MD vs DO war

[UnderdogMD]

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Though I do agree with your signature, I must say this article demonstrates my point. People tend to do this:

-I had a bad experience with a specific DO rotation, internship, or residency, and had a better experience with my allopathic counterpart.
--> Everything DO is screwed up, this means all DO schools, rotations, internships and residencies are sub par to MD. Ergo, MD > DO

-I had a bad experience with a specific MD rotation, intership, or residency.
--> That one program must be bad, I will stay away from it specifically ... carry on.

Instead of evaluating DO stuff on a specific basis (like MD jazz), stuff like bad SDN posts or one person's experience tend to make everyone think that anything DO has to be inadequate.

I definitely understand the point you are making here. That weaknesses of certain DO programs are reflective of the whole field while weaknesses of certain MD programs are isolated incidents.

However, hypothetically speaking, if there was some way to evaluate the merits of all DO programs and compare them to all MD programs what do you think you would find?

On a whole, I would predict that you have a greater chance of running into certain inadequacies as a DO than as an MD. Is this point so hard to concede? This is different than saying all DO training sites are inferior or inadequate, or that DOs are in someway inferior or inadequate to MDs.

 

[JaggerPlate]

I have no beef with DOs but if everyone sits here like all is good, no one is served. It is good for applicants to be aware of possible problems and look into them.

I agree that a divide is not best for anyone. Personally I think that the two paths should integrate into one and fall under LCME accredidation standards. There really doesnt seem to be any reason other than traditon and foolish pride to keep the 2 separate. Furthermore since COCA doesnt seem to have anyone's interest in mind besides their own, this would improve the problems at some of the newer osteo medical schools.

Thank you for a civil and well spoken response. A few things about your post:

-I like that you said 'possible problems,' and to 'look into them.' It does serve an applicant well to know potential risks and to make decisions accordingly. However, it is not wise for applicants to assume that all DO schools suffer from these problems, and avoid Osteopathic Medicine as a whole (that is if they are interested in becoming a DO).

-I agree that the divide is not good ... but I think we differ on what we view as 'the divide.' I see the divide as MD and DOs in discussions such as this, where physicians are arguing amongst themselves instead of working towards the goal of health. However, the divide between the AOA and AMA and making everything LCME is definitely something for a different day. Truthfully, (and this will be quick) I know that people do have problems with the AOA looking out for them, but I also think some people like the idea of having more of an identity as a DO. The whole separate but equal thing just gets complicated, and different people have different opinions. I think this issue will continue to be addressed in the future, and I don't know if anyone can accurately guess what will happen.

 

[JaggerPlate]

I definitely understand the point you are making here. That weaknesses of certain DO programs are reflective of the whole field while weaknesses of certain MD programs are isolated incidents.

However, hypothetically speaking, if there was some way to evaluate the merits of all DO programs and compare them to all MD programs what do you think you would find?

On a whole, I would predict that you have a greater chance of running into certain inadequacies as a DO than as an MD. Is this point so hard to concede? This is different than saying all DO training sites are inferior or inadequate, or that DOs are in someway inferior or inadequate to MDs.

Very interesting point. The only problem that I potentially see with your idea of cumulatively comparing all MD vs DO programs is that there are somewhere around 130 American MD schools and 28 DO schools. It's hard to observe a true trend when comparing numbers that different. If you compared them all and found 10 'poor' MD programs and 10 'poor' DO programs, the numbers would appear to be equal, but obviously this demonstrates much more of a problem with DO schools.

I also think that many DO schools are quite new, and still trying to establish their roots. This also leads to many more MD schools being associated with bigger universities (ie. more money for big medical centers, research, etc etc), which creates quality rotation spots, and potentially no travel to complete these rotations.

Now, I know what you want me to say ... based on all this (no matter how much I try to build a case against it), it would seem that you are more likely to run into a problem as a DO student than an MD student?

However, I am not going to say this ... I am going to say that all the data is presented, I think I have been fair, and people should make up their own minds.

 

[Terpskins99]

I suggest you recheck your math.

I think you misunderstood what he was trying to say.

He's saying that up to 2/3rds of all osteopathic graduates end up in allopathic residencies. Thats actually true (well, last I checked it was more like 50/50). So if the ACGME decided to exclude DO's from entering their programs, about 1/2 the DO's would be out of luck for residency simply because the AOA doesn't have enough PGY-1 positions available for everyone. Its no secret that DO hospitals have been closing at a faster rate than MD hospitals over the past 20 years. Thats a fact.

Tired's observation about surgery is something I've seen as well. Surgery is old guard about everything, not just DO's. For example, many programs (even general surgery) are especially hostile towards foreign medical grads.

 

[notdeadyet]

He's saying that up to 2/3rds of all osteopathic graduates end up in allopathic residencies. Thats actually true (well, last I checked it was more like 50/50). So if the ACGME decided to exclude DO's from entering their programs, about 1/2 the DO's would be out of luck for residency simply because the AOA doesn't have enough PGY-1 positions available for everyone. Its no secret that DO hospitals have been closing at a faster rate than MD hospitals over the past 20 years. Thats a fact.

I'm curious to see what happens with the residency situation in the coming years as well.

We've increased MD school class enrollments over the past couple of years and there are plans to continue to do so. Yet there has been no significant increase in residency slots and I haven't yet heard of any plans to do so.

I think we'll see a squeeze on competitive residencies getting more competitive and more allopaths turning to primary care due to lack of options. I would imagine that this effect would be felt as strongly or more so by osteopathic graduates. I would also imagine that some IMGs would find themselves left out in the cold.

Or maybe someone will wave a wand and increase residency slots by 20% in the next year or two. But I haven't heard plans of this...

 

[Terpskins99]

I'm curious to see what happens with the residency situation in the coming years as well.

We've increased MD school class enrollments over the past couple of years and there are plans to continue to do so. Yet there has been no significant increase in residency slots and I haven't yet heard of any plans to do so.

I think we'll see a squeeze on competitive residencies getting more competitive and more allopaths turning to primary care due to lack of options. I would imagine that this effect would be felt as strongly or more so by osteopathic graduates. I would also imagine that some IMGs would find themselves left out in the cold.

Or maybe someone will wave a wand and increase residency slots by 20% in the next year or two. But I haven't heard plans of this...

Don't forget that there are a couple new US allopathic programs opening up as well.

I think the first people that will get hammered are FMG's coming from the caribbean islands. Legitimate FMG's will probably stay the same, since they had limited options to begin with and those rare few that have been matching competitive residencies will likely continue to do so (e.g. their board scores are so astronomically high that they're too good for some programs to pass up). The DO's will start feeling the squeeze as well, but most DO's go into primary care to begin with.

 

[Instatewaiter]

I have to say that I am quite surprised that this discussion remained so civil and in pre-allo no less.

 

[167649]

I'm curious to see what happens with the residency situation in the coming years as well.

We've increased MD school class enrollments over the past couple of years and there are plans to continue to do so. Yet there has been no significant increase in residency slots and I haven't yet heard of any plans to do so.

I think we'll see a squeeze on competitive residencies getting more competitive and more allopaths turning to primary care due to lack of options. I would imagine that this effect would be felt as strongly or more so by osteopathic graduates. I would also imagine that some IMGs would find themselves left out in the cold.

Or maybe someone will wave a wand and increase residency slots by 20% in the next year or two. But I haven't heard plans of this...

There are no plans to do so, and certainly with our economy in the shape it is any significant training expansion isn't going to happen soon. I think the squeeze will be more apparent on carribean/foreign students than DO graduates. It is clear they are already at the bottom of the pecking order in terms of the US allo match, and as such I think they will suffer first. Even with the increase in number or enrollment of MD/DO schools, there will still be plenty of training positions to fill for them, while generally foreign grads will have a much tougher time matching. Agreed though that the more competitive allo residencies are going to get even more competitive for MDs, let alone DO's trying to match in.

 

[Kate6058]

So, which DO schools have a home hospital and which use away rotation sites?

 

[notdeadyet]

So, which DO schools have a home hospital and which use away rotation sites?

If you're seriously interested, I'd recommend either posting on the osteopathic forums or you can do a quick look at the web pages of the 22 schools from the AOA site. DO schools that have their own hospitals will mention it in the section of the site about clerkships.

 

[JaggerPlate]

So, which DO schools have a home hospital and which use away rotation sites?

Like NotDeadYet said ... go over to pre osteo to get this information. Remember though that not having a 'home hospital' does not equate to bad rotation sites. Many older and extremely established (PCOM) do not actually have a home hospital, but still have no problem whatsoever with rotations. Ask specific questions about specific schools and you will receive solid answers on where would be best for YOU to attend if rotation sites are a concern for ya.

 

[travoltage]

i would love to read an article about the residency slots position...do you guys think there will be more residencies opening or at least slots due to higher volume of students?

 

[Instatewaiter]

not any time soon.

 

[pride4jc727]

Is there really a difference nowadays between allopaths and osteopaths? Correct me if I am wrong, but aren't they just the same physicians, but osteopaths learns some hand manipulation techniques? I hate divisions in medicine; rather, whether MD or DO we need to focus on what is really important: treating people and the conditions they have in an accurate and effective way, regardless of the degree initials at the end of our names.

 

[167649]

i would love to read an article about the residency slots position...do you guys think there will be more residencies opening or at least slots due to higher volume of students?

No. The absolute last thing most academic medical centers are going to do right now is expand training programs. Most are having enough financial trouble as it is.

What this means is that carribean/foreign students will have an increasingly hard time matching in. For US students (MD and DO), the more competitive specialties will become even more competitive, but since there is already a very large surplus of training spots per US grads, there will still be enough positions for them. It's the carribean that really gets slammed with this.

 

[JaggerPlate]

Is there really a difference nowadays between allopaths and osteopaths? Correct me if I am wrong, but aren't they just the same physicians, but osteopaths learns some hand manipulation techniques?

Correct. Both are fully licensed physicians that can practice in any field of medicine and surgery. DOs complete the same curriculum as their MD counterparts + additional training in Osteopathic Manipulation. I am actually unsure about how the curriculum differs between MD and DO (nor do I really want that issue to blow up) ... I've heard more bio chem for MD.

I hate divisions in medicine; rather, whether MD or DO we need to focus on what is really important: treating people and the conditions they have in an accurate and effective way, regardless of the degree initials at the end of our names.

This is the correct mindset ... but unfortunately is only obtainable in an ideal world. The division does no one any good, but there are various factors that keep it at least somewhat alive. I believe the division is shrinking all the time, but as for now ... there will be little tiffs, different mindsets concerning things, but the reality is that both are able to practice identical medicine (which is most important).

 

[Terpskins99]

i would love to read an article about the residency slots position...do you guys think there will be more residencies opening or at least slots due to higher volume of students?

They may certainly increase the number of residencies, but they'll do so based on what the market demands and not because of the number of students.

In any event, there's no immediate need to do so. Last year there were at least a thousand PGY-1 slots that remained available after the match.

 

[notdeadyet]

They may certainly increase the number of residencies, but they'll do so based on what the market demands and not because of the number of students.

In any event, there's no immediate need to do so. Last year there were at least a thousand PGY-1 slots that remained available after the match.

Correct. Expect all residencies to become more competitve in the coming years as med schools increase enrollments (and new schools open up) but residency slots do not expand to meet them.

Competitve residencies that had their choice of applicants will become more so. Somewhat competitive residencies will become more cuttroat, leaning more heavily on higher board scores, research background, and school reputation.

At less competitive residencies, expect desirable locations to fill up much faster.

The net of it will be the many residency slots that go unfilled will stop doing so. Folks who are not competitive will find themselves with fewer options.

 

[NobodyOwnsMeTHO]

There is no war "MD for life".........throws up weird finger gesture that forms md letters!

 

[JaggerPlate]

There is no war "MD for life".........throws up weird finger gesture that forms md letters!

you're a dork.

 

[NobodyOwnsMeTHO]

you're a dork.

Thanks JaggerPlate, I couldn't help myself 🙂

 

[Iquitos]

And these are the same kids who were arguing on a thread last week saying how little time they have as pre-meds and how stressful it is lol. Here's an idea, put down the US News rankings, use your "getting into medical school" hardcover book as a doorstop, and go out and have a drink.

Heck no, didn't you know that you don't stand a chance of being accepted if you don't have the US News ranking memorized? That's totally fare game in an interview. I was asked what school was ranked #17 in NIH funding. I attribute my acceptance soley to the abilty to answer that question correctly.

I think I went to a grand total of four classes my entire first 2 years of med school. Why would the teacher/student ratio matter?

Totally agree......Why go to class when you can study the notes on your own or listen to lecture MP3's on double speed if you find yourself losing sleep over not going to class.