Osteopathic General Surgery

[488677]

Fellow osteopathic medical students!


…ok so maybe I am not an osteopathic medical student yet, but as you can see by my username, I want to be!

In order to not feel completely inadequate to the 45/4.00 premedical students, I have done my best to stay away from these forums over the past four years. However, now that my future is at stake, I feel that it is time to give in and ask a couple of questions:

I have the scores and ECs that make me a qualified candidate for both allopathic and osteopathic medical schools.

With that being said, I have a firm conviction in the osteopathic philosophy and approach. Read Still’s book (although I do not know how relative it is to modern day osteopathy), shadowed DOs, and have received OMT--loved it! I think it’s the future of medicine, and I think it’s detrimental for a sustainable healthcare system. I could go on for hours about my excitement in osteopathic medicine. Bottom line: I would love nothing more than to be a DO.

Now here’s the kicker: I want to be a surgeon. I am thinking about pursuing a residency in general surgery or neurosurgery (depending on if my family still likes me/knows who I am) with the possibility of pursuing a fellowship after general surgery (again…depending if my wife and family still like me).

I know that legally DOs and MDs are equivalent in everyway and that they both have access to the same specialties. I also know 65% of DOs end up in primary care. There are fewer general surgery residencies available to DOs, and the high and mighty ACGME prefers their superior MDs over the DOs…even if you do kick their ass in the steps.

So I guess here are my questions:

1) How difficult is it to become a practicing surgeon as a DO compared to an MD?
2) Are you limited as an osteopathic surgeon to practice in a particular area?
3) As a recently certified osteopathic surgeon, is it difficult to receive referrals from the all-mighty MDs?
4) How much do osteopathic surgeons incorporate their osteopathic training (including OMT) into their practice?

I want to be a DO. I want to be a surgeon—whether it be through an AOA or AOA/ACGME residency (although I am open-minded for other specialties). I want to have few restrictions on where I can live and practice medicine when I am older.

These are my priorities. I would love to hear your thoughts.


Thanks, docs!


PS. I have read other threads on the issue of osteopathic surgery, but I haven’t been able to find the information I am seeking.

PPS. What's with all the hate on AOA general surgery residencies?

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[RM38]

It really isn't overly difficult to be a surgeon if you apply the DO route but there are a few issues depending on the field of surgery you want to go into. Just like in the ACGME, AOA programs vary greatly in quality and experience and where you wind up matching obviously will be one of the major determinates of your experience during training. You also need to know that while the AOA has residencies in various surgical fields, specialties like Urology, Neurosurgery, Opthalmology and ENT have very few spots available and are only found in several areas which you may or may not want to live in, and along with Ortho (which has a decent number of spots) are obviously very competitive. Gen Surg is also becoming more competitive (but doable even for an average/slightly below average applicant), but new programs have been opening at a decent rate recently so there should be a reasonable amount of opportunities in the future. The issue (especially w/ gen surg) is that if the proposal for AOA surgeons to not be allowed to do ACGME fellowships goes through, then you will be heavily limited in fellowship opportunities if you want to train beyond Gen Surg. There are several AOA fellowships in Critical Care, Vascular and Plastics, but there is only a few programs in each field. Going to an allopathic school would obviously allow you to completely avoid this issue. I am at an AOA Gen Surg program and I believe I am getting quality training. Our senoirs are very knowledgable and probably more skilled than the community allopathic program I rotated at as a student, so I really don't think I am getting inferior training. As far as research goes most AOA programs don't do a lot, so you would have more opportunity in the Allopathic world there. There are several AOA programs like Mercy Des Moines that do a decent amount of research though. I have also heard several programs are also trying to gain dual accreditation which would help avoid the problems with fellowships in the future. If you really like manipulation you may want to know that in surgery we never really use or talk about it (even at an AOA program), and it is just something we review for boards but rarely ever use (at least at my and all the programs I rotated at). Hope this helps.

 

[cabinbuilder]

1) How difficult is it to become a practicing surgeon as a DO compared to an MD? Difficulty gaining admission into prospective residencies about the same.

2) Are you limited as an osteopathic surgeon to practice in a particular area?No, why would you be? It's a free country
3) As a recently certified osteopathic surgeon, is it difficult to receive referrals from the all-mighty MDs?[No, we are all doctors, nobody cares about your initials. Only pre-med's do
PPS. What's with all the hate on AOA general surgery residencies?Lots of misconceptions amongs pre-meds in these forums. Bottom line usually you only attend one residency program whether DO or MD so NOBODY can tell you which is better because almost NOBODY has every attended both.If you want to be a surgeon, you will go where they take you and be happy you get to do what you want to do

 

[488677]

It really isn't overly difficult to be a surgeon if you apply the DO route but there are a few issues depending on the field of surgery you want to go into. Just like in the ACGME, AOA programs vary greatly in quality and experience and where you wind up matching obviously will be one of the major determinates of your experience during training. You also need to know that while the AOA has residencies in various surgical fields, specialties like Urology, Neurosurgery, Opthalmology and ENT have very few spots available and are only found in several areas which you may or may not want to live in, and along with Ortho (which has a decent number of spots) are obviously very competitive. Gen Surg is also becoming more competitive (but doable even for an average/slightly below average applicant), but new programs have been opening at a decent rate recently so there should be a reasonable amount of opportunities in the future. The issue (especially w/ gen surg) is that if the proposal for AOA surgeons to not be allowed to do ACGME fellowships goes through, then you will be heavily limited in fellowship opportunities if you want to train beyond Gen Surg. There are several AOA fellowships in Critical Care, Vascular and Plastics, but there is only a few programs in each field. Going to an allopathic school would obviously allow you to completely avoid this issue. I am at an AOA Gen Surg program and I believe I am getting quality training. Our senoirs are very knowledgable and probably more skilled than the community allopathic program I rotated at as a student, so I really don't think I am getting inferior training. As far as research goes most AOA programs don't do a lot, so you would have more opportunity in the Allopathic world there. There are several AOA programs like Mercy Des Moines that do a decent amount of research though. I have also heard several programs are also trying to gain dual accreditation which would help avoid the problems with fellowships in the future. If you really like manipulation you may want to know that in surgery we never really use or talk about it (even at an AOA program), and it is just something we review for boards but rarely ever use (at least at my and all the programs I rotated at). Hope this helps.

thanks for the insight.

i am glad you are liking your AOA residency, and it's definitely encouraging to get some positive feedback about an AOA residency.

i guess i am a little confused about what happens after your residency. where exactly do you apply for a job and how do you go about doing so? do you submit a resume' to the hospital/private practice? does your employer simply look at where you completed your residency and then decide whether or not to interview/hire you?

 

[488677]

1) How difficult is it to become a practicing surgeon as a DO compared to an MD? Difficulty gaining admission into prospective residencies about the same.

2) Are you limited as an osteopathic surgeon to practice in a particular area?No, why would you be? It's a free country
3) As a recently certified osteopathic surgeon, is it difficult to receive referrals from the all-mighty MDs?[No, we are all doctors, nobody cares about your initials. Only pre-med's do
PPS. What's with all the hate on AOA general surgery residencies?Lots of misconceptions amongs pre-meds in these forums. Bottom line usually you only attend one residency program whether DO or MD so NOBODY can tell you which is better because almost NOBODY has every attended both.If you want to be a surgeon, you will go where they take you and be happy you get to do what you want to do

ya know, i was really hoping somebody would say something like this. to be honest, this is what i always thought until i started reading this forum!

call me ignorant or naive, but i am really trying to understand why AOA residencies are considered the red-headed stepchild in the world of residencies on these forums? if you do not plan on doing a fellowship after residency, why wouldn't i want to apply to an AOA g-surg residency? why are ACGME residencies considered the "gold-standard" as someone else described them? not trying to be an ass--just trying to understand.

thanks guys; i know how much you probably hate pre-meds by now.

 

[dozitgetchahi]

ya know, i was really hoping somebody would say something like this. to be honest, this is what i always thought until i started reading this forum!

call me ignorant or naive, but i am really trying to understand why AOA residencies are considered the red-headed stepchild in the world of residencies on these forums? if you do not plan on doing a fellowship after residency, why wouldn't i want to apply to an AOA g-surg residency? why are ACGME residencies considered the "gold-standard" as someone else described them? not trying to be an ass--just trying to understand.

thanks guys; i know how much you probably hate pre-meds by now.

It's because the quality of AOA residencies varies even more widely then the quality of ACGME residencies and the worst AOA residencies are really, really bad.

http://forums.studentdoctor.net/showthread.php?t=812886

Read through this post for some gsurg-specific insight. A gsurg residency at a tiny hospital would result in mediocre (at best) training - and yet the AOA just stamped its approval on one in the last couple of years.