone, and then call me back?"

...time passes....

The PD finally agreed to hold the offer for 24 hours, and no longer.

The res returned, called the PD of the GI program here at home that night, explained the problem. He was unwilling to let a good slot go, for the chance of a slot elsewhere.

The GI PD here arranged for him to be interviewed the next day. Most interviews were not for a few weeks. They offered him a spot, he took it, called back the other program and turned it down. Sensing a "run on the bank", the GI PD also offered to someone else who had interviewed early, who accepted.

Our GI PD called all of the applicants scheduled for interviews and informed them that they had already filled all slots, and offered to pay for any cancellation fees for airfare, etc. This created a cascade of phone calls and panic as people tried to move interviews up, programs offered only to early applicants, etc.

The match is much better than the nightmare of exploding offers, earlier offer/application deadlines, and other problems in a "free for all" system. The history of the match is well documented in a JAMA article, admittedly written by the guy who came up with the algorithm.

Many anti-match commentators suggest that low resident salaries and poor working conditions are outgrowths of the match -- these issues are much more complicated. I don't argue that residents are underpaid (or conversely that they end up in way too much debt). And I agree that resident work hours are a problem, although shortening workhours significantly might require lengthening overall training time to compensate. I just don't see the match as the primary driver for these issues.

Although the match might not be perfect, I truly believe it is much better than the alternatives. Clearly, it's got some problems. Prematch offers to DO's, problems with the couples match and prelim spots, the length of time between ROL submission and match day are all areas that need work. Perhaps the drama of match day has gone over the top, also.

Anyway, good luck to everyone, student and PD alike, next week!

 

[polygonal]

Unfortunately, you are going to get some emotional responses to this question because as sophiejane said the reason people bring this up if often due to motivations other than curiosity about the history of the two matches.

Interestingly, I just had this conversation with some of my classmates a couple of days ago. Some of them are racial minorities and they drew parallels between being a DO and being a minority. I actually thought that was a pretty good analogy in many ways. We all want the same opportunities (in this case residencies) but there is also this desire to keep our uniqueness. I could draw many other parallels but I won’t for time’s sake.

The fact is that the government regulates the number of CMS funded residencies. The number of “allopathic” residency slots far exceeds the number of graduating US MDs. Either the slots go empty (bad for the hospitals, bad for patients) or they are filled with DOs or FMGs. I won’t comment on which is better for everyone.

All that said, I agree with you. I like internal consistency and I think the match should be joined. There are a lot of residencies that still emphasize OMM (yes, even radiology, I saw it this week) and I think that would have to be addressed somehow. Many of us have brought this up to the AOA through student resolutions and it is like banging your head against the wall. The old guard at the AOA opposes it for a variety of political, economic and probably emotional reasons. In the end, I really don’t think this will have any effect on you though. Like the minority parallel, the current system may seem unfair to you because it does increase our opportunities in some ways but there is still a bias against DOs at some places.

 

[drusso]

It cracks me up how some people think that are simple solutions to very, very old problems...

The reasons for the current system are grounded in the history of the "old system." When internships and residencies were started in the early 1920's, the AMA expressly forbade MD hospitals from hiring DO interns. So, DO's had to start their own training programs...

When WWII came around and MD's went to war, DO's were not allowed to serve, but hospital by-law committees started granting DO's hospital privileges to cover the MD's patients. They discovered that DO's could actually practice medicine! When, the MD's came back from war, they wanted to keep the DO's out of their hospitals, but the hospital administrators actually liked the DO's...but, most MD's would refuse to work at hospitals were DO's practiced.

After WWII, US government surveys were conducted and discovered that there was a HUGE shortage of hospitals in the US. The Hill-Burton Act was passed and DO's applied and received many grants and $$ to start osteopathic hospitals....http://en.wikipedia.org/wiki/Hill-Burton_Act

Well, the DO's applied to have their hospitals accredited by the old American Hospital Association (AHA) which was tight with the AMA. The AHA wouldn't accredit the new osteopathic hospitals...

So, the DO's started their own hospital accreditation agency and received "Deeming Authority" from the US government to accredit hospitals. This became the Health Facilities Accreditation Program...

https://www.do-online.org/index.cfm?PageID=edu_main&au=D&SubSubPageID=acc_hfmain&SubPageID=acc_main

Then, in the 1960's Lyndon Johnson passed the Social Security Act and Medicare. Part of this huge legislation package required that graduate medical education be funded through Medicare payments to hospitals accredited by either the old AHA or AOHA (the old name for HFAP). Hospitals make a lot of money of this indirect funding: Hospitals get paid approximately $120K per intern/resident for training them. They turn around and pay house-staff approximately $40K and absorb the rest for "medical education."

Then in the mid-2000's some students on SDN began thinking that the two kinds of residency programs/graduate medical education should be combined as there is really little difference in training between MD's and DO's these days...a good and idealistic idea, but what about all the competing interests that have developed over the last 60 years or so?? How are you going to satisfy *their* interests...

**Many hospitals are accredited by the HFAP program (both predominantly MD and predominantly DO). If you do away with HFAP what happens to them??

**Many community hospitals depend on the surplus money from Medicare Graduate Medical Education to fund services for under-served communities. What happens to them if you merge the two systems?? Some community hospitals will lose money. How will you compensate them??

**Many DO's feel that historically the old guard MD's weren't exactly "honorable" in their previous interactions with the DO community and prefer to have own federally-recognized "back-up" accreditation systems. How are you going to asuage them??

And it goes on and on...

My point is that what seems an "obvious" solution to someone on the "outside" is actually far more complex on the "inside." There is usually a considerable amount of money, power, or both at stake. These issues can be resolved, but they require the dedicated time, energy, and resources of many people to insure that all the stakeholders in the process are treated fairly.

I hope that TexPre-Med will dedicate a substantial portion of his or her career to cracking this nutt.
**

 

[doctor2wannabe1]

And exactly how much osteopathic training is there in anesthesia, EM, etc.?
Not much.

Few Osteopaths ever use OMM/OMT, so there is no excuse.
Allopathic residencies have just as much claim to say, you don't have M.D. after your name so you don't qualify.

It is all the same. Do you want a piece of fruit or a piece of fruit? An allopath or osteopath?

Still, I'd rather just know if anyone has ever cared enough to talk to someone of power about this. Rather than just argue opinions.

- huh i am really confused , does that me anesthesiologist must be a D.O.? or cana M.D.beacome an anesthesiologist

 

[Tired]

My point is that what seems an "obvious" solution to someone on the "outside" is actually far more complex on the "inside." There is usually a considerable amount of money, power, or both at stake. These issues can be resolved, but they require the dedicated time, energy, and resources of many people to insure that all the stakeholders in the process are treated fairly.

I hope that TexPre-Med will dedicate a substantial portion of his or her career to cracking this nutt.
**

The history in your post was fascinating. As an MD student I know next to nothing about DO's, either the history or current practice. Thank you for the post.

What bothers me every time this discussion comes up is that there is a general dismissal of MD student concerns about the perceived "unfairness" of the dual match system that cuts us out of some residencies while allowing the DO's in. Yes, MD students don't typically clamor for the FP slots, but certainly if the Ortho slots were open to us we would.

Despite the backhanded "you don't know anything" responses to the OP, I can't be the only person who notices how the DO posters here are quick to claim equivalence to the MD degree when it suits their purposes (residencies, ability to practice in surgical subspecialties, general medical knowledge and education), but then quickly turn around and claim to be distinct when it comes to issues that may affect their own bottom line (hospital funding, autonomy of the AOA).

 

[Winged Scapula]

- huh i am really confused , does that me anesthesiologist must be a D.O.? or cana M.D.beacome an anesthesiologist

Anesthesiologists can be either MD or DO; there are residency training programs in both allopathic and osteopathic hospitals. The post above was alluding to the fact that most DO anesthesiologists do not use the OMM taught to them during medical school and very little is taught during a DO residency.

 

[doctor2wannabe1]

i thought so,but you guys are smart

 

[drusso]

Despite the backhanded "you don't know anything" responses to the OP, I can't be the only person who notices how the DO posters here are quick to claim equivalence to the MD degree when it suits their purposes (residencies, ability to practice in surgical subspecialties, general medical knowledge and education), but then quickly turn around and claim to be distinct when it comes to issues that may affect their own bottom line (hospital funding, autonomy of the AOA).

That's probably pretty accurate. Like most things in life, it comes down to money, power, and turf. People who have a stake (financial, personal, or professional) pretty much don't want to cash in their chips even it aggravates other people. It's a complex issue. There's over 120 years of equity and investment in the osteopathic medical profession and any significant change is going to have to accomodate many competing agendas: The allopathic profession, the osteopathic profession, the US heath care system, insurance payors, patients, hospitals, students, etc.

Welcome to medicine.