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

[DetectiveAlonzo]

DO is cool option if you don't MIND primary care as an ultimate option. Simple.

But **** OPP.... **** the COMLEX... and **** the crybabies who act like DO is an inferior degree.

We learn the same amount of stuff MDs plus that garbage science known as OPP.

Stupid-ass OPP takes up a bulk of our time that could be MUCH better dedicated to research... or board studying.

Things that MD students get to do more often than us.

As a whole... I got no complaints.

Rather be here than in the Caribbean.

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[frappalino16]

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

until these recent changes, I would say that getting ortho was easier as a DO than an MD due to AOA ortho residency positions.
Source: am ortho resident

 

[TX8]

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.

With more and more PCPs choosing to be employees of large hospital systems rather than own their own practice they don't have the option to choose which specialists they refer to or add additional services. They are required to only refer to specialists within the system and only offer approved services. However, PCPs that own their own practice are free to preferentially refer their patients to DO specialists or branch out a bit from their specialty and offer additional services they feel qualified to provide (such as noninvasive cosmetic procedures).

 

[Lexdiamondz]

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.

All DOs being funnelled into pricare isn't the same as pricare being all DOs.

 

[AnatomyGrey12]

All DOs being funnelled into pricare isn't the same as pricare being all DOs.

And neither will happen honestly. People always seem to separate the world into PC and subspecialty surgery, and completely neglect the fact that there are many uncompetitive specialties out there that DOs match very well in.

 

[tux4]

And neither will happen honestly. People always seem to separate the world into PC and subspecialty surgery, and completely neglect the fact that there are many uncompetitive specialties out there that DOs match very well in.

That's because on SDN it is subspecialty surgery or bust with some settling for EM.

DO's will continue to match just fine with a majority of applicants practicing in the field they desire. We may not all satisfy our wall of diplomas with names like Johns Hopkins or Upenn but most don't care. Like others have said, a lot of people end up in DO school because of either subpar GPA, MCAT, etc and just want to end the pain with applying to things and interviewing and just practice medicine.


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[grapefruit17]

My best friend in my class is currently about to start residency at Emory. And she interviewed at Hopkins.

With hard work, and the ability to adapt..people would be surprised at the possibilities.

 

[acapnial]

My best friend in my class is currently about to start her residency at Emory. And she interviewed at Hopkins.

With hard work, and the ability to adapt..people would be surprised at the possibilities.

gas? psych?

 

[grapefruit17]

It was a primary care residency. lol I'm not far enough along to be looking at fellowships with my friend, we're still lowly incoming interns.

Of course, you have to work hard, harder than most to end up at a solid place but many people who enter do school are capable of it. I.e if you have big ambitions, work hard. Very, very hard. You might surprise yourself

 

[68PGunner]

And neither will happen honestly. People always seem to separate the world into PC and subspecialty surgery, and completely neglect the fact that there are many uncompetitive specialties out there that DOs match very well in.

I feel the same way. However, I guarantee you that your tone is going to be much more somber after 1st year from your experience with all the bs from the AOA, DO expansion, and other useless gimmicks.

 

[68PGunner]

It was a primary care residency. lol I'm not far enough along to be looking at fellowships with my friend, we're still lowly incoming interns.

Of course, you have to work hard, harder than most to end up at a solid place but many people who enter do school are capable of it. I.e if you have big ambitions, work hard. Very, very hard. You might surprise yourself

So, now we need top quartile, top board scores, and research to match to solid primary care residencies? I've heard everything now...

 

[DetectiveAlonzo]

FWIW... I'll take a backwoods, swamp, hoodrat ratchet residency that many IMGs get into if that's what it takes.

#shouldhavedonepodiatry

#orbetteryetnursing

#orevenapsyd

 

[grapefruit17]

So, now we need top quartile, top board scores, and research to match to solid primary care residencies? I've heard everything now...

I actually never said any of those things...?

I said you have to work hard, harder than most...chill..matching a good program that's well known is competive in any area of medicine.

 

[68PGunner]

I actually never said any of those things...?

I said you have to work hard, harder than most...chill..matching a good program that's well known is competive in any area of medicine.

It's primary care... That's my point.

 

[DrfluffyMD]

It's actually really easy to quantify. One criteria they use in nuclear medicine divide the probablity of PE between 0-20, 20-80 and 80-100%

Here's Drfluffy's criteria for ACGME competitiveness, using the percentage difference between USMD ACGME match rate and DO ACGME match rate

0-20% difference: no significant bias against DO applicants.
20-80% difference: intermediate bias against DO applicant.
80%-100+% difference: heavy bias

Example: ACGME GI fellowship
USMD match rate: 309/381 or 81%
DO: 28/73 or 48% match rate.
Conclusion: heavy bias as MD holder are nearly twice as likely to match.

 

[grapefruit17]

You don't think primary care at Ivy League residencies is competive..? I'm confused what you're getting at

 

[DrfluffyMD]

double post

 

[AnatomyGrey12]

I feel the same way. However, I guarantee you that your tone is going to be much more somber after 1st year from your experience with all the bs from the AOA, DO expansion, and other useless gimmicks.

Oh I've already resigned myself to that fact. I'm at a DO school because it will allow me to be a doctor. I am one of the few that did my research very thoroughly, and I know all the BS that happens. I just plan on busting tail from day 1 so I can have as many options as possible. Also once I'm done with school I'll kiss the AOA goodbye. School expansion will slow down I think, because of COCA having their accreditation scrutinized. I think they might actually kick it in gear (fingers crossed).

 

[acapnial]

You don't think primary care at Ivy League residencies is competive..? I'm confused what you're getting at

Ivy league is a term best suited for undergrad. It doesn't have the same stamp of quality in the world of residency. Also emory and johns hopkins aren't ivy league, if that's what you were referring to.

So, now we need top quartile, top board scores, and research to match to solid primary care residencies? I've heard everything now...

It might not be THAT competitive, but the truth is there's no specialty out there where you can be a terrible applicant and fall backwards into a great residency.

 

[grapefruit17]

I worded that a little off. My main point was that name definitely attracts more applicant. Ivy League or not, I do feel like a lot of applicants associate good with more well known names, driving up the competition a bit. But I do agree, name doesn't determine quality of the program and there are many reputable names that probably have poorly run programs.

And yes to the second part of your post. I agree. It may not be ortho level competive, but as a do applying to the md match I feel like that was one negative against me. Applying as an average do applicant to solid programs, whether primary care or whatever, is more challenging then people may realize. And you have to work hard to be average on boards, mainly for usmle. 230 usmle isn't the walk in the park that many first/second/pre dos think.

 

[DrfluffyMD]

I worded that a little off. My main point was that name definitely attracts more applicant. Ivy League or not, I do feel like a lot of applicants associate good with more well known names, driving up the competition a bit. But I do agree, name doesn't determine quality of the program and there are many reputable names that probably have poorly run programs.

And yes to the second part of your post. I agree. It may not be ortho level competive, but as a do applying to the md match I feel like that was one negative against me. Applying as an average do applicant to solid programs, whether primary care or whatever, is more challenging then people may realize. And you have to work hard to be average on boards, mainly for usmle. 230 usmle isn't the walk in the park that many first/second/pre dos think.

To be fair, internal medicine at MGH is more competitive than the average community and lower tier academic ortho.

Peds at CHOP is quite possibly ortho level too.

 

[Lexdiamondz]

To be fair, internal medicine at MGH is more competitive than the average community and lower tier academic ortho.

Peds at CHOP is quite possibly ortho level too.

I don't know why anyone would think differently. Matching Peds at CHOP is undoubtedly harder and more impressive than the majority of Ortho matches.

The best residencies in any field are gonna be hard, even if that field overall isn't that competitive.

 

[IslandStyle808]

It's actually really easy to quantify. One criteria they use in nuclear medicine divide the probablity of PE between 0-20, 20-80 and 80-100%

Here's Drfluffy's criteria for ACGME competitiveness, using the percentage difference between USMD ACGME match rate and DO ACGME match rate

0-20% difference: no significant bias against DO applicants.
20-80% difference: intermediate bias against DO applicant.
80%-100+% difference: heavy bias

Example: ACGME GI fellowship
USMD match rate: 309/381 or 81%
DO: 28/73 or 48% match rate.
Conclusion: heavy bias as MD holder are nearly twice as likely to match.

This analysis doesn't taking into account the reputability of the residencies of USMD and DO students. DO students have difficulty matching into mid-tier to top-tier places where their rep. carries a great deal of weight. DO bias at the fellowship level does exists, I definitely believe this, but the results you have are confounded by the initial bias faced by DOs during residency selection.

 

[BorntobeDO?]

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

I think it is the first big wave of 'scribes' completing medical schools. They have come in with it on their mind from the beginning.

 

[DetectiveAlonzo]

I think it is the first big wave of 'scribes' completing medical schools. They have come in with it on their mind from the beginning.

That's pretty it. Everybody and their moms who did scribing wants to do EM. Or they were previous EMTs.

 

[67552931811]

It's actually really easy to quantify. One criteria they use in nuclear medicine divide the probablity of PE between 0-20, 20-80 and 80-100%

Here's Drfluffy's criteria for ACGME competitiveness, using the percentage difference between USMD ACGME match rate and DO ACGME match rate

0-20% difference: no significant bias against DO applicants.
20-80% difference: intermediate bias against DO applicant.
80%-100+% difference: heavy bias

Example: ACGME GI fellowship
USMD match rate: 309/381 or 81%
DO: 28/73 or 48% match rate.
Conclusion: heavy bias as MD holder are nearly twice as likely to match.

I was wrong .

 

[DrfluffyMD]

Um, what? Source? They haven't released that info on DOs since 2011. Did you just make up those numbers there, orrrr.......?

Did you read my post before you accuse myself, no, NRMP and ERAS for making those numbers up?

 

[DrfluffyMD]

Neither source shows 73 DOs applied, dawg. Unless you are privy to info that isn't publicly available?

Go to
ERAS Statistics - ERAS - Services - AAMC

Select data from ACGME fellowship with applicant data. You will download a document called "gastroenterology"

This document will show that 73 applicant from Osteopathic school applied to GI fellowship through ERAS 2016.

Good luck.

 

[NurWollen]

Y'all should just do Peds. You can have any pediatric fellowship you want. Money is overrated anyway.

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[W19]

Not sure why this is a surprise though! We all in the MD world have predicted that... There isn't a shortage of applicants with 240s on step1 in the MD world who want to get into these competitive surgical subspecialties. The top DO students will have to compete with these MD students for those spots, and the bottom DO students will have to compete with many FMG/IMG with step1 score in the 230s for FM/IM/Peds spots. This in no way is a good thing for DO.

By the way, how that ortho program at Broward even begin to screen 450+ applicants for only 3 spots?

 

[Staphylococcus Aureus]

Is it true that F/IMGs study for +6 months for step 1? Is this fact taken into account when PDs view these applicants?

 

[ortnakas]

By the way, how that ortho program at Broward even begin to screen 450+ applicants for only 3 spots?

Audition rotations

 

[DrfluffyMD]

Audition rotations

Didn't Broward PD said that they are phasing out audition rotations?

 

[W19]

Audition rotations

I see...

Why is Broward ortho a community program? That program is in a big trauma hospital...

 

[ortnakas]

Didn't Broward PD said that they are phasing out audition rotations?

No idea-- I'm not familiar with Broward specifically. I just have a few friends who are going for ortho and apparently auditions are king in the DO ortho world. I can see how that might phase out with the ACGME transition, but on the other hand, for programs with such few spots, they have to limit the pool somehow, and sticking to people you're familiar with isn't an unreasonable way to do it. Not that they don't screen for academic qualifications as well, but picking by humans-that-won't-suck-to-work-with-for-five-years kind of makes sense.

(Before somebody comes back with "but what about the 265+ MD who is super qualified," I said not unreasonable, not best possible)

 

[DrfluffyMD]

No idea-- I'm not familiar with Broward specifically. I just have a few friends who are going for ortho and apparently auditions are king in the DO ortho world. I can see how that might phase out with the ACGME transition, but on the other hand, for programs with such few spots, they have to limit the pool somehow, and sticking to people you're familiar with isn't an unreasonable way to do it. Not that they don't screen for academic qualifications as well, but picking by humans-that-won't-suck-to-work-with-for-five-years kind of makes sense.

(Before somebody comes back with "but what about the 265+ MD who is super qualified," I said not unreasonable, not best possible)

I remember in the beginning of this thread the PD talked about how he is phasing out audition, persumably to be more intune with the ACGME world. I always think audition rotation benefit those who can afford to travel and do a bunch of those more than it should.

 

[GypsyHummus]

Huh, maybe not getting into DO school was a blessing in disguise.

#podlife
#notallDOsarePCP

FWIW... I'll take a backwoods, swamp, hoodrat ratchet residency that many IMGs get into if that's what it takes.

#shouldhavedonepodiatry

#orbetteryetnursing

#orevenapsyd

 

[Animalcules]

Is it true that F/IMGs study for +6 months for step 1? Is this fact taken into account when PDs view these applicants?

Don't worry, you are at every possible advantage compared to most FMGs who take the exam in their non-native language and have not gone trough med school answering USMLE style questions.

If you still can't outcompete them, I would suggest you should have studied longer for Step 1 yourself. Don't count on protectionist PDs.


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[Staphylococcus Aureus]

Don't worry, you are at every possible advantage compared to most FMGs who take the exam in their non-native language and have not gone trough med school answering USMLE style questions.

If you still can't outcompete them, I would suggest you should have studied longer for Step 1 yourself. Don't count on protectionist PDs.

I was more referring to IMGs, but yes obviously US med students have the edge on an exam written for US med schools. Was simply curious if PDs see a 230 as a 230 no matter the surrounding factors, for better or worse.

 

[Drrrrrr. Celty]

Not sure why this is a surprise though! We all in the MD world have predicted that... There isn't a shortage of applicants with 240s on step1 in the MD world who want to get into these competitive surgical subspecialties. The top DO students will have to compete with these MD students for those spots, and the bottom DO students will have to compete with many FMG/IMG with step1 score in the 230s for FM/IM/Peds spots. This in no way is a good thing for DO.

By the way, how that ortho program at Broward even begin to screen 450+ applicants for only 3 spots?

God, all of your posts are about the world being on fire. Probably more than half of the people at my school who matched into FM didn't even take the USMLE and made it predominately into either university programs or very large community programs.

 

[ThreeCheers]

Don't worry, you are at every possible advantage compared to most FMGs who take the exam in their non-native language and have not gone trough med school answering USMLE style questions.

If you still can't outcompete them, I would suggest you should have studied longer for Step 1 yourself. Don't count on protectionist PDs.


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lol which D.O. schools spoon-feed their students with USMLE style questions on their exams? Name names please because that sure as hell isn't the case with my school.

 

[Drrrrrr. Celty]

lol which D.O. schools spoon-feed their students with USMLE style questions on their exams? Name names please because that sure as hell isn't the case with my school.

KCU and RVU and TCOM.

From my experience my exams were almost identical in nature to Uworld. Long stems, commonly include the question as something entirely different or a focused point about the pathophysiology of the disease or related complications ( My professor loved crap like you have UC, the antibody commonly found in these patients is associated with what disease i.e p-anca for micro vasculites), never just diagnose what this person has.

 

[AlteredScale]

KCU and RVU and TCOM.

From my experience my exams were almost identical in nature to Uworld. Long stems, commonly include the question as something entirely different or a focused point about the pathophysiology of the disease or related complications ( My professor loved crap like you have UC, the antibody commonly found in these patients is associated with what disease i.e p-anca for micro vasculites), never just diagnose what this person has.

Primary sclerosing biliary sclerosis, toxic megacolon, mucosal layer only, innate mediated, distal colon, bloody stool!


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[Drrrrrr. Celty]

Primary sclerosing biliary sclerosis, toxic megacolon, mucosal layer only, innate mediated, distal colon, bloody stool!


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I feel like most times our path tests were very comprehensive. And had there been more time to honestly study for them, they would have been golden for boards.

 

[ThreeCheers]

Jealous. My school does alright with testing second and third order questions, but a lot of our professors force us to learn random stuff from their PhD research. I know students at nearby D.O. (and M.D.) schools that complain of the same thing.

I still think it was a weird choice to accuse D.O. students as a whole of having an advantage in that aspect vs. IMG's. I've always heard that Caribbean schools were the ones that gave their students few academic responsibilities outside of learning how to answer USMLE style questions, but truthfully I've never researched Caribbean schools myself so I'm unsure.

 

[Giovanotto]

Jealous. My school does alright with testing second and third order questions, but a lot of our professors force us to learn random stuff from their PhD research. I know students at nearby D.O. (and M.D.) schools that complain of the same thing.

I still think it was a weird choice to accuse D.O. students as a whole of having an advantage in that aspect vs. IMG's. I've always heard that Caribbean schools were the ones that gave their students few academic responsibilities outside of learning how to answer USMLE style questions, but truthfully I've never researched Caribbean schools myself so I'm unsure.

My school is terrible at this. They are "trying" to make exams more board-style but they fall flat on their heads with every single exam. They are hilariously poorly written as far as mirroring boards. It's quite sad...

 

[johnnxyz]

I start a DO school this year and I've given thought to this merger thing. I feel like if you're going for surgery or surgical subspecialties then you better have the stats that the MDs will have, but for non surgical stuff besides dermatology I can see a scenario where DOs benefit. Here's my logic (correct me if I'm wrong): the MDs who might have gone to anesthesiology or radiology or even academic IM will instead go to the surgical subs that DOs had protected for them, opening those ACGME spots up for DOs.

 

[IslandStyle808]

I start a DO school this year and I've given thought to this merger thing. I feel like if you're going for surgery or surgical subspecialties then you better have the stats that the MDs will have, but for non surgical stuff besides dermatology I can see a scenario where DOs benefit. Here's my logic (correct me if I'm wrong): the MDs who might have gone to anesthesiology or radiology or even academic IM will instead go to the surgical subs that DOs had protected for them, opening those ACGME spots up for DOs.

Nope. Remember that the match rate for derm is around 70 percent. So those people who wouldn't have matched into a derm ACGME residency will now have a chance at matching into derm AOA residencies. DOs who cannot compete against these MDs will be pushed out of derm. This would be the same trend for the surgical sub-specialties as well.

DOs are not as competitive as MDs overall and so a lot of them will be pushed into less competitive residencies and even programs.

 

[jw3600]

I start a DO school this year and I've given thought to this merger thing. I feel like if you're going for surgery or surgical subspecialties then you better have the stats that the MDs will have, but for non surgical stuff besides dermatology I can see a scenario where DOs benefit. Here's my logic (correct me if I'm wrong): the MDs who might have gone to anesthesiology or radiology or even academic IM will instead go to the surgical subs that DOs had protected for them, opening those ACGME spots up for DOs.

Glass half full kind of guy. Merger is only good for the DO profession. Not really great for any single individual DO student. It will be a little better once there is one match in 2020 though.

 

[DrWhozits]

Glass half full kind of guy. Merger is only good for the DO profession. Not really great for any single individual DO student. It will be a little better once there is one match in 2020 though.

I've always been a glass half-empty guy, but on this issue I'm not. I have yet to hear a compelling argument for how this is bad for DOs not pursuing a surgerical sub (so most)