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Research at DO schools: does it exist?

Discussion in 'Medical Students - DO' started by DOPhD student, Oct 14, 1999.

  1. DOPhD student

    DOPhD student Senior Member
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    Recently, I've been thinking about research at DO schools, and I did some homework. What I found out really surprised me. PIs from my school received ~ $5,000,000 funding from the NIH last year and the amount has steadily increased. However, compared to more established schools such as Baylor College of Medicine or UT Southwestern Medical School (which has about 10 Nobel prize winners among its PIs), the funding at my school is but a drop in the bucket. Baylor PIs received ~ $170,000,000 NIH funding. Now what that means is there is much more research going on at the highly funded schools as compared to the less funded schools. What surprised me even more is that some DO schools are receiving even less funding. One DO school receives a little over $300,000 and another even much less, $50,000. It makes me wonder if DO schools just don't hire enough PhDs who want to actively participate in research instead of just teaching medical students. I don't wish to debate the value of primary care orientation at DO schools VS. the research issue. Being pro-primary care is fine, but to be the discoverer of knowledge is is just as important, if not more than, being the knowledge consumer. Reputation is built upon the legacy of research, and DO schools, if they wish to play on a level playing field in the future, had better be prepared to "play with the big boys."
     
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  3. Ponyboy

    Ponyboy Senior Member
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    I think that it's also important for medical schools to have educators who do active research. If I'm going to be taught something, I want to be taught by someone who is up-to-date in their respective fields and is aware of new ideas and technologies. This is especially important in clinical sciences but it is also quite applicable in basic sciences.
     
  4. jdaasbo

    jdaasbo Senior Member
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    here is an idea:

    How about a medical school which has all the basic sciences taught by Clinicians (ie MDs DOs, etc). Have lots of Ph.D.s but keep them in the labs, doing the research and cranking out the numbers. I think that research endeavors are wonderful, but at the same time i think it is RARE that someone who is grossly engaged in hard core Nobel Prize level research has any interest at all in teaching med students.

    I think it is silly to have Ph.D. faculty teaching patient case workshops in biochem, when they have knowledge only of biochemistry.

    My dream curriculum is something like this. Basic sciences taught by DO/MDs who have had research experience, but are also clinicians. Lots of patient exposure in the first two years, but make that continuous with the basic science stuff. For instance, when learning about Sickle cell first have a lecture including the pathology and relevant basic science stuff. Then have a workshop on phlebotomy and venipuncture. Follow that up in the afternoon by seeing a sicle cell patient yourself by yourself (interviewing, etc) drawing a blood specimen, taking it to the lab and looking at in under the microscope.

    This would be hard as hell to implement but it is just a fantasy.

     
  5. Ponyboy

    Ponyboy Senior Member
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    It's been my experience that some of the best educators are also the ones who are doing the most research. I think that the main reason behind this is the fact that those who love discovering knowledge are oftentimes the ones who also love sharing the knowledge. That is why they make good educators. In many schools, MD's do teach basic science courses alongside their PhD counterparts. I think that it's good to have both viewpoints as we get to see things from a research standpoint as well as a clinical standpoint.
    Incidentally, we had a lecture on thalassemia and sickle cell yesterday and this afternoon, we had a blood collecting workshop. (the sickle cell patient interviewing and collection would be a bit difficult to orchestrate though)
     
  6. drusso

    Physician Moderator Emeritus Lifetime Donor Classifieds Approved 10+ Year Member

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    I think that much of the deficit in research funding at DO schools reflects the fact that back in the "bad old days" the profession was so busy putting every drop of its energy into political fights with allopathic medicine that research suffered. Imagine being an AOA board of trustees member 40 years ago. Are you going to allocate money for research or to pay lawyers fighting for your physicians' practice rights in some state where MD's were trying to illegalize osteopathic medicine? Also, during the so called "golden era of medicine" the reserach and grant awarding process was so political that MD's effectively managed to keep the DO's out. It wasn't until the early 1970's that NIH hired its first DO researcher, if I recall correctly.

    Relatedly, some of the best musculoskeletal osteopathic research was conducted before World War II. After that there's this gap of about 30 years where very little was done. Today, I think that there is a renewal of interest in osteopathic research. Now that many of the political fights have been settled, I see DO schools getting more involved in research, especially in clinical research, and being able to attract faculty with research experience.

    UMDNJ-SOM has back-pain and headache centers that are doing interesting clinical research.
    http://www3.umdnj.edu/%7Esom/departments/index.html

    Western University has a center for disability studies that has a research component:
    http://www.westernu.edu/cdihp.html

    The profession is definitely way behind the curve in this arena, especially in basic biomedical science research. It wouldn't hurt if the AOA got a little more aggressive about awarding training grants to scientist-practitioner types of programs.


    ------------------
    David Russo, MS3
    UNTHSC/TCOM
    Research Fellow, Department of Osteopathic Manipulative Medicine


    [This message has been edited by drusso (edited October 15, 1999).]
     
  7. bri1856

    bri1856 Member
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    I believe the reason that it is difficult to find osteopathic schools that do a lot research is that most of them are private institutions. These institutions have difficulty providing the necessary support and facilities to attract and keep research scientists. Additionally, many of these school do not have MS or PhD granting programs which provide cheap and good labor for these researchers.
     
  8. IDAHO

    IDAHO Member
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    DO/PhD student;

    Where did you get the NIH grant information?
     
  9. DOPhD student

    DOPhD student Senior Member
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    I am aware of the past struggles with "the power that be" and the scarcity of resources which were allocated to the fight for parity. However, the AOA needs to develop new agendas to encourage research on all fronts - not just OMT research - including basic biomedical research at osteopathic schools. The osteopathic community's claim to be an equal, separate, but distinct group of physicians obligates us to be self-sufficient, well rounded professionals actively involved in patient care, medical education, and research.

    I got the funding info. from various publications and employment announcements.
     
  10. ewagner

    ewagner Senior Member
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    It is my opinion, that there is a trade off when attending a DO medical school. With only so much time allowed in school, and with the inclusion of OPP/ODT in curriculum, research classes are ommitted from the curriculum. That only seems to make sense. Where one allopathic school receives an entire class on research, we trade that for osteopathic principles and practice. It only stands to reason that this may be so. This is neither good nor bad, depending on what you want to do. Personally, I would like a little bit more on research design and statistics as opposed to learning 15 ways to correct a rib dysfunction yadda yadda. I hope this is not offensive to any die hards out there.
     
  11. drusso

    Physician Moderator Emeritus Lifetime Donor Classifieds Approved 10+ Year Member

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    My friends at MD schools got just a little research methodology and design classes in the first two years of medical school as I did! Have you ever seen what the USMLE expects from students in terms of the ability to interpret research or evidence-based medicine? It's pathetic. I'm willing to wager that more than half of all medical students (regardless of degree) can't tell the difference between relative risk and an odds ratio or explain what a confidence interval is.

    That's the principle reason why I'm earning an MPH in epidemiology in addition to my DO degree: I'll be able to plan, conduct, and analyze clinical research AND correct any nasty rib somatic dysfunctions that may occur concomitantly [​IMG]

    DOPhD--I agree with you 100% But, let me ask you this: Do YOU intend to conduct research, teach medical students, and train graduate students at an osteopathic institution? Probably not. Your options would be very limited. You'll probably go to whatever university or medical school offers you the best deal regardless of the "brand" of medicine attached to it. I don't blame you either. But, in the final analysis, the osteopathic profession loses yet another otherwise productive member. So, the real question is, "How should the osteopathic profession create incentives to train and retain DO/PhD or DO/MPH clinician-scientists?"

    Any thoughts?

    ------------------
    David Russo, MS3
    UNTHSC/TCOM
    Research Fellow, Department of Osteopathic Manipulative Medicine


    [This message has been edited by drusso (edited October 16, 1999).]

    [This message has been edited by drusso (edited October 16, 1999).]
     
  12. ewagner

    ewagner Senior Member
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    Drusso,
    I'd be willing to take a bet that other schools get more research design and reading classes than at least I do at my school. There is another medical school in my city that has an entire class on research design (I saw their test!).
    As a matter of fact, when I was in PT school we read more research, conducted more research and had a research class. Now this is not criticism of my school or of you. Rather, this is an observation. You may be an extraordinary researcher, and I say "well done", but the fact remains, there must be a trade off somewhere in the curriculum.
     
  13. 2003

    2003 Senior Member
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    Many do not want to do research and that is fine. The problem is that research is the basis of medicine (not to mention funding, prestige...etc.) and DO's have a harder time getting involved in research than their MD counterparts. It may be a trade-off but many DO's aren't even presented with the option at their schools. I hope to be able to do an MPH along with the DO degree I just started in August. After/during this process I am sure the onus will always be on me to get involved in research whereas MD's, in my opinion, get offered more research opportunities. It would be good if there were some more highly established research programs at DO schools so that we had the option.
     
  14. njdevil

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    I believe that the research that is imperative to a medical school is basic sciences. Why are are the big-time medical schools "bigtime". The publish and produce. To have a good research program, you must have students, funds, and faculty. How can Kirksville compete with Harvard when Harvard has undergrad, grad students, and post docs working for a professor. How does Harvard or any other school with a real research program do this. Well, it is a University with a medical school. Until, DO schools have a full-fledged university with them...it will be difficult to "catch up". A bigtime research scientist, thinks of ideas and writes grants, while he or she has many people working for them. At a lot of DO schools, the pHDs are simply working in there lab with help from one or two others. So:

    #1 they don't have the hands to do the research

    #2 the big-time researchers aren't going to come to a place that doesn't provide grad students for them.

    So, being private isn't the problem, being strictly a medical is the problem.

    I wonder how Michigan State's pHDs do...probably better than Des Moines, KCOM in terms of producing.
     
  15. DOPhD student

    DOPhD student Senior Member
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    I feel that the lack of good research coming out of DO schools is not entirely based on the fact that some DO schools are private and not state supported institutions. It has to do more with mentality and drive rather than strictly economics. When DO schools begin to encourage their faculty members AND students to do research, good research will be produced, and with good research, the money will come. There are no stipulations that NIH grants be given only to state schools. The administrators must first change their unilateral focus, and everything will fall right into place. Sorry Drusso, I know you're probably an UTF of some sort and have your biases. My biases lie with basic biomedical research, in whatever field, because I think that's the language most people (the people who allocate resources) understand and that's also what brings in the money.

    [This message has been edited by DOPhD student (edited October 18, 1999).]
     
  16. It is nice to see some discussion about research at DO institutions. I hope that all of you consider a career in clinical research. Maybe I can shed some light on this topic for you.

    The American Osteopathic Association, American Association of Osteopathy and the American Association of Colleges of Osteopathic Medicine have also issued mission statements to increase research among Osteopathic physicians and Osteopathic institutions.

    The major challenge to among DO institutions is how to best implement, foster, and develop a competitive research program in institutions with no research tradition and minimal research infrastructure.

    Here are the issues:
    1. Infrastructure
    The majority of income for some DO schools comes from tuition and fees. This is contrary to the distribution of sources of revenue for medical schools nationwide which includes medical service (44%), federal research (20%), other income (15%), state and local government (14%), tuition and fees (6%), and other federal income (5%). DO schools need to seek monies to develop an environment to perform research. This includes start-up costs for a laboratory, research administration, grants and contracts people, etc. They will have to seek outside funding otherwise tuition will just go up and up and up and so will the number of students in each school. (is this already happening?)

    2. Faculty
    Information on the clinical research training of Osteopathic medical school faculty is limited. Overall, the training of clinical researchers is variable and has included subspecialty fellowship training, masters programs in public health and epidemiology, and one or more years of laboratory-based research. The NIH, Robert Wood Johnson Clinical Scholars program, University of Michigan School of Public Health, and the Harvard School of Public Health (Clinical Effectiveness program) provides training for physicians in clinical research. The curriculum of these programs typically consists of statistics, epidemiology, study design, grant proposal preparation and the ethics of clinical research. DO faculty members need at least one year of research training.

    Nationwide the distribution of medical school faculty is about 80% clinical and 20% non-clinical. About 65% of medical school faculty have a medical degree, 25% have a PhD and 10% have other degrees. Information on the research involvement of faculty at allopathic and osteopathic medical schools is limited. A 1987 study found that the median effort of physician faculty was 25% compared to 95% of PhD faculty in the same department (Beaty 1987). This suggest that more PhDs are doing research than physicians. All PhDs at DO institutions should be doing some type of scholarly activity.

    3. Funding
    Research funding among Osteopathic institutions ranges from zero to over 7 million dollars. The Osteopathic institutions with the most funding include, Kirksville, Oklahoma, Ohio, Texas, Michigan State, Chicago, UMDNJ and Nova Southeastern. Research conducted by faculty members at these institutions is supported by the University and through agencies such as the American Osteopathic Association, National Institutes of Health, the National Oceanic and Atmospheric Administration, the American Heart Association, the American Diabetes Association, and the Arthritis Foundation.

    Many research institutions fund a portion of their own research activities, including start-up funds for new investigators, bridging funds for experienced investigators and funding research that cannot be funded by other sources. The NIH and other government agencies provide the largest amount of support for clinical research.
    DO institutions need to secure more funding.

    4. Students
    Here is where you come in.
    Why should I do clinical research?
    ? There is a lack of clinical researchers in the Osteopathic community.
    ? Nationwide, there has been a decline in physician-conducted research and physician scientists.
    ? The NIH has recommended that more patient-oriented research by physicians be funded.
    ? Clinical research allows for collaboration between colleagues and institutions.
    ? Clinical investigators are highly sought after by academic centers, government and industry.
    ? Promotion committees at academic centers recognize clinical research as scholarly activity.
    ? Clinical research provides academic recognition.
    Where can I get clinical research training?
    Osteopathic Institutions
    Osteopathic medical institutions conduct basic science and clinical research and offer advance training in public health and biomedical sciences.
    1) Arizona College of Osteopathic Medicine of Midwestern University. The Health Professions Education program offers coursework in research design and methods and research biostatistics.
    2) Chicago College of Osteopathic Medicine. The doctor of Osteopathic medicine program has formal coursework in epidemiology during the second year.
    3) Kirksville College of Osteopathic Medicine. The health management graduate program offers three masters degrees (geriatric medicine, public health and health administration) all three have formal coursework in epidemiology, biostatistics and health policy.
    4) Lake Erie College of Osteopathic Medicine. Research training information not available.
    5) Michigan State University of Osteopathic Medicine. The doctor of Osteopathic medicine program has formal coursework in epidemiology and biostatistics during the third semester. MSU also offers a Medical Scientist Training Program and a DO/PhD degree.
    6) New York College of Osteopathic Medicine. Research training information not available.
    7) Nova Southeastern University. The doctor of Osteopathic medicine program has formal coursework in medical epidemiology during the second semester. There are also research electives each year.
    8) Ohio University College of Osteopathic Medicine. The doctor of Osteopathic medicine program has formal coursework in medical epidemiology during the first year.
    9) Oklahoma State University College of Osteopathic Medicine. The school offers a PhD program in biomedical sciences.
    10) Philadelphia College of Osteopathic Medicine. PCOM offers a combined DO/MPH program and an MS in Biomedical Sciences. The MPH program is a joint program with Temple University.
    11) Pikesville College of Osteopathic Medicine. Research training information not available.
    12) Touro University College of Osteopathic Medicine. Research training information not available.
    13) University of Health Sciences College of Osteopathic Medicine. Research training information not available.
    14) University of Medicine and Dentistry of New Jersey College of Osteopathic Medicine. The school offers a DO/PhD program.
    15) University of New England College of Osteopathic Medicine. The doctor of Osteopathic medicine program has formal coursework in epidemiology and Public Health during the first year.
    16) University of North Texas Health Science Center - Texas College of Osteopathic Medicine. The school offers a DO/MPH and DO/PhD degree.
    17) University of Osteopathic Medicine and Health Sciences College of Osteopathic Medicine and Surgery. The college of health sciences offers an MPH degree but the program has just been started and is not accredited by the Council on Education for Public Health at this time.
    18) West Virginia school of Osteopathic Medicine. The doctor of Osteopathic medicine program has formal coursework in medical ethics during the first year.
    19) Western University of Health Sciences ? College of Osteopathic Medicine. The school offers a offers a Masters of Science in Health Professions Education.

    Schools of Public Health
    There are 29 schools of public health and 23 graduate programs in community health and preventive medicine accredited by the Council on Education for Public Health in the United States. Schools of public health offer formal training in research methods, epidemiology and biostatistics. John Hopkins, Harvard University, University of North Carolina, University of Washington, University of Michigan, University of California at Berkley, Columbia University, University of Minnesota, Emory University, University of Pittsburgh, Yale University, University of California-Los Angeles, Tulane University and University of Texas-Houston are the top-ranked public health schools in the United States. Some of these schools offer a one-year condensed program for students with advanced degrees (D.O.).

    My recommendations:
    1. Find a mentor
    2. Get advanced training (ie MPH, PhD, subspecialty training, extra classes in epidemiology, biostatistics, study design, grant writing, scientific writing)
    3. Consider a rotation or fellowship at the NIH or another research institution

    Contact me if you have any further questions:
    John Kylan Lynch, DO, MPH
    National Institutes of Health/NINDS
    Neuroepidemiology Branch
    Federal Building, Room 714
    7550 Wisconsin Avenue
    Bethesda, MD 20892-9130
    Email: [email protected]

     
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  17. MSUCOM2003

    MSUCOM2003 Member
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    Hello,


    As a first-year at MSU, I get a unique perspective on research opportunities at DO schools, because we have an MD college here as well. It is painfully obvious that there is more research going on across the tracks at the MD school (which, by the way is considered a primary care institution). I agree with some of the previous notes describing the "old boys network" that prevented DO's from getting significant research funding in the old days. However, I believe that the AOA and Osteopathic agencies could do a better job of providing incentives for good PhD's, and opportunities for good DO researchers. Case in point: At the nearby University of Michigan, DO's lead several divisions, and do significant clinical research. Why aren't they at my school? Why is it so difficult for DO students to find role models in medical research?

    From my experience, much work needs to be done at the basic science level (and not just in OMM). It's obvious that Osteopathic training gives us an advantage in Anatomical and Physiological research. And, if we've been teaching self-healing for over a hundred years, why aren't we the leaders in Immunology and Allergy!?!?!?!

    Clinical research is important, but it will not provide the massive funding needed to come close to competing with the UofM's, UCLA's etc.


    Sudhir
    MSUCOM 2003
    ex-kidney researcher
     
  18. DOPhD student

    DOPhD student Senior Member
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    Thank you for the insight, Dr. Lynch. Now the question is, since we can pinpoint the problem, what do we do to address it? What can we as students or future clinicians or scientists do to convey our message to the administrative organizations at the local, state, and national level to help steer the profession in the direction that we, inheritors of the DO legacy, want?
    Thanks in advance for your unique perspective.
     

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