REALITY of the merger: PD: "We went from 170 applications to 450 applications our first cycle"

[Drrrrrr. Celty]

EM was nasty this year. I would definitely label it a competitive specialty. No idea where the spike in interest is coming from.

The same place where the interest in psych is probably. 90s kids who grew up on video games.

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[ZucattiManicotti]

All this is making me worried that I will be attending a DO school.

I want to be an addictions psychiatrist.

Also am Canadian, so needing an H1b does not help.

 

[AnatomyGrey12]

EM was nasty this year. I would definitely label it a competitive specialty. No idea where the spike in interest is coming from.

For some reason it has a rep of a lifestyle specialty... as someone who has worked closely with the ER for a number of years my response whenever I hear this is

 

[68PGunner]

For some reason it has a rep of a lifestyle specialty... as someone who has worked closely with the ER for a number of years my response whenever I hear this is

It comes from the mentality that you're working 15-17 days in a month for 340-360Ks a year.

 

[Drrrrrr. Celty]

All this is making me worried that I will be attending a DO school.

I want to be an addictions psychiatrist.

Also am Canadian, so needing an H1b does not help.

Work hard and you'll get it.

 

[AnatomyGrey12]

It comes from the mentality that you're working 15-17 days in a month for 340-360Ks a year.

Agreed. And that is a fairly low number honestly. The EM docs at my hospital say you can fairly easily find a starting salary at 400+ outside of the coasts. They walk around like zombies though, just as much as the surgeons do.

 

[68PGunner]

Agreed. And that is a fairly low number honestly. The EM docs at my hospital say you can fairly easily find a starting salary at 400+ outside of the coasts. They walk around like zombies though, just as much as the surgeons do.

I have been to the EM as a pt. What is so gruesome about EM?

 

[IslandStyle808]

Yes and no. I really like the academic faculty in EM because I feel they respect hard work and select residents based on merit and who they can see themselves working with. I Love the idea of the SLOE because it allows everyone to prove themselves and show their dedication. However if you look at the numbers it still seems that DOs have a harder time matching into an ACGME residency when compared to MDs. There are a lot of great programs that will consider DO's, but there are also a lot of programs that simply don't interview DO's. The majority of the programs I interviewed with did not have any current DO residents, and I can't remember meeting any DO applicants.

If you look at Charting Outcomes in the Match for DOs, EM has one of the lowest match rates at 76%.
http://www.nrmp.org/wp-content/uploads/2016/09/Charting-Outcomes-US-Osteopathic-2016.pdf

As it stands DO's have a good chance at matching at an ACGME program as long as they apply broadly (which everyone should do) and apply to programs known to be receptive to DO applicants. But unfortunately I can't say that DO applicants are on the same playing field as MD applicants.

In the end, the top programs are looking for ways to weed out the competition. This means outing DOs. However, compared with other fields, DO applicants do rather well in the match. Even PM&R, which you could considered one of the most DO friendly fields, has a match rate of 77%. Only a 1% difference from EM.

 

[ZucattiManicotti]

Work hard and you'll get it.

It just makes me anxious.

I mean there is the whole sdn attitude that anything beyond GP in rural nowhere is too competitive for DO and with the visa situation I worry many PDs will automatically rank internationals (even if they graduated from an American school) super low....

 

[AnatomyGrey12]

there is the whole sdn attitude that anything beyond GP in rural nowhere is too competitive for DO

No there isn't. A few posters are all about the sky falling but most are very reasonable and just say that matching competitive specialties/programs is harder than as an MD. Take care of your crap and don't fail anything, score decent on boards, and you will be fine.

 

[Ho0v-man]

EM was nasty this year. I would definitely label it a competitive specialty. No idea where the spike in interest is coming from.

High hourly compensation + short residency training + inability of people in their mid twenties to understand that their bodies can't cycle shifts forever

I don't see why everyone is lining up to supervise an army if midlevels though tbh.

 

[mackin95]

As a DO, what kind of step 1 score do I need for academic ob programs, assuming that location is not an issue? And community ob programs?

 

[DrfluffyMD]

EM is hot now because of reimbursement, just like how rads was hot between 2001 to 2008 due to the job market.

Those things are always cyclic and you can't predict how things pan out when you graduate.

 

[Drrrrrr. Celty]

EM is hot now because of reimbursement, just like how rads was hot between 2001 to 2008 due to the job market.

Those things are always cyclic and you can't predict how things pan out when you graduate.

What is the employment situation like in Rads?

 

[AnatomyGrey12]

I have been to the EM as a pt. What is so gruesome about EM?

The shifts can be basically super high intensity the whole time. Not bad for a brand new attending, but after a few years they say it really wears on you. Burnout is high in EM.

 

[Drrrrrr. Celty]

The shifts can be basically super high intensity the whole time. Not bad for a brand new attending, but after a few years they say it really wears on you. Burnout is high in EM.

I'm curious if you think that many of the EM doctors working in urgent care are there because they burnt out?

 

[IslandStyle808]

What is the employment situation like in Rads?

Jalby and I believe one of the residents on here stated that the market is slowly getting better. So competition should start to rise soon.

 

[AnatomyGrey12]

I'm curious if you think that many of the EM doctors working in urgent care are there because they burnt out?

No idea, where I am a lot of the urgent care places use FM physicians that want to make some extra cash and take a shift every now and then. It wouldn't surprise me though.

 

[DrfluffyMD]

What is the employment situation like in Rads?

Much better now, but med students tend to be a few years behind the actual job market

 

[Mr Roboto]

I'm curious if you think that many of the EM doctors working in urgent care are there because they burnt out?

Urgent care doc who did my pre-matriculation physical was an EM doc who said it was a great financial decision for him, because he gets dozens of emailed offers a week from similar places. He said they love hiring EMP because it increases the acuity of the patients their facility sees without sending them to an ER, so better billing. He said he worked around 30 hours a week for 250k, no call, regular hours, and loved life.

 

[Ioannes Paulus]

EM is getting tougher. Only 2 or 3 open programs in the SOAP this year. Same for OB.

 

[DrfluffyMD]

Looking at the charting outcomes I doubt a wide net and a 210 will fail to match.

Radiology is what percent IMG now? It's not a picky field and going off of the >500 comlex having essentially everyone match speaks volumes about it.

Was just looking at the NRMP 2016 match data and the 2016 ERAS data before my match. This is the data from last cycle of Interventional Radiology fellowship match. 21 DO graduates and 203 MD graduates matched into IR. According to the ERAS data, 26 DO grads and 208 MD grads applied. This represent a 81% match rate for DO grads and 98% match rate for MD grads. It's quite unfortunate.

 

[Drrrrrr. Celty]

Was just looking at the NRMP 2016 match data and the 2016 ERAS data before my match. This is the data from last cycle of Interventional Radiology fellowship match. 21 DO graduates and 203 MD graduates matched into IR. According to the ERAS data, 26 DO grads and 208 MD grads applied. This represent a 81% match rate for DO grads and 98% match rate for MD grads. It's quite unfortunate.

Seems like even splitting off from DR hasn't made IR all that competitive.

 

[DrfluffyMD]

Seems like even splitting off from DR hasn't made IR all that competitive.

This is the fellowship match. I haven't looked into the residency match data.

EDIT: Looks like 10 DOs matched the integrated program.

 

[2021Doctor]

There is a study that indicates that students applying to EM should take the USMLE.
Among osteopathic students who reported a USMLE score, 61% (95% CI 53.6–67.2) matched compared to 39% (95% CI 30.7–47.3) of those who did not report a USMLE score (difference=22%, 95% CI 11.2–32.5, p<0.0001).
Should Osteopathic Students Applying to Allopathic Emergency Medicine Programs Take the USMLE Exam?

 

[Drrrrrr. Celty]

There is a study that indicates that students applying to EM should take the USMLE.
Among osteopathic students who reported a USMLE score, 61% (95% CI 53.6–67.2) matched compared to 39% (95% CI 30.7–47.3) of those who did not report a USMLE score (difference=22%, 95% CI 11.2–32.5, p<0.0001).
Should Osteopathic Students Applying to Allopathic Emergency Medicine Programs Take the USMLE Exam?

Charting outcomes for 2016 has 77% of DO applicants matching into EM. I doubt in 2014 ( likely 2013 since the paper was accepted in 2014) only 51% of DOs match or that there were 100 more people who ranked programs than now.

 

[DrfluffyMD]

There is a study that indicates that students applying to EM should take the USMLE.
Among osteopathic students who reported a USMLE score, 61% (95% CI 53.6–67.2) matched compared to 39% (95% CI 30.7–47.3) of those who did not report a USMLE score (difference=22%, 95% CI 11.2–32.5, p<0.0001).
Should Osteopathic Students Applying to Allopathic Emergency Medicine Programs Take the USMLE Exam?

Probably going to be more competitive now since ED is getting more popular. Take the USMLE.

Looking at the ERAS 2016 statistics and the NRMP 2017 match data (for the last cycle)

587 DO candidates applied through ERAS
283 DO candidates matched EM, 3 matched Med-EM combined program, 1 matched Ped-EM combined program for a total of 287 matches

This is a 48.9% match rate. Seems to be a bit different vs. the 77% Charting outcome number would provide. I didn't look at that document, perhaps it counts AOA program too?

Bonus data: 74 DO candidates applied to ACGME ortho. 3 matched for a 4% match rate. 172 IMG plus FMG applied to ACGME ortho, 13 matched ortho for a 7.5% match rate

I for one, am very glad that my chosen field of radiology appears to be more accessible, and dare I say, demonstrate less bias, toward my DO colleagues.

Just in case I messed up the years by misunderstanding how the cycles align (I am used to the fellowship cycle by now), I also looked up the ERAS 2016 NRMP report. 224 DO's matched EM that year and 4 matched ortho.

Source

Main Residency Match Data - The Match, National Resident Matching Program
ERAS Statistics - ERAS - Services - AAMC

 

[AnatomyGrey12]

Probably going to be more competitive now since ED is getting more popular. Take the USMLE.

Looking at the ERAS 2016 statistics and the NRMP 2017 match data (for the last cycle)

587 DO candidates applied through ERAS
283 DO candidates matched EM, 3 matched Med-EM combined program, 1 matched Ped-EM combined program for a total of 287 matches

This is a 48.9% match rate. Seems to be a bit different vs. the 77% Charting outcome number would provide. I didn't look at that document, perhaps it counts AOA program too?

Bonus data: 74 DO candidates applied to ACGME ortho. 3 matched for a 4% match rate. 172 IMG plus FMG applied to ACGME ortho, 13 matched ortho for a 7.5% match rate

I for one, am very glad that my chosen field of radiology appears to be more accessible, and dare I say, demonstrate less bias, toward my DO colleagues.

Just in case I messed up the years by misunderstanding how the cycles align (I am used to the fellowship cycle by now), I also looked up the ERAS 2016 NRMP report. 224 DO's matched EM that year and 4 matched ortho.

Source

Main Residency Match Data - The Match, National Resident Matching Program
ERAS Statistics - ERAS - Services - AAMC

Those numbers are very misleading as it includes all the people who applied to AOA programs and matched in the AOA match.

 

[DrfluffyMD]

Those numbers are very misleading as it includes all the people who applied to AOA programs and matched in the AOA match.

Did AOA programs also use ERAS? That was not the case when I was matching.

 

[Drrrrrr. Celty]

Did AOA programs also use ERAS? That was not the case when I was matching.

I don't believe they did. That being said, I do believe that some people apply and interview in both matches and then can choose to opt to use the AOA match which subsequently removes from from the ACGME match. The numbers are to say the least a disservice.

 

[AnatomyGrey12]

Did AOA programs also use ERAS? That was not the case when I was matching.

I don't think so but even if they don't the numbers you cited are misleading and wrong. I know people who applied to both ACGME and AOA ortho programs, got some ACGME interviews but ultimately couldn't take the risk of not going through the AOA match. This practice is not uncommon, and because these people applied through ERAS they are counted in the numbers you cited even though they never went through the NRMP match and matched their specialty of choice in the AOA.

 

[DrfluffyMD]

I don't think so but even if they don't the numbers you cited are misleading and wrong. I know people who applied to both ACGME and AOA ortho programs, got some ACGME interviews but ultimately couldn't take the risk of not going through the AOA match. This practice is not uncommon, and because these people applied through ERAS they are counted in the numbers you cited even though they never went through the NRMP match and matched their specialty of choice in the AOA.

I qualified those numbers as represenative of the amount of ACGME matches. Those data represent no more and no less than that.

 

[Drrrrrr. Celty]

I qualified those numbers as represenative of the amount of ACGME matches. Those data represent no more and no less than that.

Yes, it tells you the absolute amount of matches in EM acgme. Which by itself has no capacity for meaningful statistical analysis or representation. If the AOA match was after the ACGME then this would be adequate, but it is not, it is before and as such people choose to remove themselves prior to obtaining a result.

 

[DrfluffyMD]

Will just have to see how the story unfolds as 2020 come closer.

 

[DrWhozits]

Probably going to be more competitive now since ED is getting more popular. Take the USMLE.

Looking at the ERAS 2016 statistics and the NRMP 2017 match data (for the last cycle)

587 DO candidates applied through ERAS
283 DO candidates matched EM, 3 matched Med-EM combined program, 1 matched Ped-EM combined program for a total of 287 matches

This is a 48.9% match rate. Seems to be a bit different vs. the 77% Charting outcome number would provide. I didn't look at that document, perhaps it counts AOA program too?

Bonus data: 74 DO candidates applied to ACGME ortho. 3 matched for a 4% match rate. 172 IMG plus FMG applied to ACGME ortho, 13 matched ortho for a 7.5% match rate

I for one, am very glad that my chosen field of radiology appears to be more accessible, and dare I say, demonstrate less bias, toward my DO colleagues.

Just in case I messed up the years by misunderstanding how the cycles align (I am used to the fellowship cycle by now), I also looked up the ERAS 2016 NRMP report. 224 DO's matched EM that year and 4 matched ortho.

Source

Main Residency Match Data - The Match, National Resident Matching Program
ERAS Statistics - ERAS - Services - AAMC

In 2016 for all specialities:

• 2918 DOs applied to ACGME programs
• 2396 matched to an ACGME program
• 586 ranked at least one program and went unmatched
• 1108 withdrew (mostly to match in AOA)
• 118 did not have a rank list

In 2017 for all specialities:

• 3590 DOs applied to ACGME programs
• 2933 matched to an ACGME program
• 657 ranked at least one program and went unmatched
• 1224 withdrew
• 186 did not have a rank list

Source: pg 15 on http://www.nrmp.org/wp-content/uploads/2016/04/Main-Match-Results-and-Data-2016.pdf
and
pg 15 on http://www.nrmp.org/wp-content/uploads/2017/04/Main-Match-Results-and-Data-2017.pdf

Point being, you cannot apply a cross analysis of the ERAS stats and NRMP stats. The NRMP provides all of the statistics one needs to analyze macro-trends for DOs. It is a little dicey when you try to look into each individual speciality due to the separate matches and the ~300 people who didn't even have a rank list.

 

[Drrrrrr. Celty]

Will just have to see how the story unfolds as 2020 come closer.

I mean, it's not like these aoa em spots are going to all close down. Plenty of them are run by people who have good connections and affiliations to DO schools. I'm sure EM will become more competitive, but I doubt by much.

 

[AnatomyGrey12]

I qualified those numbers as represenative of the amount of ACGME matches. Those data represent no more and no less than that.

No you didn't, you gave percentages and said things like "48.9% match rate for EM" and "4% match rate for ortho" which are just flat out not true. Especially when the charting outcomes clearly gives a 77% match rate for EM. The raw data you presented mean very little to ones chances of matching outside of saying that few people match ACGME ortho and a decent amount match ACGME EM.

 

[clamsauce]

While some people succeed at it, why would somebody go to a DO school if you plan on doing some super competitive surgical residency? Basically shooting yourself in the foot. Better to wait a year, spruce up your application with a better GPA/MCAT letters of rec, and apply to MD.


Not wise to climb mountains without the proper equipment.

 

[jw3600]

While some people succeed at it, why would somebody go to a DO school if you plan on doing some super competitive surgical residency? Basically shooting yourself in the foot. Better to wait a year, spruce up your application with a better GPA/MCAT letters of rec, and apply to MD.


Not wise to climb mountains without the proper equipment.

Why would anyone develop type II diabetes? What an idiot. There's really no need to develop medical therapy for people like that. They should have thought it through more.

Are you serious? A large majority of the people in DO schools are there after exhausting all their options for MD. Present company included. Your list of reasoning is simplistic and at large with how the world works.

 

[AnatomyGrey12]

While some people succeed at it, why would somebody go to a DO school if you plan on doing some super competitive surgical residency? Basically shooting yourself in the foot. Better to wait a year, spruce up your application with a better GPA/MCAT letters of rec, and apply to MD.


Not wise to climb mountains without the proper equipment.

Well seeing as the chances are better at a DO school than an MBA program it should be fairly obvious....

 

[clamsauce]

some people just need to realize they arent cut out for it. or at least not blame DO schools for hindering their ability to be neurological plastic dermatologistist ENT billionaires or whatever they think they will be when they grow up.

of course u cant tell people that bc truth is painful lol

only need like a 30 to get into most state MD schools. excluding maybe the californians and some northeastern places.


A 30 isnt that hard to get, I mean CMON it isnt that hard to get into a state MD school in most places.

but hey id be mad too if somebody slammed the ortho door in my face too so keep at the hangry

 

[DrfluffyMD]

some people just need to realize they arent cut out for it. or at least not blame DO schools for hindering their ability to be neurological plastic dermatologistist ENT billionaires or whatever they think they will be when they grow up.

of course u cant tell people that bc truth is painful lol

only need like a 30 to get into most state MD schools. excluding maybe the californians and some northeastern places.


A 30 isnt that hard to get, I mean CMON it isnt that hard to get into a state MD school in most places.

but hey id be mad too if somebody slammed the ortho door in my face too so keep at the hangry

Not the most sensitive comment. Have you worked with DOs side by side? Some of them are the best clinician I know.

Trouble is, with the merger, I think we are heading to a separate and not equal training system with DO focusing on primary care and MD focusing on specialization, whereas previously DO candidates can specialize at more or less similar difficulities vs their MD counter parts (less programs but less competition).

 

[jw3600]

some people just need to realize they arent cut out for it. or at least not blame DO schools for hindering their ability to be neurological plastic dermatologistist ENT billionaires or whatever they think they will be when they grow up.

of course u cant tell people that bc truth is painful lol

only need like a 30 to get into most state MD schools. excluding maybe the californians and some northeastern places.


A 30 isnt that hard to get, I mean CMON it isnt that hard to get into a state MD school in most places.

but hey id be mad too if somebody slammed the ortho door in my face too so keep at the hangry

Really nothing you have said is relevant. I liked it better when you had zero posts not 6.

 

[68PGunner]

Not the most sensitive comment. Have you worked with DOs side by side? Some of them are the best clinician I know.

Trouble is, with the merger, I think we are heading to a separate and not equal training system with DO focusing on primary care and MD focusing on specialization, whereas previously DO candidates can specialize at more or less similar difficulities vs their MD counter parts (less programs but less competition).

If primary care physicians are all DOs, I think it would backfire on the whole MD = specialization deal. In that scenario, the DOs would become the gatekeepers to the referral base. If that's the case, what's stopping DOs from doing fellowships in order to offer their clients the specialized service.

 

[Drrrrrr. Celty]

If primary care physicians are all DOs, I think it would backfire on the whole MD = specialization deal. In that scenario, the DOs would become the gatekeepers to the referral base. If that's the case, what's stopping DOs from doing fellowships in order to offer their clients the specialized service.

I don't understand any of this post.

 

[Drrrrrr. Celty]

Not the most sensitive comment. Have you worked with DOs side by side? Some of them are the best clinician I know.

Trouble is, with the merger, I think we are heading to a separate and not equal training system with DO focusing on primary care and MD focusing on specialization, whereas previously DO candidates can specialize at more or less similar difficulities vs their MD counter parts (less programs but less competition).

Uh.... no.
DOs are going to suffer in getting into subspecialty surgery, but aside from that, you're painting a rather reactionary image.

 

[68PGunner]

I don't understand any of this post.

What's a possible benefit of all primary care physicians being DOs especially when DOs are going to be the de facto go to options for all kind of ailments and the drivers for the referral base?

Once you have that answer, reread my post again.

 

[Ho0v-man]

some people just need to realize they arent cut out for it. or at least not blame DO schools for hindering their ability to be neurological plastic dermatologistist ENT billionaires or whatever they think they will be when they grow up.

of course u cant tell people that bc truth is painful lol

only need like a 30 to get into most state MD schools. excluding maybe the californians and some northeastern places.


A 30 isnt that hard to get, I mean CMON it isnt that hard to get into a state MD school in most places.

but hey id be mad too if somebody slammed the ortho door in my face too so keep at the hangry

You know there's more to it than getting a 30. I have two MD schools in my state. One said I was DOA without research and they don't "...exactly fall all over ourselves for non-trads." The other wanted all prerequisites within 3 years of applying. Both wanted a premedical committee letter who wouldn't write one unless I signed up for their SMP that's not even affiliated with a med school. It looks like you're at LMU with a very high MCAT so you must know numbers aren't the only issue.

Now if you're talking about the traditional students with a perfect app but a 500 MCAT who just don't want to do a retake for whatever reason then yeah I get it.

 

[Drrrrrr. Celty]

What's a possible benefit of all primary care physicians being DOs especially when DOs are going to be the de facto go to options for all kind of ailments and the drivers for the referral base?

Once you have that answer, reread my post again.

I read your post prior to reading the original one. I think largely all of it is painting an absurd picture that has no pertinence to reality.

 

[DrfluffyMD]

If primary care physicians are all DOs, I think it would backfire on the whole MD = specialization deal. In that scenario, the DOs would become the gatekeepers to the referral base. If that's the case, what's stopping DOs from doing fellowships in order to offer their clients the specialized service.

Nothing. What's stopping the current primary care docs from specializing?

Hint: it has to do with the current resource distribution in graduate medical education.

It actually was already done, in a way, in the form of AOA ortho and derm programs, which drew the ire of ACGME.