Need info for my detractors

I always get a good chuckle reading opinions on this subject coming from pre-meds. And yet I find myself, not yet a DO student responding.... somehow admitting your double standards makes them okay.

To the point, I've shadowed with 6 DOs over the last 2 years. I've asked all of them this question. Most had never heard word one about DOs being inferior. One said, quite convicingly, that "only pre-meds worry about that stuff". The point was, most saw NO difference between the two.

A couple did talk about how sometimes they had patients that had questions about DOs. They also made it clear that their practices were strong and growing (these two had only been out of residency less than three years each). From the financial end of things, they were doing fine.

FYI, three of these DOs were in FM (one did a fellowship in Sports Medicine, and that was his focus). Two were pediatricians, and one had just finished an EM residency.

But take this advice for what it's worth. I obviously never got into the nitty gritty of how they were doing financially. But all were very positive about the prospects for future DOs. BTW, all of these people were from the western US, although I don't know if that makes much of a difference. Seems to me (and this is just an opinion gathered from what these physicians said) that the western states were pretty good ground for DOs just out of residency. This was due to the fact that the west has lots of areas of physician shortage, not too many medical schools, and a pretty laid back culture.

 

ToeJam,

Don't worry at all about the D.O. degree limiting your future opportunities. While my first 3 days of orientation have been boring, I am getting a strong message from the faculty and administration. They are already strongly emphasizing a very kind, holistic approach to medicine. They are really pushing mutual respect, "family", etc. I think it is pretty nice.

You'll do great.

 

There may be individuals out there with biases against D.O.'s. Some of these individuals might have powerful positions on residency committees, etc. But, as an organized phenomenon, there is really no "anti-D.O." conspiracy, at least none that I've encountered.

 

Being a DO student in my 4th year, doing the majority of my rotations with student from top-rated MD schools, I can safely say there is NO difference in the level of preparation between the two.

There is however a bias out there, in terms of allopathic program directors for residency. This is especially true in specialties like surgery, ophtho, derm, EM, rads, and ortho. While researching the fields I am interested in (surgery), I have been told basically flat-out by several people that no DO will do a residency at their institution. This is mostly true at the bigger name university hospitals, but some larger community hospitals as well.

While I am not saying it is impossible, it will take much more work, sweat, and most importantly shmoozing, to even be considered at some of these places. It will take higher grades, and board scores compared to the allopathic applicant as well.

 

There is perhaps, another type of bias. There is the bias AGAINST DO residencies. And in a way, I think I feel biased against them.

Here's why:

I am a DO in an MD residency. I feel quite good about the education that I am receiving. I know that I have protected didactics, thorough ACLS, PALS, ATLS, BLS training, skills labs, required journal club, required presentations, and many many patients to see in the large hospitals that I rotate to. I know that the RRC (residency review committee) oversees my program's certification ( and if they don't like what they see, they will shut it down). I realize there are checks and re-checks in the process.

But I always wonder, how the smaller DO hospitals with a Ka-jillion residencies are able to do the same...I sometimes worry about the looser guidelines. I know that some of my fellow residents feel the same way. I mean, the DO residents come to OUR didactics. That isn't a problem, but you gotta wonder "how do they get away with that for residency certification".

That in no way means osteopathic medical education is lacking...no way. But sometimes, I know there is a little voice in your head that says "now, do I trust that EM resident from that little bitty non-trauma designated hospital?"

This is a very candid response...and is not anti-anything. Rather, pro stricter guidelines and certifications. I am happy with my education, and the people that I graduated with were perhaps the most brilliant people I will ever have the luck to work with or study with.

 

As I understand it, there are two organizations that actively discriminate against the other profession: the national association of surgeons (from the MD world), and the American Osteopathic Association. Both of these organizations do a great job of keeping up the barriers between MDs and DOs.

I've been told by several that if you are a DO and you're going to apply to an ACGME surgical subspecialty, you better be damn good, and lucky to boot.

 

First of all, you have to be a damn good MD to get a ACGME surgical subspecialty also. There's plenty of decent DO surgical programs. It's a matter of perception of a program vs reality of a program, sometimes two different things.

As far as the AOA putting up barriers between MDs and DOs, I agree, they do practice this at times. However, it's done for a reason. The AMA constantly offers the AOA a seat in their House of Delegates. The AOA constantly turns it down. Why? Because the osteopathic medicine is not a subspecialty of the AMA! If DOs were to accept the seat, what's their reason for existence in general? DOs are more well rounded, and the public is slowly but surely going to the side of holistic care, in all specialties. We dont offer anything different to patients, we offer more to patients. Why should we align ourselves with a group of people who offer less? It aint a popularity contest, folks.

The number of DOs has doubled in 10 years. It's the quickest doubling rate for any medical professional grouping in history. However, these doctors are young. They are just starting to make their way up the professional ladder. Give it 10 years and you will see DOs in very high leadership positions in all of medicine. 10 years ago osteopathic medicine was classified as alternative by journals, textbooks, and insurance companies. Today it's considered mainstream. Why? Because in reality it's a more comprehensive training! Really! Whether your use OMT or not, learning the anatomy and mechanisms behind the treatments of these dysfunctions helps in every treating every disease process, whether it benefited by OMT or not. The position of the AOA is fine at present. They've made changes to relax requirements of the rotating internship, something that will bring more docs back to the AOA. They're tweaking the boards to better reflect the current climate of testing. They're starting to run massive ad campaigns to enlighten the public on the "best kept secret in medicine". The next step for DOs is to be published more often. The profession needs to dedicate itself to more benchwork, something that DOs historically have no patience for, as the profession is very patient oriented, not lab oriented.

All for now.