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Ok deal.
MD vs DO
- Thread starter sacholiver
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I think the residency merge is reason enough to go MD over DO. At this time we don't know how the merge will affect DOS and in what tend of timeline. We do know that it won't hurt MDs.
L
LoveBeingHuman:)
Quick question: What if someone in a DO school chooses to take the USMLE and kicks *** on it? Like 240+
How much would that lower the damage of being a DO in regards to matching, given the merger? Assuming that the program in question is open to considering DO's?
How much would that lower the damage of being a DO in regards to matching, given the merger? Assuming that the program in question is open to considering DO's?
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I mean it only seems right that someone with a higher board score gets the spot over someone with a lower one, but I would bargain that isn't the case
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Board score is only one part of the whole application. Reputation of your school, research, clinical training in 3rd and 4th year, LOR from well known physicians, AOA are all important. It also happens to be that DO schools either don't have or severely lacking in all of these areas. So to answer your question, it's like instead of being 10ft behind the starting line to the race of residency you're now "only" 8 ft behind. It's unlikely that you will ever able to finish first in either scenarios. The damage is already done the day you take on the DO title.
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There's the rub.
To answer your question, your Step 1 score is one of the most important factors in getting an interview. In evaluating interviewed candidates, non-academic factors take over.
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The key point is this: Many many high end programs and even those at the mid-high level simply wont consider DOs. It just wont happen and this isnt just for the uber competitive fields like derm or ortho, there are tons and tons of programs even in less competitive fields such as IM that wont consider DOs. This is the point residents/attendings/MS4's are repeatedly trying to make; it's not just the top name programs that arent going to look at DOs.
Realistically, even a top DO is likely going to struggle to do better than a middle tier IM program while someone with that same 250+ Step 1 on the MD side of things has a much much higher chance at generating interest at some of the top IM programs, even if they are coming from a lower tier MD program.
So while you might not think your making a big assumption in saying "assuming a program will consider DOs" you are in many cases. And the merger wont really address this; in fact you could argue it will actually be a negative to DOs at least early on.
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Yet another DO I met on the interview trail said people at her school are actually discouraged from pursuing research and was surprised to find that research is required of everyone at my school.
Your board score is not the be-all end-all. Clinical grades, clinical evals, letters of rec are all extremely important as well. If you spent your IM rotation shadowing and never had patients assigned to you that you followed and made plans for, your evals aren't going to attest to things that you didn't do. Research and publications are always beneficial and in some specialties are expected or even required for an interview.
Step 1 gets your foot in the door, or it closes the door. After that, it's the rest of the application and the interview that really matters.
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DOs are inherently disadvantaged compared to MDs for many reasons that are already stated. However, I'm always curious as to the purpose of the COMLEX scores. Say you get a 250+ on USMLE and barely pass the COMLEX (or even fail the COMLEX). Would a crappy COMLEX score really hurt you in the end?
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Side note: I have to say that I'm pleasantly surprised at the continued respectful, productive discourse in this thread, when these threads typically devolve quickly. Keep it up! 🙂
A
AnatomyGrey12
It would depend on what programs you are applying to. ACGME programs couldn't give a crap about it most likely. For AOA you would be hosed. COMLEX scores matter to be able to graduate, for osteopathic residencies, and the ACGME programs who accept it and are DO friendly (mostly PC)
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What about if the merger already happened and AOA residencies are opened up to MD applicants? Will a poor COMLEX score still hurt the DO applicants for AOA residencies?
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It def would. The merger doesnt change what a program director wants in their program. If you do poorly on comlex its prob safe to assume you didnt take the usmle to risk failing.
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Im talking about the case of excelling the USMLE and winging/barely passing the COMLEX
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My school has neither promoted or discouraged research but def distances itself away from it because none of the tenured faculty are on active extramural grants. They have their seventh seed grant from the school with one lab assitant getting paid 7.65 an hour and perform their own research. The extent of their scholarly work going to posters that arent even presented at local or regional conferences. Whats good is this type of limbo is now being changed and we are hiring faculty who will perform much morre impacting work than..jaoa.
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If its an aoa program they will consider the comlex on equal if not higher regard. If its ACGME that has looked at uslme than tthat will be the premising factor.
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It isn't always the case. This guy scored 260 on Step 1, 276 on Step 2. He couldn't land a competitive residency. Granted he went to a carib school, so it's very different than DO, but it still stands that there's more to landing competitive residencies than board scores alone. It seems that the quality of the clinical training one receives in 3rd and 4th year is important. I've also heard there are some programs that will not look at DO applicants.
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This should help inject some objectivity into the discussion. In 2015, the match rate for allopathic seniors was ~94% and for osteopathic seniors was ~80%. The osteopathic rate has been on the rise since 2011.
http://www.nrmp.org/wp-content/uploads/2015/05/Main-Match-Results-and-Data-2015_final.pdf
http://www.nrmp.org/wp-content/uploads/2015/05/Main-Match-Results-and-Data-2015_final.pdf
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Good point. This is a cut-throat system.
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This is true. For some programs there is an ingrained fear that matching a DO or Carib graduate will diminish the quality of the applicant pool in subsequent years.
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Sounds like an institutional problem.
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My respectful opinion: Go to UI.
I recently completed the interview trail for general surgery. Not the most competitive field, but tougher to get a spot than FamMed, IM, EM, Anesthesia. I'm an average applicant from a good MD school and had plenty of interviews at a wide array of programs. The better programs I interviewed with had no DOs interviewing. In the programs that did invite DOs, all the osteopaths were exceptional candidates, top of their classes.
During several candid conversations with residency coordinators and program directors (I consider myself a young Upton Sinclair), they admitted that to invite a DO or FMG to interview, the individual's stats had to be significantly above an MD candidate. Some program directors simply filtered out all DO applications (apparently a function on the program's ERAS system). Foreign trained graduates often get filtered out too.
I don't think DOs make worse physicians, and I don't think a strong bias against the degree is fair. I don't know anything about LMU. But I am 100% certain that there still exists a strong bias against DOs when it comes to achieving a desired residency. What if you fall in love with ENT third year? Or radiation oncology? Or want to do EM in a highly desirable location? You are setting yourself up for an unneeded uphill battle.
Some poster also stated, "yeah, but what if you get a 260..." We all thought we were special snowflakes coming in to medical school. Achieving a 260 is incredibly rare. That is top 5% at my school, and our USMLEs are consistently above the national mean. Even getting a 240 is a huge accomplishment.
You also need to rethink the "making a change" angle. I see the appeal of being at a new program open to change. However, you will not be in a position to make changes. You have never practiced medicine, and therefore don't really know what types of experience/curriculum will produce the optimal physician. Even as a 4th year now I'm only just beginning to catch glimpses of what parts of medical school were foundational vs. worthless. And I change my opinion on this a lot.
Good luck on your decision.
I recently completed the interview trail for general surgery. Not the most competitive field, but tougher to get a spot than FamMed, IM, EM, Anesthesia. I'm an average applicant from a good MD school and had plenty of interviews at a wide array of programs. The better programs I interviewed with had no DOs interviewing. In the programs that did invite DOs, all the osteopaths were exceptional candidates, top of their classes.
During several candid conversations with residency coordinators and program directors (I consider myself a young Upton Sinclair), they admitted that to invite a DO or FMG to interview, the individual's stats had to be significantly above an MD candidate. Some program directors simply filtered out all DO applications (apparently a function on the program's ERAS system). Foreign trained graduates often get filtered out too.
I don't think DOs make worse physicians, and I don't think a strong bias against the degree is fair. I don't know anything about LMU. But I am 100% certain that there still exists a strong bias against DOs when it comes to achieving a desired residency. What if you fall in love with ENT third year? Or radiation oncology? Or want to do EM in a highly desirable location? You are setting yourself up for an unneeded uphill battle.
Some poster also stated, "yeah, but what if you get a 260..." We all thought we were special snowflakes coming in to medical school. Achieving a 260 is incredibly rare. That is top 5% at my school, and our USMLEs are consistently above the national mean. Even getting a 240 is a huge accomplishment.
You also need to rethink the "making a change" angle. I see the appeal of being at a new program open to change. However, you will not be in a position to make changes. You have never practiced medicine, and therefore don't really know what types of experience/curriculum will produce the optimal physician. Even as a 4th year now I'm only just beginning to catch glimpses of what parts of medical school were foundational vs. worthless. And I change my opinion on this a lot.
Good luck on your decision.
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A perfectly legitimate concern, in my opinion. A large part of perception about the strength of a residency program is based on the current resident credentials. It's also logical to assume that the quality of the people you'll work alongside based on their institution. I'm sure many students feel like me where not only I want to be taught by great faculty but also learn alongside with the best students. Both combine together will make the learning experience much more beneficial. Just want to elaborate on this statement a bit.
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Not necessarily. Residency programs are a bit like stock pickers, they have to develop a strategy that works for the time and place. Some will take the best people they can land, regardless of medical school (a value investing mindset), others will not.
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DOs have a great chance of getting a residency. I don't think anyone was argued otherwise in this thread. That should continue to be the case as FMGs are squeezed out of spots.
What people here are saying is that MDs have a better chance at getting any specific ACGME residency, especially in a selective speciality or elite program.
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Plus, even within programs there are disagreements and conflicts about who should be chosen. My own program was an almost comical example of such.
Of course if you want to have to answer a lot of awkward questions, try not filling one year.
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I totally agree. I just want to add that students who are more qualified for whatever reason most likely choose to go to an MD school. If for no other factor, that alone should make the acceptance rate for MD seniors higher.
