I've always heard that PMR was a DO friendly specialty, but I've also heard that you have way more opportunities in PMR as an MD. I'm applying to both MD and DO schools this summer, but I don't know which way to lean. I feel like the DO skillset would be good to have for PMR. Then again, plenty of MDs are in PMR and you all seem to do just fine. I know I'm a very hands-on kind of individual and I want to make extensive use of physical exams. What do you all think? Do PMR residencies stress being hands-on? Do you learn some OMM? Let me know, folks! I'm very interested in this field!
MD or DO for PMR?
- Thread starter DDX2k
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PM&R is indeed one of the most DO friendly specialties, if not THE most. Sure, there may still be a very, very, very slight bias of US MD > DO when applying to some allopathic PM&R residencies, all other things being equal. But when are all other things equal? Coming out of PM&R residency, when its time to look for fellowships or jobs, I think the base degree is less of an issue compared to where someone did their residency, and his/her actual performance during residency.
That said, in the off chance that you change your mind about specialties during med school (hey, it happens), you could consider that, in some allopathic programs in some other specialties, the MD may indeed be looked upon more favorably than the DO degree. Should it be? I don't think so. But it is what it is.
Good PM&R residency training should be hands-on. A kick-ass physiatrist should be able to perform a kick-ass physical exam, be adept with procedures, etc. You learn and perfect these skills by doing (with proper supervision and tutelage, of course), not so much by reading. Reading helps provide appropriate and meaningful context though. I imagine the same can be said for OMT. Now, as an MD, I did not learn any practical OMT techniques during med school or residency, although I did learn about the history and basic principles of OMM from my DO attendings and residency mates. OMT can be a nice additional treatment tool to have in your belt, and some of my DO colleagues do use it as part of their practice. But some dont. As you said, it is not mandatory to succeeding in PM&R.
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Part of it depends on the area of the country. In areas where there are osteopathic schools or hospitals, people are more aware of what a DO is. In other areas, people have no clue and think they are eye doctors or chiros. Everyone knows what an MD is.
Keep in mind a few things. First, you may change your mind and not go into PM&R. Few med students go in to the field they thought they would when they entered meds school. Although PM&R is DO-friendly, other fields may not be. It would be especially hard to go into a surgical specialty, and somewhat hard to go into a ROAD specialty.
Second, whichever school you go to will shape your approach to medicine. There is no research saying one is right, the other wrong. Just different approaches. Figure out which one gels with your values and beliefs better.
Last, IMHO, it depends more on who you are than what you are, when it comes to PM&R. We don't ccare as much where you got you degree, which degree you have, or your exact board scores. We want to know you are eager to go in to the field, and know what we do.
I am biased as a DO but I think that if you are thinking about choosing a field with a musculoskeletal focus then osteopathic training is definitely a good fit. The principles of structure and function (with respect to the musculoskeletal and neurological systems) are integral in PM&R training and fortunately taught from day one in DO school. OMM is a great skill set to have for anyone interested in musculoskeletal medicine whether it be ortho, family + sports medicine, etc. As a physiatrist, it's not taught in allopathic PM&R residency programs but I'm sure you could find an attending that could help further develop/maintain your skills. Personally, I use OMM for diagnosis primarily in residency but hope to incorporate more treatment when I'm finally practicing.
the truth is that you will have more opportunities and never regret graduating from a US allopathic med school. get into med school, but go allopathic if you have a choice--this statement has nothing to do with the training received but more with the status quo which is allopathic. check out any residency program at any location (other than a designated osteopathic program)...
BTW, i think you would be surprised at how many DOs are performing OMM in any specialty...
BTW, i think you would be surprised at how many DOs are performing OMM in any specialty...
DDX2K,
I personally chose the osteopathic route as I said before because it gave me the medical training along with the additional emphasis on musculoskeletal training. I did not even know about the field of PM&R when I applied and I'm very thankful for the osteopathic education I was given because it complements the field so well.
I would suggest shadowing an osteopathic physiatrist and a primary care specialty like family medicine, pediatrics, or internal medicine if you have the opportunity. I think that this will help you understand the value of osteopathic training in a broad spectrum.
I'm a proud DO and I've never had any regrets and it has never held me back in a professional goals...just my 2 cents.
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Everyone's experience is different. I have never perceived one iota of "discrimination" as a DO beyond the occasional, "what's a DO?" But, maybe people talk about me behind my back...I don't know. Having said all that, the type of medical degree is just one variable in the equation---consider cost, geography, clinical opportunities, research opportunities, etc. Also, your interests might change. The DO degree is a good fit for many specialties---not just PM&R. Go where to the school that offers you the best value for the time, $, and tears. If that happens to be a DO school, then great. You'll be fine with a degree from any US medical school--MD or DO.
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MD vs DO?
No difference since they changed the internship requirement thing- I think that was in the late 70's.
No difference since they changed the internship requirement thing- I think that was in the late 70's.
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It is great that you think you know what you want to do. That can change over the next few years. You may want to be a neurosurgeon when it is all said and done. MD will give you more options. Study like crazy for Step 1. Do well overall. Hopefully life will then take you where you want.
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I think the point is well made that an MD opens more doors for surgical spec. Some DO schools, esp the newer ones, may also be lacking in well organized clinical years. I went to an established DO school and specif. sought out strong OMT training. It is true that a minority of DOs use OMT but that will only make you more in demand if you do. With good OMM/DO training your MSK eval and PE skills will exceed your MD counterparts, at least upon entry to PMR residency.
Keep in mind that some PMR programs are run by staff who are Inpt attendings and are more concerned about your internal med skills that will save them phone calls backing you up.
When the health care system collaspses I look forward to my cash only OMT practice as a backup
Keep in mind that some PMR programs are run by staff who are Inpt attendings and are more concerned about your internal med skills that will save them phone calls backing you up.
When the health care system collaspses I look forward to my cash only OMT practice as a backup
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