Psychiatry Residencies that say NO to DOs....

[snowkhat]

Hey guys...I was wondering if you could help provide a list of programs that are not considering DOs....whether they are transparent about the subject or not.

I have a feeling Yale is one of them.

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[snowkhat]

Hey if you guys have had any experience please post. Lots of lurkers no posters.

 

[whopper]

I have heard from more than one faculty member that Columbia will not consider an applicant that is a D.O. for general residency, though they will consider such a person for fellowship. This information is over 5 years old. Things may have changed.

 

[psychnewbie]

I'm not sure you will be able to get many definitive responses on this but a good way to gauge "DO friendliness" is to check out where the current residents went to med school. For Yale, I don't think a single resident came from a DO school. So, you are probably right about them.

 

[HCE]

Hey guys...I was wondering if you could help provide a list of programs that are not considering DOs....whether they are transparent about the subject or not.

I have a feeling Yale is one of them.

Yale has been open in the past to DO's. Forget Columbia. They prefer mass murderers from eastern Europe over DO's.

 

[Doc Samson]

I don't know that I've ever seen or heard of a DO at MGH/McLean or Harvard Longwood. Second what's already been said about Columbia (though perhaps less emphatically than the mass murderer comment).

 

[HCE]

I don't know that I've ever seen or heard of a DO at MGH/McLean or Harvard Longwood. Second what's already been said about Columbia (though perhaps less emphatically than the mass murderer comment).

I stand by my comment. Look at the first paragraph under "Background" at this link:

http://www.nytimes.com/info/radovan-karadzic/

 

[snowkhat]

So. Possibly...

Yale
Harvard-Longwood
Columbia

I wonder about west-side schools? UCSF-Main, UCLA-Main, Stanford?

It's frustrating sometimes being a DO candidate. Apparently, academic or standardized achievement means nothing if you don't have the right letters behind your name. I'm stoked with the interviews I do have but ideally I would like all allopath programs open to all my DO colleagues, regardless of specialty.

 

[clement]

So. Possibly...

Yale
Harvard-Longwood
Columbia

I wonder about west-side schools? UCSF-Main, UCLA-Main, Stanford?

It's frustrating sometimes being a DO candidate. Apparently, academic or standardized achievement means nothing if you don't have the right letters behind your name. I'm stoked with the interviews I do have but ideally I would like all allopath programs open to all my DO colleagues, regardless of specialty.

Yale interviews DO's for psych. Most ivy leagues are actually more progressive than some "small-time" places, believe it or not. A lot also depends on the PD in the year you apply. In general, younger PD's are more DO-open, if you will.

California in general, and San Francisco in particular, are extremely competitive- even for MD applicants. In NYC, in particular, Mt. Sinai, Columbia, and Cornell do not have a fondness for DO residents, except maybe in their PM & R departments. They do have DO attendings though. The general rule you may derive from this pattern: The more desirable the location + more prestigious program = tougher for MD's, even tougher for DO's.

Bottom line, outside of a small pocket of snobbery on the east coast and California/northwest big-names, you have a fair chance at really good programs whose locations may not be so *hot*...

 

[Doc Samson]

I stand by my comment. Look at the first paragraph under "Background" at this link:

http://www.nytimes.com/info/radovan-karadzic/

A little more digging finds that he spent a year at Columbia "taking advanced courses in psychiatry and poetry." This sounds more like an exchange student than someone accepted to the residency program.

 

[nancysinatra]

A little more digging finds that he spent a year at Columbia "taking advanced courses in psychiatry and poetry." This sounds more like an exchange student than someone accepted to the residency program.

Doc Samson,

Are you disputing the provincial snobbery of the New York medical establishment?

I seriously think it WOULD be a bigger wound to the pride of certain uptown institutions to take a DO than a clever mass murderer.

Meanwhile, the rats run free in the subways of Manhattan... for all their selectivity, they don't seem to have solved a single public health problem in their city in a 100 years.

 

[HCE]

A little more digging finds that he spent a year at Columbia "taking advanced courses in psychiatry and poetry." This sounds more like an exchange student than someone accepted to the residency program.

Who knows. Bottom line for me is that Columbia or any other school which as a policy rejects a class of medical students for any reasons other than their individual abilities says more about the institution then the potential applicants. It also troubles me that they use public tax dollars to fund those positions. If they have cirteria and reject individuals for not meeting those criteria, all well and good. But if they want to exclude a class of people because of the school they went to, to me its not a whole lot different than rejecting them because of their gender or skin color. If they want to run their own private club at Columbia, let them use their own endowment money to support the residencies.

 

[Doc Samson]

Not saying anything about Columbia's position on DOs. Just saying that Karadzic didn't do his residency there.

 

[silas2642]

Who knows. Bottom line for me is that Columbia or any other school which as a policy rejects a class of medical students for any reasons other than their individual abilities says more about the institution then the potential applicants. It also troubles me that they use public tax dollars to fund those positions. If they have cirteria and reject individuals for not meeting those criteria, all well and good. But if they want to exclude a class of people because of the school they went to, to me its not a whole lot different than rejecting them because of their gender or skin color. If they want to run their own private club at Columbia, let them use their own endowment money to support the residencies.

Yet how many allopaths do the osteopathic programs accept? Although I understand your position, in a way I have a difficult time sympathizing with the DO's-- for one reason or another you chose to enter osteopathic medicine, that's the bed that you made....

This is the only match that we have and for every DO applicant that is accepted, that's potentially an allopathic applicant that is not, and we don't have another match to fall back on.

 

[Red Beard]

Yet how many allopaths do the osteopathic programs accept? Although I understand your position, in a way I have a difficult time sympathizing with the DO's-- for one reason or another you chose to enter osteopathic medicine, that's the bed that you made....

This is the only match that we have and for every DO applicant that is accepted, that's potentially an allopathic applicant that is not, and we don't have another match to fall back on.

Derp.

 

[HCE]

Yet how many allopaths do the osteopathic programs accept? Although I understand your position, in a way I have a difficult time sympathizing with the DO's-- for one reason or another you chose to enter osteopathic medicine, that's the bed that you made....

This is the only match that we have and for every DO applicant that is accepted, that's potentially an allopathic applicant that is not, and we don't have another match to fall back on.

I wasn't aware that there were allopaths out there wanting to get in to osteopathic residencies. If this is the case, I agree with you, and they should be open to all, with the understanding that the allopaths would have to take the additional osteopathy courses that others have suffered through.

 

[HCE]

Not saying anything about Columbia's position on DOs. Just saying that Karadzic didn't do his residency there.

Yeah, I understand and assumed he didn't do a residency there, since I believe he was only there a year, and taking poetry classes as well. I also assumed that whatever psychiatry courses he took were at the medical school, and I assume taught by psychiatrists at Columbia. Most folks I know associated with Ivy League schools and programs are great folks, and quite competent. What makes me lash out sometimes is the elitist attitude that a few of the "old boys" at these institutions display from time to time. They are a dying breed, and when they crawl out in the middle of the night, I like to spray them like I would a New York cockroach.

 

[whopper]

Bottom line for me is that Columbia or any other school which as a policy rejects a class of medical students for any reasons other than their individual abilities says more about the institution then the potential applicants.

A problem we have here is the only real and accurate way to gauge one's quality is to see them work in the field for an extended period of time. No one can do that when there's thousands if not more applicants for a few spots.

I've taken courses in Industrial (AKA organizational/personnel) psychology. There is a lot of published data about the process by which institutions take applicants. Unfortunately no method that is used is very good. Letters of recommendation barely have any validity. The best indicators are standardized test scores, but as we know, that is not a very good method. We've all known, I'm sure, several people who score poorly on such tests but are great clinicians.

From the institution's viewpoint, given their limited resources in taking applicants, many programs do the stereotypical "we'll make several piles, anyone below this score, a D.O., an FMG, (etc) will not even be consisdered."

While this method is arguably a "fast food" method of filtering through applicants, unfortunately there really isn't much that can be done. I know plenty of D.O.s and FMGs that IMHO are better than many AMGs. The only two residents I know of that were kicked out of my program were AMGs who both scored very well in medical school and the USMLE. That written, no matter how you slice and dice it, if you start doing the "pile" method, you will in general tend to get better applicants though you will also throw out several great applicants that you never would've even had the chance to consider.

It's all statistics. If I had 10,000 applications and I use the pile method, however flawed, when I widdle down the applicants to 1,000, I will on average have better applicants than not vs the 10,000 I started with. I would not have the time to give every single applicant the time and consideration that person truly deserved. A rough analogy is a google search. That search engine uses an algorithm to pick the best sites, but any algorithm is not perfect.

The real shame of this type of method is I've seen people that IMHO would've been great doctors but they could not pass the USMLE, or they were blown out of the water while in pre-med by an undergraduate college that had a weed-out policy where several courses were designed to fail a large portion of the students--no matter what. Several of these people are victims of the way the system is designed, but unfortunately, it's the best we got considering the circumstances.

By the time people are eligible for fellowship, things change. There are far fewer applicants for fellowship positions and as a result, the programs can give more individualized time in weighing a candidate, though the reverse is also true, the programs will also accept poor candidates due to lack of applicants that otherwise would've been widdled out using the "pile" method.

 

[whopper]

I stand by my comment. Look at the first paragraph under "Background" at this link:

Any program big enough, large enough, and with a history long enough will have at least some people that are terrible....no matter how good the program.

It's all statistics.

 

[HCE]

A problem we have here is the only real and accurate way to gauge one's quality is to see them work in the field for an extended period of time. No one can do that when there's thousands if not more applicants for a few spots.

I've taken courses in Industrial (AKA organizational/personnel) psychology. There is a lot of published data about the process by which institutions take applicants. Unfortunately no method that is used is very good. Letters of recommendation barely have any validity. The best indicators are standardized test scores, but as we know, that is not a very good method. We've all known, I'm sure, several people who score poorly on such tests but are great clinicians.

From the institution's viewpoint, given their limited resources in taking applicants, many programs do the stereotypical "we'll make several piles, anyone below this score, a D.O., an FMG, (etc) will not even be consisdered."

While this method is arguably a "fast food" method of filtering through applicants, unfortunately there really isn't much that can be done. I know plenty of D.O.s and FMGs that IMHO are better than many AMGs. The only two residents I know of that were kicked out of my program were AMGs who both scored very well in medical school and the USMLE. That written, no matter how you slice and dice it, if you start doing the "pile" method, you will in general tend to get better applicants though you will also throw out several great applicants that you never would've even had the chance to consider.

It's all statistics. If I had 10,000 applications and I use the pile method, however flawed, when I widdle down the applicants to 1,000, I will on average have better applicants than not vs the 10,000 I started with. I would not have the time to give every single applicant the time and consideration that person truly deserved. A rough analogy is a google search. That search engine uses an algorithm to pick the best sites, but any algorithm is not perfect.

The real shame of this type of method is I've seen people that IMHO would've been great doctors but they could not pass the USMLE, or they were blown out of the water while in pre-med by an undergraduate college that had a weed-out policy where several courses were designed to fail a large portion of the students--no matter what. Several of these people are victims of the way the system is designed, but unfortunately, it's the best we got considering the circumstances.

By the time people are eligible for fellowship, things change. There are far fewer applicants for fellowship positions and as a result, the programs can give more individualized time in weighing a candidate, though the reverse is also true, the programs will also accept poor candidates due to lack of applicants that otherwise would've been widdled out using the "pile" method.

I understand the need to weed out numbers. I have no problem with setting minimum standards. Thus an institution that puts applications in a pile based on score is fine by me. The D.O. and FMG piles I don't buy. You could put together piles with redheads and left handed applicants, and that would also reduce the pool. The same issue arises: the piles aren't reflective of the applicants' abilities. I also have a problem with institutions who encourage applications from D.O's and FMG's, take their application fees, and then stick them in a pile as unhirable because of where they graduated from. If they want to be honest, they should post in their materials something to the effect that "D.O's and FMG's Need Not Apply."

 

[whopper]

You'll get no argument from me that this method blows and encourages ignorance against FMGs and DOs. I'll also add that some of the faculty that will not consider a DO, when they announce so, do it in a manner where I just get this idea that this person really does have a narcissist streak.

IMHO, the filtering need not include DOs and FMGs because these people often take the same standardized exams that AMGs take. Given that studies show that standardized exams, however flawed, are the best method of choosing a candidate, if they're going to filter people out, it should be based on the best method available-standardized scores. Even that method, by studies, aren't great, but they're the best we got.

(Accentuating how flawed standardized tests are... for me, according to my USMLE scores, I was one of the top people in the country for Pulmonology--a field where I knew just as much as the next medstudent. I scored in the lowest categories for behavioral sciences in USMLE I and psychiatry in USMLE II. Don't ask me WTF was going on there. I knew psychiatry and the behavioral sciences better than almost any medstudent or resident I knew when I took those tests).

That's just my opinion, but my larger point is the entire process is full of flaws, and unfortunately, the medical academic community is one full of intellectual narcissism. I'm sure I don't have to point any examples of this.

"D.O's and FMG's Need Not Apply."

Perhaps it may be a bit more honest, but I don't think they'll do this because it'll make them look ignorant.

 

[Manicsleep]

Yet how many allopaths do the osteopathic programs accept? Although I understand your position, in a way I have a difficult time sympathizing with the DO's-- for one reason or another you chose to enter osteopathic medicine, that's the bed that you made....

This is the only match that we have and for every DO applicant that is accepted, that's potentially an allopathic applicant that is not, and we don't have another match to fall back on.

derp

--> why?

Its a valid point whether you think it ignorant or not. Why do we even have osteopathic schools these days. Are psychiatric osteopaths still "lightning bone setters?" There is very little difference in todays DO and MD once they are in clinical rotations in medical school and except for a few people (both MD and DO) there is no difference once in residency/practice.

So to have separate residencies, schools, accreditations is stupid. They should just merge the two already...except the power structure in the osteopathic world doesn't want to do this and there are more than a few brainwashed DOs.

 

[silas2642]

--> why?

Its a valid point whether you think it ignorant or not. Why do we even have osteopathic schools these days. Are psychiatric osteopaths still "lightning bone setters?" There is very little difference in todays DO and MD once they are in clinical rotations in medical school and except for a few people (both MD and DO) there is no difference once in residency/practice.

So to have separate residencies, schools, accreditations is stupid. They should just merge the two already...except the power structure in the osteopathic world doesn't want to do this and there are more than a few brainwashed DOs.

I want to be absolutely clear here-- I do not see DO's or IMG's/FMG's as "inferior" in any way-- I believe that physicians and med students have to be taken one at a time. I agree that it's somewhat useless to have two different systems and that combining osteopathic medicine and allopathic medicine into one degree/match system makes sense. However, similar efforts have been tried in the past and have failed.

I actually don't understand the DO's in the sense that they wanted to be seen as allopaths but similarly state that, "they treat the patient, not the disease," and learn manipulations, "so we have more tools in our bag." It seems that the degree is having somewhat of an identity crisis in that they want to be seen the same as MD's but simultaneously be seen differently.

 

[HCE]

--> why?

Its a valid point whether you think it ignorant or not. Why do we even have osteopathic schools these days. Are psychiatric osteopaths still "lightning bone setters?" There is very little difference in todays DO and MD once they are in clinical rotations in medical school and except for a few people (both MD and DO) there is no difference once in residency/practice.

So to have separate residencies, schools, accreditations is stupid. They should just merge the two already...except the power structure in the osteopathic world doesn't want to do this and there are more than a few brainwashed DOs.

I agree with both of your points.

 

[snowkhat]

Yet how many allopaths do the osteopathic programs accept? Although I understand your position, in a way I have a difficult time sympathizing with the DO's-- for one reason or another you chose to enter osteopathic medicine, that's the bed that you made....

This is the only match that we have and for every DO applicant that is accepted, that's potentially an allopathic applicant that is not, and we don't have another match to fall back on.

Osteopathic residency programs were instituted because of the very problem of selection bias. Osteopath students needed a place to match. You are correct, the Osteopathic match doesn't take allopath students (it kind of negates the purpose of there institution and also allopaths don't have the OMT training).

My biggest argument is that programs may be taking less qualified allopath students and overlooking DO candidates just due to the fact that they went to an osteopathic school. Just like how Joe Schmo MD with a 250 Step 1, might be overlooked if he went to Smithville, State MD school in North Dakota versus someone with a 210 from Ivy League USA.

Also, the NMS, Osteopathic match, is not a fall back. It doesnt' work that way. If you match in it you are automatically withdrawn from the allopathic match. If you want to go allopath, you have to withdraw from the osteopathic match.

Regardless, it's unfortunate that there is still this adversarial undercurrent in medicine and academics.

 

[snowkhat]

I understand the need to weed out numbers. I have no problem with setting minimum standards. Thus an institution that puts applications in a pile based on score is fine by me. The D.O. and FMG piles I don't buy. You could put together piles with redheads and left handed applicants, and that would also reduce the pool. The same issue arises: the piles aren't reflective of the applicants' abilities. I also have a problem with institutions who encourage applications from D.O's and FMG's, take their application fees, and then stick them in a pile as unhirable because of where they graduated from. If they want to be honest, they should post in their materials something to the effect that "D.O's and FMG's Need Not Apply."

I was told by a program director that there is such a pile. For that particular program it was the FMG pile. It was due to the sheer volume of IMG/FMG applicants that blanket all residency slots desperate for a position.

Also, two programs, one surgery and one ER, told my fiance, DOs need not apply. Straight up.

 

[Manicsleep]

I was told by a program director that there is such a pile. For that particular program it was the FMG pile. It was due to the sheer volume of IMG/FMG applicants that blanket all residency slots desperate for a position.

Also, two programs, one surgery and one ER, told my fiance, DOs need not apply. Straight up.

That is just an idiotic viewpoint and overall their loss.

As far as the dogpile. I think that is reasonable. You have to cut down to manageable numbers. Derm/radiology programs do that with any applicants.

 

[Manicsleep]

Osteopathic residency programs were instituted because of the very problem of selection bias. Osteopath students needed a place to match. You are correct, the Osteopathic match doesn't take allopath students (it kind of negates the purpose of there institution and also allopaths don't have the OMT training).

My biggest argument is that programs may be taking less qualified allopath students and overlooking DO candidates just due to the fact that they went to an osteopathic school. Just like how Joe Schmo MD with a 250 Step 1, might be overlooked if he went to Smithville, State MD school in North Dakota versus someone with a 210 from Ivy League USA.

Also, the NMS, Osteopathic match, is not a fall back. It doesnt' work that way. If you match in it you are automatically withdrawn from the allopathic match. If you want to go allopath, you have to withdraw from the osteopathic match.

Regardless, it's unfortunate that there is still this adversarial undercurrent in medicine and academics.

DOs could consider letting MDs into their programs.
Alternatively, their are a few dual accredited programs out there. I did a rotation at one of these places way back when (Geisinger) and MDs/DOs worked really well together.

But DOs do have 2 advantages. The prematch option and their own protected residencies (although most don't really think much of these residencies). I think this can be irritating sometimes, especially prior to matching.

 

[Manicsleep]

I want to be absolutely clear here-- I do not see DO's or IMG's/FMG's as "inferior" in any way-- I believe that physicians and med students have to be taken one at a time. I agree that it's somewhat useless to have two different systems and that combining osteopathic medicine and allopathic medicine into one degree/match system makes sense. However, similar efforts have been tried in the past and have failed.

I actually don't understand the DO's in the sense that they wanted to be seen as allopaths but similarly state that, "they treat the patient, not the disease," and learn manipulations, "so we have more tools in our bag." It seems that the degree is having somewhat of an identity crisis in that they want to be seen the same as MD's but simultaneously be seen differently.

Neither do I. I was agreeing with your post and disagreeing with the 'derp' statement.

 

[nancysinatra]

Yeah, I understand and assumed he didn't do a residency there, since I believe he was only there a year, and taking poetry classes as well. I also assumed that whatever psychiatry courses he took were at the medical school, and I assume taught by psychiatrists at Columbia. Most folks I know associated with Ivy League schools and programs are great folks, and quite competent. What makes me lash out sometimes is the elitist attitude that a few of the "old boys" at these institutions display from time to time. They are a dying breed, and when they crawl out in the middle of the night, I like to spray them like I would a New York cockroach.

I agree with you that many Ivy League people are great, but I disagree that those with the "old boy" mentality are a dying breed. I think they are as common as New York City cockroaches.

Someone really needs to catalogue WHERE the greatest innovations in medicine, science, the humanities and the arts are coming from these days. Yeah a percentage must come from Ivy League institutions--but really, Ivy League achievements probably tend to come from the same certain highly productive departments within those institutions. The Ivy Leagues as a whole have plenty of dead wood in the form of self perpetuating smugly ignorant people who have the resources and ability to jump through the usual high class academic hoops, but nothing much more that makes them special.

There is no geographic monopoly on intelligence or creativity. For someone growing up in a North Dakota cornfield, or another country, for that matter, an Ivy League school or residency is not an option and for the most part never will be. A DO school might be way more within reach though. The Ivies can kiss that person goodbye from the day they are born til the day that they perhaps win a Nobel Prize under the auspices of a different university. (Sure there are exceptions--but the fact that they are exceptions proves the rule). Same for someone born in another country, unless they are rich and can pay their way through med school, get a lawyer and a visa. Those are the only foreigners welcome under the rules described above. Yet tests show, Americans LAG BEHIND in many categories of basic knowledge like math and geography. So by filtering out ambitious foreigners, they are just filtering out the smart people.

That's what you get in an academic culture built on class and geography. In recent years they have opened things up a bit for minorities but nothing essential has changed. Almost no one from a truly disadvantaged upbringing--with the scruffy academic record to prove it--ever shows up in those medical schools.

And who even cares? There are many other vibrant universities where people can get on with their work, instead of just talking about themselves.

Plus, as I have posted before, Freud himself would have gone into the "Need Not Apply" pile at the places above, which says enough.

Yes I understand that for the sake of expediency committees and departments must "narrow things down." And they can go on doing that. That's called mass production and it's the whole mechanism behind the production of 20th century bland junk the world over.

What I would be worried about, as an applicant, is the quality of education at such a place. It cannot possibly be individually tailored and very unlikely would be responsive to resident concerns.

 

[Manicsleep]

What I would be worried about, as an applicant, is the quality of education at such a place. It cannot possibly be individually tailored and very unlikely would be responsive to resident concerns.

True of almost all residency programs to some degree. True of life.

The truth is that there is no real way for MD programs to know whether an applicant is going to be excellent or not. They can only make an educated guess based on scores, grades, LORs, medical school, research etc, personal statements and eventually the interview.

An MD>DO paradigm has been created. Some places are extremely militant about this but for the most part, people try to be fair. Unfortunately, DOs are more to blame for the current state than MDs. I think most MDs and DOs would prefer just one system. Osteopaths don't use the osteopathic system anymore and I really havent seen any significant research proving their methods are effective. DOs are really no different from MDs. The sooner they realize it, the better it is for everyone.

 

[billypilgrim37]

Given we've been unable to identify a list of over maybe 5 programs that will not consider DOs, and given that the few programs on that list are a hard match for any applicant from an uncompetitive medical school, allopathic or osteopathic, I'm not sure exactly some of the extreme comments on this thread ("being anti-DO is as bad as being a puppy-kicking Nazi!," "the quality of residency at Columbia must be bad because they don't interview DOs!") make any sense at all.

 

[Daftrage]

That is just an idiotic viewpoint and overall their loss.

As far as the dogpile. I think that is reasonable. You have to cut down to manageable numbers. Derm/radiology programs do that with any applicants.

I was speaking with my PD and he said that they had around 600 applicants and that 500 were IMG's. They hand out about 50-60 interviews for 8 spots.

The Chair at UAB stated they had around 850 applicants and implied that over 650 were IMG's. They hand out about 75 interviewers for 8 slots.

How could anyone honestly expect a program to mull over every detail of applications when they are bombarded like that. I am sure that the "upper tier" schools are easily breaking 1000 largely consisting of IMG's. I think programs have to pile simply due to volume with only a few exceptions due to true bias.

 

[Red Beard]

--> why?

Specifically:
1) The "this is the bed you made" nonsense
2) The absurdity of an American MD grad worrying that the presence osteopaths (and I presume FMGs) is somehow going to prevent them from obtaining whatever specialty they choose.
3) The implied notion that residency selection should be anything other than a meritocracy, regardless of the current status quo.

Perhaps "derp" was not the most fluent way of expressing this.

 

[silas2642]

Specifically:
1) The "this is the bed you made" nonsense
2) The absurdity of an American MD grad worrying that the presence osteopaths (and I presume FMGs) is somehow going to prevent them from obtaining whatever specialty they choose.
3) The implied notion that residency selection should be anything other than a meritocracy, regardless of the current status quo.

Perhaps "derp" was not the most fluent way of expressing this.

I guess I'm having difficulty understanding why you believe that "this is the bed you made" statement is nonsense. Why is it nonsense? Why wouldn't it reasonable for an allopathic program to express a preference for US allopathic graduates where all LCME-accredited US med schools are forced to meet a very specific criteria? You at least have more of an idea of the kind of applicant you're evaluating in that these schools are almost all tried and true because the med school has, at least in most circumstances, done a good portion of the weeding out for you. I would assert that this is similar to a program favoring applicants who are from their affiliated med school-- you have an idea of the quality of the applicant based on prior experiences.

And you guys know this-- you know that it will be more diffficult matching into an allopathic residency, particularly a competitive one, as an osteopath. However, when I read these boards, it's always like, "I chose the DO route because it's more holistic and I want to treat the entire patient"-- fine. But realize that if you enter this path for whatever reason it's going to be harder to match because of the above reasons.

Am I saying that DO schools are inferior? No, not at all. But it does seem with the the accreditation of a for-profit school (RVU) along with new osteopathic schools popping up at an incredible rate that it would be reasonable for program directors to be a little hesitant about some osteopathic candidates.

Should the application procedure for residency selection be a meritocracy? Absolutely. Can it ever be? Probably not-- too many applicants who are qualified for too few positions. You have to weed them out, and one of the easiest places to start, as many have already stated, is to do it by degree, board scores, etc.

 

[Red Beard]

I guess I'm having difficulty understanding why you believe that "this is the bed you made" statement is nonsense. Why is it nonsense? Why wouldn't it reasonable for an allopathic program to express a preference for US allopathic graduates where all LCME-accredited US med schools are forced to meet a very specific criteria? You at least have more of an idea of the kind of applicant you're evaluating in that these schools are almost all tried and true because the med school has, at least in most circumstances, done a good portion of the weeding out for you. I would assert that this is similar to a program favoring applicants who are from their affiliated med school-- you have an idea of the quality of the applicant based on prior experiences.

And you guys know this-- you know that it will be more diffficult matching into an allopathic residency, particularly a competitive one, as an osteopath. However, when I read these boards, it's always like, "I chose the DO route because it's more holistic and I want to treat the entire patient"-- fine. But realize that if you enter this path for whatever reason it's going to be harder to match because of the above reasons.

Am I saying that DO schools are inferior? No, not at all. But it does seem with the the accreditation of a for-profit school (RVU) along with new osteopathic schools popping up at an incredible rate that it would be reasonable for program directors to be a little hesitant about some osteopathic candidates.

Should the application procedure for residency selection be a meritocracy? Absolutely. Can it ever be? Probably not-- too many applicants who are qualified for too few positions. You have to weed them out, and one of the easiest places to start, as many have already stated, is to do it by degree, board scores, etc.

The tone I perceived in your initial post was one of shaming--"you chose to become an osteopath, how dare you now try to take a residency position away from I who truly deserve it." I am reactive to this kind of attitude in general, and more personally being due to my being an osteopath.

Something I am working on.

I must have misperceived your message.

 

[Manicsleep]

I agree mostly with Silas' post.

Specifically:
1) The "this is the bed you made" nonsense
2) The absurdity of an American MD grad worrying that the presence osteopaths (and I presume FMGs) is somehow going to prevent them from obtaining whatever specialty they choose.
3) The implied notion that residency selection should be anything other than a meritocracy, regardless of the current status quo.

Perhaps "derp" was not the most fluent way of expressing this.

I believe there have been efforts to incorporate the MD and DO degree.
I think the pre-match option is something that should be taken out. Either you are in the match or you aren't. Just take a look at last years match results.
It should be a meritocracy. In a meritocracy, there should be no overt advantages such as pre-match.
I have posted previously that DOs and MDs don't really (with some rare exceptions) have practices that are different in any real manner. I work with MDs and DOs and usually don't know which is which unless I ask or it is on some stationary/name tag/document etc.
Even across specialties, I have had this talk with other physicians and they usually can't tell if someone is a MD/DO until they actually tell you. This is double edged because on one hand, yes osteopaths are competent but at the same time they bring nothing extra to the table. There is no 'holistic' extra that DOs learn that MDs don't learn. We all try to help ease the suffering of the patient and in optimal cases, cure it. The problem is that DOs want to sell us on this 'extra' when its just not there. It should be all LCME based and everyone should be conferred an MD.

 

[whopper]

I think programs have to pile simply due to volume with only a few exceptions due to true bias.

Unfortunate but true.

There is no perfect system. I do think the DO/FMG thing is a worse system of weeding someone out vs. simply using someone's USMLE scores but any method ultimately is flawed. A system that judged only on USMLE scores, while that has the most amount of data backing it, that too is too simplistic a method.

Someone who judges someone simply on the brand of a D.O. without checking out the actual person's quality of work that has the full opportunity do to so, now that's someone that would get under my skin. I understand a DO's frustration with the given system, but IMHO, it is what it is. Programs do not have this opportunity.

The real victims here are those that would've made great doctors that cannot enter residency due to some type of blemish on their record that is not indicative of their potential. Yes, a DO degree is not looked upon as favorably as an M.D. in several circles, but in the long run, most DOs will get into a residency program. They might not get into Columbia, but if someone truly wants to go into the academic route, they can do several things, Columbia aside, to get on that track.

No one can create a fair filter system to widdle down thousands of applicants to just a few dozen based simply on grades, USMLE scores, letters of recommendation, and clinical rotation assessments.

 

[Doc Samson]

I think what this boils down to is who knows who. Aside from standardized test scores, I think most folks agree that the application packet is essentially worthless subjective data at best and an out-and-out pack of lies at worst. Thus, many residencies look for reliable data, namely:

1) A resident from a program that they've had good luck with in the past

2) A LOR from someone they know and trust

Some programs may never have taken a DO applicant before for a variety of reasons (including some hospitals historically not credentialing DOs to provide care) - thus for them option 1 is out. Give the diaspora effect of many DO clinical rotations, it is often unlikely that there clerkship attending will know the PD at Columbia, MGH, wherever, so option 2 is unlikely.

For the most part, programs are looking for "safe bets" in terms of residents that will perform well, show up for call, not be grossly personality disordered, not kill anyone, etc. The only available indicators of these are 1) Workd of mouth from a trusted source, and 2) the interview. Since interviews are at a premium due to simple supply and demand, word of mouth governs who gets them - unfortunately for many DOs, this may rule them out of opportunities at some of the most competitive programs. Not saying it's right or wrong, just how it is.

 

[whopper]

application packet is essentially worthless subjective data at best and an out-and-out pack of lies at worst.

According to my old personell psychology textbook, applications to colleges and places of employment using the standard method (test scores, LORs, etc), are more likely than not going to weed out the worse applicants while leaving a significant and sizeable minority group that could do the job well weeded out.

In the end, many of those people in that sizeable group will still get into psychiatry residency. I have seen a few people, some of them close friends, get a brand they didn't deserve that blew them out of the water completely in their road to becoming a practicing doctor. The worst situation was a buddy of mine was written up as cheating on exams by his PD when there was no evidence to back it up and in fact he was mad at my friend for wanting to transfer out of his program. (The program was highly malignant. The PD forced some people to take Paxil or be kicked out when there was no evidence they were mentally ill.) Of course it was not true, my friend pursued a lawsuit where attendings from his program were willing to back him in court, but the damage was done. No program will now touch him.

My sympathy goes out to people in cases like the above. For DOs and IMGs, yes, the situation is not what I'd like it to be but there's still plenty of great options around. If you're such a great candidate, it's Columbia's loss to not accept an applicant like you. If you are good, you will be able to stand out Columbia or not. Pedro Ruiz, an FMG, eventually became an APA president. Columbia is not your end-all-be-all. I'd rather be with Merrill Rotter at Albert Einstein, Phil Resnick at Case Western, John Kennedy at UC than several of the places that have a name brand that do not live up to that name. I can name a few, but since there's a likelihood I'll be sitting next to them at a dinner at a near future conference, I'm keeping my mouth shut.

Just as much as branding someone as a DO as worse may be unfair, don't judge your future on not being able to get into Columbia. While that is a great institution, I know a few terrible people that got into it's programs that I wouldn't touch with a 10 foot pole.

 

[HCE]

According to my old personell psychology textbook, applications to colleges and places of employment using the standard method (test scores, LORs, etc), are more likely than not going to weed out the worse applicants while leaving a significant and sizeable minority group that could do the job well weeded out.

In the end, many of those people in that sizeable group will still get into psychiatry residency. I have seen a few people, some of them close friends, get a brand they didn't deserve that blew them out of the water completely in their road to becoming a practicing doctor. The worst situation was a buddy of mine was written up as cheating on exams by his PD when there was no evidence to back it up and in fact he was mad at my friend for wanting to transfer out of his program. (The program was highly malignant. The PD forced some people to take Paxil or be kicked out when there was no evidence they were mentally ill.) Of course it was not true, my friend pursued a lawsuit where attendings from his program were willing to back him in court, but the damage was done. No program will now touch him.

My sympathy goes out to people in cases like the above. For DOs and IMGs, yes, the situation is not what I'd like it to be but there's still plenty of great options around. If you're such a great candidate, it's Columbia's loss to not accept an applicant like you. If you are good, you will be able to stand out Columbia or not. Pedro Ruiz, an FMG, eventually became an APA president. Columbia is not your end-all-be-all. I'd rather be with Merrill Rotter at Albert Einstein, Phil Resnick at Case Western, John Kennedy at UC than several of the places that have a name brand that do not live up to that name. I can name a few, but since there's a likelihood I'll be sitting next to them at a dinner at a near future conference, I'm keeping my mouth shut.

Just as much as branding someone as a DO as worse may be unfair, don't judge your future on not being able to get into Columbia. While that is a great institution, I know a few terrible people that got into it's programs that I wouldn't touch with a 10 foot pole.

I assume Columbia does the honorable thing and returns application fees to D.O.s who have mistakenly applied because they were unaware of Columbia's unwritten policy of not hiring D.O.s. Yeah, right....

 

[boodgie1]

My friend, an osteopathic student at UMDNJ, has invites to Columbia, Yale and Cornell!

 

[atsai3]

Whining about the weight of history seems to come up every year from students who have not done well academically. At every stage of your life, you try to accomplish your goals; sometimes you succeed, sometimes you fail, and that has implications for each successive stage of education. You just need to deal with that.

This is not Taiwan where getting into a high quality (well, top quality) middle school is deterministic of your ability to get into a top quality high school, which is deterministic of your ability to get into a top quality college, which is deterministic of your ability to get a top quality job. In the U.S., if you do not do well academically in university, then you might not get into a high-ranked medical school. If you go to a low-ranked allopathic (or osteopathic or Caribbean) medical school, it is not impossible to get into a good residency, but it is certainly harder. If you do not come from a good residency with supervisors who are solidly in your corner, it is not impossible to get into a good fellowship, but it is harder. This has nothing to do with "Ivy League snobbery" but has everything to do with efficiency and the weight of history. No doubt there are high quality applicants from osteopathic and Caribbean schools out there, but because life is harder for osteopathic and Caribbean graduates there are few very persons who would willingly choose to go there over a good allopathic school, so the overall pool of applicants is likely to be lower-quality on average. Ivy League residency programs have enough qualified applicants that they can afford to use screening procedures that give them a reasonably good probability of obtaining high quality applicants. If a program can have its pick of applicants from a higher quality applicant pool (on average), then why not pick from that pool?

The only thing osteopathic and Caribbean grads can do is work hard to try to get off the trajectory-- if you succeed, then that's great; if not, then too bad. But stop whining about it.

-AT.

 

[digitlnoize]

Whining about the weight of history seems to come up every year from students who have not done well academically. At every stage of your life, you try to accomplish your goals; sometimes you succeed, sometimes you fail, and that has implications for each successive stage of education. You just need to deal with that.

This is not Taiwan where getting into a high quality (well, top quality) middle school is deterministic of your ability to get into a top quality high school, which is deterministic of your ability to get into a top quality college, which is deterministic of your ability to get a top quality job. In the U.S., if you do not do well academically in university, then you might not get into a high-ranked medical school. If you go to a low-ranked allopathic (or osteopathic or Caribbean) medical school, it is not impossible to get into a good residency, but it is certainly harder. If you do not come from a good residency with supervisors who are solidly in your corner, it is not impossible to get into a good fellowship, but it is harder. This has nothing to do with "Ivy League snobbery" but has everything to do with efficiency and the weight of history. No doubt there are high quality applicants from osteopathic and Caribbean schools out there, but because life is harder for osteopathic and Caribbean graduates there are few very persons who would willingly choose to go there over a good allopathic school, so the overall pool of applicants is likely to be lower-quality on average. Ivy League residency programs have enough qualified applicants that they can afford to use screening procedures that give them a reasonably good probability of obtaining high quality applicants. If a program can have its pick of applicants from a higher quality applicant pool (on average), then why not pick from that pool?

The only thing osteopathic and Caribbean grads can do is work hard to try to get off the trajectory-- if you succeed, then that's great; if not, then too bad. But stop whining about it.

-AT.

1. The days of DO school being a back-up are largely over. I have more than a few classmates who scores >260 on USMLE Step 1, who had >30 MCATS, and >3.8 GPAs. I myself chose DO school for many reasons, but chief among them were the low tuition (LECOM), the PBL program (I have a family and wanted to have a flexible schedule), the location (gorgeous gulf coast florida), and the clinical, private-practice, community oriented rotations. I have zero interest in acedemia or research, so this school fit better with my goals than a research heavy academic institution, which I hope I will NEVER wind up in.

2. Can we please get back on topic a bit? For this thread to be helpful to DO's, it needs to just be a list of places that "blacklist" or "weed out" or "discriminate" against us.

So far, we have (possibly):

Columbia
Yale
Harvard-Longwood
Mt. Sinai
Cornell
Misc. California Programs

Fortunately for me, none of those are places I'd like to go. I do know that the top two programs on my personal list are very DO friendly (i.e. "we consider DO applicants equal with allopathic applicants), accept the COMLEX, and have plenty of current DO residents, while still being fairly well respected programs.

 

[billypilgrim37]

1. The days of DO school being a back-up are largely over.

http://www.studentdoctor.net/2009/04/gpa-and-mcat/

While I certainly believe you that there are plenty of folks who could have obtained admission to an allopathic program who chose to attend an osteopathic program instead, there still remains the fact that the AVERAGE osteopathic student received a really bad MCAT score (a 25). As long as this is true, we simply aren't going to believe that the days of DO school being a back-up are over. And we know when we look at your clinical grades that you were competing against a pool that, on average, received a 25 on the MCAT. So, when you get honors in a rotation, is that because you did really well? Or because you had very little competition? We have no way of knowing. When we look at a kid who went to a competitive medical school, we know EXACTLY who they were competing against, and we can interpret their grades much more easily and know "what we're getting."

I can accept an argument that the MCAT is a terrible predictor of how good a doctor you are, how smart you are, etc. But those are separate arguments from your point #1. The numbers say that DO school is still a back-up option for a tremendous number of applicants.

 

[atsai3]

1. The days of DO school being a back-up are largely over. I have more than a few classmates who scores >260 on USMLE Step 1, who had >30 MCATS, and >3.8 GPAs. I myself chose DO school for many reasons, but chief among them were the low tuition (LECOM), the PBL program (I have a family and wanted to have a flexible schedule), the location (gorgeous gulf coast florida), and the clinical, private-practice, community oriented rotations. I have zero interest in acedemia or research, so this school fit better with my goals than a research heavy academic institution, which I hope I will NEVER wind up in.

2. Can we please get back on topic a bit? For this thread to be helpful to DO's, it needs to just be a list of places that "blacklist" or "weed out" or "discriminate" against us.

So far, we have (possibly):


Fortunately for me, none of those are places I'd like to go. I do know that the top two programs on my personal list are very DO friendly (i.e. "we consider DO applicants equal with allopathic applicants), accept the COMLEX, and have plenty of current DO residents, while still being fairly well respected programs.

The averages argue against. Clearly I can't speak to individual cases of DO students with >30/>3.8 or who had specialized reasons for choosing to go the DO route. But anyone looking at averages will retain the presumption that DO and Caribbean schools are still regarded as a backup. Because of the difficulties they face, all else equal, no one would willingly choose the DO route. Specialized reasons, of course, render the comparison not all else equal. That is, if there were an allopathic school down the street that cost the same and had a PBL-oriented curriculum with private practice community oriented rotations, the average applicant -- indeed, most applicants -- will choose the allopathic school. On average, then, this will deplete the DO and Caribbean applicant pool of high quality members and therefore lower the average quality of their residency applicant pools.

In terms of getting the thread back on track, snowkhat mentioned UCSF (Main) as possibly filtering out DO's. This is probably true on average, since there are currently no DO's in the program. But there was a FMG in the most recent UCSF graduating class. If I were a DO or a Caribbean applicant I would not take this as evidence that I had a shot at getting in but should rather interpret this as a very rare occurrence (much like the DO student with >30/>3.8 who turns down admission at an allopathic school).

-AT.

 

[digitlnoize]

http://www.studentdoctor.net/2009/04/gpa-and-mcat/

While I certainly believe you that there are plenty of folks who could have obtained admission to an allopathic program who chose to attend an osteopathic program instead, there still remains the fact that the AVERAGE osteopathic student received a really bad MCAT score (a 25). As long as this is true, we simply aren't going to believe that the days of DO school being a back-up are over. And we know when we look at your clinical grades that you were competing against a pool that, on average, received a 25 on the MCAT. So, when you get honors in a rotation, is that because you did really well? Or because you had very little competition? We have no way of knowing. When we look at a kid who went to a competitive medical school, we know EXACTLY who they were competing against, and we can interpret their grades much more easily and know "what we're getting."

I can accept an argument that the MCAT is a terrible predictor of how good a doctor you are, how smart you are, etc. But those are separate arguments from your point #1. The numbers say that DO school is still a back-up option for a tremendous number of applicants.

I welcome data on this (but PM me a link, b/c I don't want this thread to get further off track).

Edit: Just saw a link above. Those numbers are from 2000-2005. Things have changed a lot in the last 5 years. In the last 5 years, my school's average accepted MCAT has gone from <24 to around 30.

My school's average accepted MCAT has been >28 since I got admitted and I'm sure has broken the 30 mark. Unfortunately, our web people are incompetent and the website has not been updated to reflect this...

Admission to medical school has become so competitive that beggars can no longer be choosers. Applicants can no longer afford to apply to DO schools as "backups". Admission to the top schools is now based more on WHO you know than on WHAT you know.

Regardless, I don't really care...I'm in and seeing the light at the end of the tunnel...we can let the pre-meds hash this out further, as they are wont to do.

 

[whopper]

I assume Columbia does the honorable thing and returns application fees to D.O.s who have mistakenly applied because they were unaware of Columbia's unwritten policy of not hiring D.O.s. Yeah, right....

Agree, if a place will not consider a D.O., then they ought to say it outright so people will not waste their time and money.

 

[atsai3]

Agree, if a place will not consider a D.O., then they ought to say it outright so people will not waste their time and money.

This seems reasonable but may be difficult to fairly implement in practice. Why should the "DO filter" be the only filter that is regarded as important enough to disclose up front? If the program director at Duke will not consider any applicants whose letters say "this medical student is not a team player", do they need to disclose this up front as well? That would ward off all non-team players from applying to Duke and save them a lot of time and money.

One could argue that DO status is something like race, sex, or religion and therefore should not be "discriminated" against, but what is being argued in this thread is that on average DO status is perceived as a marker for quality. Irrespective of the special cases who chose to go to a DO school specifically because their step-godfather was dying in a nursing home nearby and they simultaneously had a non-negotiable preference to study anatomy in a non-cadaver-based curriculum in a geographic area next to the ocean, all else being equal, the average person would not choose to go to a DO school. It may be that the overall competitiveness of the residency applicant pool (osteopaths and allopaths) is increasing. But that just means the distribution of quality (of osteopaths and allopaths) is shifted to the right. For the program director faced with hundreds of applications who needs to make a screening policy based on averages, filtering out DO applicants would seem to be an efficient first cut at selecting an interview pool.

-AT.

 

[Manicsleep]

I remember trying to get osteopathic residents, we had a couple of really good ones rotate through, to work with their medical schools to facilitate putting us on some kind of a list. We wanted to let them know that we were open to DOs coming here etc.

The school administration wanted no part of it although in words they played the part. After a couple of months we got frustrated and said forget it. It had to do with being ACGME only. I don't know what the osteopathic version of that is but they wanted us to try and get that accreditation. That was not going to happen and since there was a policy of no pre matches, we got very few DOs and got MDs that were of lower quality or IMGs.

I think the DO vs MD issue has been and will be one of power. The AOA doesn't want to become irrelevant even though it really serves no real purpose. DO=MD for all intents and purposes but as long as DOs stay apart, certain doors will be closed to them. In California this is particularly true and you can pretty much say that the major programs are unfriendly although I don't think they are exclusive.