Penalize ACGME programs that refuse to interview/rank DOs

[Tozanzibarbymotorcar]

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I believe that there should be a penalty for ACGME programs that consistently refuse to interview DOs OR rank them . Programs should also not be allowed to screen DOs out in ERAS. The same goes for former AOA programs. Thoughts?

*added rank

 

[AnatomyGrey12]

No. They can choose not to interview us. I agree they shouldn't be allowed to simply screen us out anymore now that residencies are merged, but they have every right to interview, or not interview, who they want.

It's unfortunate but the reality is that we are viewed as having gone to second tier medical schools. That's part of our resume now. The only way to change that perception is to better our product and show that we really aren't second tier, and are just as good as USMD schools with our training. Unfortunately the AOA is hellbent on not doing anything of the sort and continuing to perpetuate the reputation that DO schools have lower standards, worse clinical training, and teach pseudoscience by ignoring the fact that cranial and chapman's points (and others) have zero scientific backing yet are still on our BOARD EXAM, and continuing this extreme proliferation of crappy schools. If you want someone to blame then blame the AOA, what they are doing is criminal and they are running our profession into the ground.

 

[trs88]

I disagree. I'd rather they not invite me out for an interview if they have no intention of ranking me, just to fulfill an interview quota so they don't get penalized. That's just a waste of my time, money and hope if I really liked the program.

 

[Dr.Bruh]

I disagree. I'd rather they not invite me out for an interview if they have no intention of ranking me, just to fulfill an interview quota so they don't get penalized. That's just a waste of my time, money and hope if I really liked the program.

This. I know a DO in ACGME Derm and he rotated at an ACGMe place, they loved him, interviewed him, then said they couldn’t rank him bc he was a DO. He said it was such a waste of time, money, in effort. So i would argue that if they aren’t gunna rank us bc we are DOs fine, but tell us up front and don’t steal our time and money.

 

[Tozanzibarbymotorcar]

just edited my post to add ranking DOs. Does this change your thoughts here?

 

[Chibucks15]

just edited my post to add ranking DOs. Does this change your thoughts here?

There’s no way to enforce these “penalties”. With how many applicants are at the places that do ‘discriminate’ The odds are that the DO has a weaker application. You see the most anti-DO at the super specialties and at ivory tower places...who attract the smartest in the world.

Any PD could just make up a myriad of reasons as to why the DO wasn’t ranked and there would be no way to prove otherwise.

This isn’t at you personally but just saying That’s the thing I don’t get...if people go into medical school wanting to do anything but the DO friendly specialties, fix yourself and go MD. Don’t complain about lack of opportunity when you (should have) known what you’re signing up for

 

[arc5005]

Do DO's not prove themselves in the workplace afterwards, or after residency, does it still seem like DO's are subpar in training compared to MD counterparts??? Isn't this really based on residency training? A DO and MD trained at the same residency, will likely have similar skills?

 

[Chibucks15]

Do DO's not prove themselves in the workplace afterwards, or after residency, does it still seem like DO's are subpar in training compared to MD counterparts??? Isn't this really based on residency training? A DO and MD trained at the same residency, will likely have similar skills?

it isn't residency...its the clinical acumen coming into residency. Which is a problem at some of the newer schools. The bias will fade eventually but it'll take a long long time at the ivory tower run by these old guys who were around before DOs were legit doctors

 

[AlbinoHawk DO]

It would seem worse if they interview DOs that spend $500 on travel just to be rejected anyway. Now if we forced them to take DOs because now DOs own 25% of ACGME that's a conversation starter

 

[Chibucks15]

It would seem worse if they interview DOs that spend $500 on travel just to be rejected anyway. Now if we forced them to take DOs because now DOs own 25% of ACGME that's a conversation starter

Then it becomes the Rooney Rule in the NFL where you have to interview at least one minority candidate for coaching positions. Teams just go through the motions, even if that guy has no shot.

 

[libertyyne]

So you want affirmative action for DO students?

Fix your schools .
1.Generate research opportunities for DO students.
2.Create Home residency programs specialties other than family practice.
3.Stop having the mission of creating PCPs.
4.Take STEP
5.Ensure that your students get good clinical rotations and advising.
6. End your fetish with OMM , dont be surprised when a plastics PDs DGAF about your chapman point training.

When do students have resumes equivalent to their MD peers they tend to match like their peers from md schools. There are still systemic problems with home programs etc, but those problems are the same when you go to an MD school without a home program you are interested in.

or you know you could just push for DO schools to become MD schools and have to same LCME standards so PDs cant discriminate. But how many schools would close and how many would shrink class sizes?

 

[Lawpy]

No. They can choose not to interview us. I agree they shouldn't be allowed to simply screen us out anymore now that residencies are merged, but they have every right to interview, or not interview, who they want.

It's unfortunate but the reality is that we are viewed as having gone to second tier medical schools. That's part of our resume now. The only way to change that perception is to better our product and show that we really aren't second tier, and are just as good as USMD schools with our training. Unfortunately the AOA is hellbent on not doing anything of the sort and continuing to perpetuate the reputation that DO schools have lower standards, worse clinical training, and teach pseudoscience by ignoring the fact that cranial and chapman's points (and others) have zero scientific backing yet are still on our BOARD EXAM, and continuing this extreme proliferation of crappy schools. If you want someone to blame then blame the AOA, what they are doing is criminal and they are running our profession into the ground.

This is the best answer 👍

 

[Goro]

No. They can choose not to interview us. I agree they shouldn't be allowed to simply screen us out anymore now that residencies are merged, but they have every right to interview, or not interview, who they want.

It's unfortunate but the reality is that we are viewed as having gone to second tier medical schools. That's part of our resume now. The only way to change that perception is to better our product and show that we really aren't second tier, and are just as good as USMD schools with our training. Unfortunately the AOA is hellbent on not doing anything of the sort and continuing to perpetuate the reputation that DO schools have lower standards, worse clinical training, and teach pseudoscience by ignoring the fact that cranial and chapman's points (and others) have zero scientific backing yet are still on our BOARD EXAM, and continuing this extreme proliferation of crappy schools. If you want someone to blame then blame the AOA, what they are doing is criminal and they are running our profession into the ground.

Blame COCA more for allowing DO schools to have crappy rotations, for allowing them to expand before they have even gotten own acts together as a school.

 

[shadowlightfox]

Blame COCA more for allowing DO schools to have crappy rotations, for allowing them to expand before they have even gotten own acts together as a school.

Wait, I thought COCA are the people you WANT to contact if things are not run properly, and AOA are the ones that are screwing everything up.

 

[Goro]

Wait, I thought COCA are the people you WANT to contact if things are not run properly, and AOA are the ones that are screwing everything up.

COCA is the accrediting body for the COMs. They are seemingly OK with the status quo, which is NOT OK. LMU, for one should have never been allowed to expand to Knoxville, or LECOM to Elmira

 

[AnatomyGrey12]

COCA is an arm of the AOA.

 

[atomheart]

The screening process has little to do with perceptions, and everything to do with arbitrarily making the applicant pool manageable. While there is some evidence that regional screening is useful (applicants are most likely to rank their regional programs due to family), the second component of applicant ranking--prestige--actually creates a larger need for screening within prestigious programs. Therefore it is the most prestigious programs that tend to screen DOs, and prestigious specialties that forego DOs altogether.

I don't believe changing the perception of DOs will change their screening, especially as many LCME schools are perceived equally poorly in terms of rotations and education. I don't believe programs should be punished for a specific type of screening either. Regional screening can be even more detrimental to DOs, and gets almost no press attention; an entire state (>5 residencies) ignored my application despite doing an away and getting letters there. The entire screening and interview process is dehumanizing, and changes applicants into numbers and ranking probabilities. Then how should applicants be ranked? An ever more nuanced discussion.

Honestly, the next logical step needs to be osteopathic programs forming their own ACGME residencies, or merging with existing LCME medical school programs to become feeders...a complicated topic, since large urban space (patient complexity) is unfairly meted to existing LCME programs, and hospitals in very rural areas would have difficulty meeting ACGME requirements in specialties other than FM. Overall COCA needs to drop it's focus on primary care and adapt to the modern medical training landscape.

 

[WedgeDawg]

Are you talking like MGH (where there are plenty of top 10 med school applicants with 260+ steps, all or nearly all Hs, and papers in top 5 journals that routinely don't get interviewed) or are you talking like community programs that for some reason just don't look at DOs?

I have very different responses based on what you mean.

 

[Tozanzibarbymotorcar]

Are you talking like MGH (where there are plenty of top 10 med school applicants with 260+ steps, all or nearly all Hs, and papers in top 5 journals that routinely don't get interviewed) or are you talking like community programs that for some reason just don't look at DOs?

I have very different responses based on what you mean.

All

 

[deleted610572]

What would your argument be for those programs that are also declining American citizens that study abroad, either Caribbean or elsewhere?

I agree that people shouldn’t go to these programs due to predatory practices, but those students who make it out the other side are just as qualified as DOs. Those applicants are screened even more heavily than us.

 

[WedgeDawg]

All

So you think that MGH should be penalized for not taking DOs? Do you know the caliber of students that MGH generally takes and, perhaps even more shockingly, does not even see fit to interview?

 

[TheRealCookieMonster]

There’s no way to enforce these “penalties”.

While I believe any program should be allowed to accept or decline an applicant for any reason, your statement is false. History proves over and over that laws or rules or penalties or whatever can absolutely be enforced even if the original mandate seems vague. There simply needs to be a willingness to enforce them from some organization/individual who has societal leverage. Affirmative action is an example as libertyyne already stated.

how many schools would close and how many would shrink class sizes?

There are easily more capable students than spots even now. Class sizes wouldn't shrink at all. And if properly funded DO schools would grow to meet standards. And that's really the issue, poor funding for medical training is what opened the door for DOs in the first place. If the fed or someone else with money made medical education a high priority we wouldn't need DOs or even as many mid levels for that matter.

 

[AnatomyGrey12]

There are easily more capable students than spots even now. Class sizes wouldn't shrink at all. And if properly funded DO schools would grow to meet standards. And that's really the issue, poor funding for medical training is what opened the door for DOs in the first place. If the fed or someone else with money made medical education a high priority we wouldn't need DOs or even as many mid levels for that matter.

No. If DO schools were mandated to meet LCME requirements more than a few would instantly shut down and every school, except maybe the state schools or PCOM, would need to drastically cut class sizes.

 

[libertyyne]

What would your argument be for those programs that are also declining American citizens that study abroad, either Caribbean or elsewhere?

I agree that people shouldn’t go to these programs due to predatory practices, but those students who make it out the other side are just as qualified as DOs. Those applicants are screened even more heavily than us.

This whole thread reminds me of this gem of an article.
Why U.S. Healthcare System Needs More Foreign Medical Grads, As Told By A Millennial Med Student | HuffPost

 

[deleted610572]

This whole thread reminds me of this gem of an article.
Why U.S. Healthcare System Needs More Foreign Medical Grads, As Told By A Millennial Med Student | HuffPost

Yes I agree. It’s crazy to me that DO students shout about affirmative action but then turn their noses up at American IMGs. Meh, best man for the job and most of the times it’s not us. The world turns, life goes on.

 

[sval]

This whole thread reminds me of this gem of an article.
Why U.S. Healthcare System Needs More Foreign Medical Grads, As Told By A Millennial Med Student | HuffPost

then we need to be treated equally as students whom attends a U.S. medical school

>whom attends
stopped reading right there

 

[libertyyne]

>whom attends
stopped reading right there

The writer was also an english major at what some would consider an amazing UG too.

 

[TheRealCookieMonster]

No. If DO schools were mandated to meet LCME requirements more than a few would instantly shut down and every school, except maybe the state schools or PCOM, would need to drastically cut class sizes.

Nothing happens instantly, especially in the medical/political world... the rest is just based on funding. If they got the money, class sizes would not shrink. When MD schools get extra state money they grow class sizes. There are more applicants than spots and enough jobs to keep thing growing.

 

[libertyyne]

Nothing happens instantly, especially in the medical/political world... the rest is just based on funding. If they got the money, class sizes would not shrink. When MD schools get extra state money they grow class sizes. There are more applicants than spots and enough jobs to keep thing growing.

you seem to not understand. LCME mandates class sizes based on resources and access to clinical rotation sites that meet their criteria. Funding for medical education will not overnight create Teritiary hospitals attached to the DO schools.

 

[libertyyne]

I mean, there are a plethora of US MD schools with ginormous class sizes

yes, a handful of MD schools have large class sizes, However look at the clinical rotation sites attached to those schools as well. and the research facilities as well as residency home programs.

 

[FourniersGreenGang]

The writer was also an english major at what some would consider an amazing UG too.

Lol was this her?? The wizard of the wards, what a gem.

 

[TheRealCookieMonster]

overnight

Ah, I see. You're right every DO school would close for sure. Class sizes would probably shrink to zero.
In the event that this process happened in our world over the course of several years, I maintain my argument. Schools would adjust, the LCME would ease them in, standards might change, some school would fail, but for the most part schools would continue to grow. The supply is there and the chances of classes shrinking is about as likely as a medical schools closing all together.

 

[libertyyne]

Ah, I see. You're right every DO school would close for sure. Class sizes would probably shrink to zero.
In the event that this process happened in our world over the course of several years, I maintain my argument. Schools would adjust, the LCME would ease them in, standards might change, some school would fail, but for the most part schools would continue to grow. The supply is there and the chances of classes shrinking is about as likely as a medical schools closing all together.

In the real world money doesnt grow on trees. So the liklihood of your argument coming true is very remote.

im not sure of what supply you are talking about. DO schools dont have the same matriculant academic metrics, schools dont have the same resources or access to tertiary health systems. Every DO school interview I attended said that they send a majority of their students into primary cares fields and were quite proud of that fact. It is a little weird that a person goes into a DO school expecting that everything the school said is a lie, and that the bench research building are hidden, the residency programs or affiliated hospitals will magically sprout up one day, and that they can just waltz into a Neurosurgery spot. The purpose of DO schools is not to create the next researchers, or sub-specialists or chairs of surgery at Hopkins, The purpose of DO schools is to generate enough primary care physicians to fill spots and to advance the OMM agenda. DO's that actually end up specialized do so inspite of their schools rather than because of them.

 

[Chibucks15]

While I believe any program should be allowed to accept or decline an applicant for any reason, your statement is false. History proves over and over that laws or rules or penalties or whatever can absolutely be enforced even if the original mandate seems vague. There simply needs to be a willingness to enforce them from some organization/individual who has societal leverage. Affirmative action is an example as libertyyne already stated.



There are easily more capable students than spots even now. Class sizes wouldn't shrink at all. And if properly funded DO schools would grow to meet standards. And that's really the issue, poor funding for medical training is what opened the door for DOs in the first place. If the fed or someone else with money made medical education a high priority we wouldn't need DOs or even as many mid levels for that matter.

affirmative action for professional school based on degree? cmon now that makes DOs sound even worse. See my later comment on the Rooney Rule in the NFL. Programs have a right to fill their spots with whoever they want. Mandating certain spots be filled by a certain degree is ridiculous

 

[Chibucks15]

In the real world money doesnt grow on trees. So the liklihood of your argument coming true is very remote.

im not sure of what supply you are talking about. DO schools dont have the same matriculant academic metrics, schools dont have the same resources or access to tertiary health systems. Every DO school interview I attended said that they send a majority of their students into primary cares fields and were quite proud of that fact. It is a little weird that a person goes into a DO school expecting that everything the school said is a lie, and that the bench research building are hidden, the residency programs or affiliated hospitals will magically sprout up one day, and that they can just waltz into a Neurosurgery spot. The purpose of DO schools is not to create the next researchers, or sub-specialists or chairs of surgery at Hopkins, The purpose of DO schools is to generate enough primary care physicians to fill spots and to advance the OMM agenda. DO's that actually end up specialized do so inspite of their schools rather than because of them.

exactly...it baffles me that people who sign up DO expect to be the special little snowflake and exception to every trend. Its in the mission statement so you best be prepared for primary care...if not, make yourself competitive for MD

 

[TheRealCookieMonster]

Mandating certain spots be filled by a certain degree is ridiculous

As is mandating certain ethnicity getting preferential treatment in the fire department hiring process. But that has happened. DOs do suck a little bit and I agree programs should have the right to choose. But their choices are subject to law and to regulation. If governing bodies, judges or politicians wanted to enforce it, they could do just that. The NFL really just self regulated to look PC and tasteful to its viewers/players. It wasn't forced to do anything by someone else. The NFL analogy doesn't really pan out.

 

[Chibucks15]

As is mandating certain ethnicity getting preferential treatment in the fire department hiring process. But that has happened. DOs do suck a little bit and I agree programs should have the right to choose. But their choices are subject to law and to regulation. If governing bodies, judges or politicians wanted to enforce it, they could do just that. The NFL really just self regulated to look PC and tasteful to its viewers/players. It wasn't forced to do anything by someone else. The NFL analogy doesn't really pan out.

this isn't 'equal opportunity'. This is a profession and these spots are selected by pedigree. Affirmative action has no place in something selected by pedigree and accomplishments. and the NFL does pan out...its mandated they interview candidates of color. Its the exact same concept

 

[FrkyBgStok]

Why would you want to go to a place that doesn’t want you? Imagine the backlash you would feel if that happened. If they are a program who is about to be penalized, do you think they would ever let you forget you are only there to fill a quota? That would be pure misery.

I would rather go to a program that looks at my whole application and me as a person. That’s a program that will be good for me.

 

[TheRealCookieMonster]

this isn't 'equal opportunity'. This is a profession and these spots are selected by pedigree. Affirmative action has no place in something selected by pedigree and accomplishments

lol I'm sure that's been said before. I'm not disagreeing that it would be ridiculous. I thought it was ridiculous when the government started it in the first place. I'm pointing out that the federal and state government that support most of what these programs do and how they operate has all the leverage and if desired could do exactly that and more based on popular agenda.

 

[TheRealCookieMonster]

Why would you want to go to a place that doesn’t want you? Imagine the backlash you would feel if that happened. If they are a program who is about to be penalized, do you think they would ever let you forget you are only there to fill a quota? That would be pure misery.

I would rather go to a program that looks at my whole application and me as a person. That’s a program that will be good for me.

I'm sure the first female neurosurgeons could answer that. A little cost benefit analysis/priorities. Money, prestige, change in values and on.

 

[deleted610572]

lol I'm sure that's been said before. I'm not disagreeing that it would be ridiculous. I thought it was ridiculous when the government started it in the first place. I'm pointing out that the federal and state government that support most of what these programs do and how they operate has all the leverage and if desired could do exactly that and more based on popular agenda.

But you are missing the argument. Affirmative action was to help hire numbers that mirror the communities ethnic percentages to better the community (in theory). Ie. 100% white firefighters in an overwhelmingly black neighborhood. DO v MD degrees do not qualify. There is no societal benefit to mandate affirmative action for medical degrees

 

[atomheart]

Why is half of this thread about things that happen during medical school? Not a single interviewer (54 and counting) has asked me about rotations or academics during medical school at any of my interviews. They looked at my scores and asked me why I applied to their program. Nobody gives a **** about whatever philosophy the school espouses and tried to push on its students, and they certainly don't care about "quality" of rotations because the value of a rotating medical student is the same as a door stopper. The MD students I trained with on my rotations were just as useful as I was, and we each trained to be licensed in the full scope of medicine and surgery.

 

[libertyyne]

Why is half of this thread about things that happen during medical school? Not a single interviewer (54 and counting) has asked me about rotations or academics during medical school at any of my interviews. They looked at my scores and asked me why I applied to their program. Nobody gives a **** about whatever philosophy the school espouses and tried to push on its students, and they certainly don't care about "quality" of rotations because the value of a rotating medical student is the same as a door stopper. The MD students I trained with on my rotations were just as useful as I was, and we each trained to be licensed in the full scope of medicine and surgery.

to provide rationale for the disparate outcomes. Have to use something to filter, and all of the inadequacies in the medical school contribute to the resume differences. Also, they have your transcripts and already decided on giving an interview doesnt mean they need to go into detail about opportunities or experiences in school at that point.

 

[sval]

I believe that there should be a penalty for ACGME programs that consistently refuse to interview DOs OR rank them . Programs should also not be allowed to screen DOs out in ERAS. The same goes for former AOA programs. Thoughts?

*added rank

You made a claim that "ACGME programs should be penalized if they refuse to interview DOs or rank them" without providing a reason why this should happen. Explaining why this should happen would go a long way in narrowing down the discussion so we don't have to imagine and debate our own strawmen.

 

[TheRealCookieMonster]

In the real world money doesnt grow on trees. So the liklihood of your argument coming true is very remote.

im not sure of what supply you are talking about. DO schools dont have the same matriculant academic metrics, schools dont have the same resources or access to tertiary health systems. Every DO school interview I attended said that they send a majority of their students into primary cares fields and were quite proud of that fact. It is a little weird that a person goes into a DO school expecting that everything the school said is a lie, and that the bench research building are hidden, the residency programs or affiliated hospitals will magically sprout up one day, and that they can just waltz into a Neurosurgery spot. The purpose of DO schools is not to create the next researchers, or sub-specialists or chairs of surgery at Hopkins, The purpose of DO schools is to generate enough primary care physicians to fill spots and to advance the OMM agenda. DO's that actually end up specialized do so inspite of their schools rather than because of them.

No it's printed by the federal government and paid for by desperate applicants. They print for many reasons and a big move on healthcare wouldn't be that shocking. Schools could also hike tuition and still be full. The supply of applicants who are capable of becoming effective physicians far exceeds the number of available spots. And on the other side there is demand for more doctors.

As for the purpose of DO schools. This is completely determined demand. They get second choice of where to send kids so primary care is the place they know they can get funding and resources for. If they gained incentives for other things their values would change accordingly. The governments desire to solve primary care could push this. As we decide we need more primary care docs and realize they come from DO schools. DO schools could easily get the support they need given the right political climate. But I do understand the cultural boundaries here. I'm sure they will continue to fade culminating the deletion of Osteopathy... It will likely die a slow death. And we will just have doctors in primary care.

 

[deleted610572]

Why is half of this thread about things that happen during medical school? Not a single interviewer (54 and counting) has asked me about rotations or academics during medical school at any of my interviews. They looked at my scores and asked me why I applied to their program. Nobody gives a **** about whatever philosophy the school espouses and tried to push on its students, and they certainly don't care about "quality" of rotations because the value of a rotating medical student is the same as a door stopper. The MD students I trained with on my rotations were just as useful as I was, and we each trained to be licensed in the full scope of medicine and surgery.

I have been asked about my rotations on 2 interviews so far this season. Mainly asking what inpatient experience was and resident contact. They were ACGME programs that take little DOs.

 

[atomheart]

I have been asked about my rotations on 2 interviews so far this season. Mainly asking what inpatient experience was and resident contact. They were ACGME programs that take little DOs.

Sometimes the question is as informative as the response. I would never disparage my own experiences, and I cannot account for anyone else's but my own. I seriously question the people attempting to account for mine.

 

[TheRealCookieMonster]

But you are missing the argument. Affirmative action was to help hire numbers that mirror the communities ethnic percentages to better the community (in theory). Ie. 100% white firefighters in an overwhelmingly black neighborhood. DO v MD degrees do not qualify. There is no societal benefit to mandate affirmative action for medical degrees

The argument is not about what was affirmative action. Affirmative Action was simply used as an example to illustrate the power the federal government has when enforcing penalties see the quote the argument is referring to:

There’s no way to enforce these “penalties”.

The government easily has enough leverage to force all residencies to consider, interview, and yes even accept DO at any U.S. residency now and for ever.

 

[deleted610572]

Sometimes the question is as informative as the response. I would never disparage my own experiences, and I cannot account for anyone else's but my own. I seriously question the people attempting to account for mine.

Yes. When I explained my experiences they liked the answer and moved along. I only bring it up because there will be the occasional questions but as long as you have the experience you will be fine.

 

[deleted610572]

The argument is not about what was affirmative action. Affirmative Action was simply used as an example to illustrate the power the federal government has when enforcing penalties see the quote the argument is referring to:



The government easily has enough leverage to force all residencies to consider, interview, and yes even accept DO at any U.S. residency now and for ever.

Fair enough. What’s the benefit to the government in enforcing these policies?