Residencies and Med school

[angryazn88]

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I've been wondering about this whole matching process for residencies and I've come to this conclusion. That it doesn't matter which school you go to, as long as you work hard and succeed(do well in school and in the board exams), you can end up matching at a residency you like. I've been thinking hard about this because I've been accepted to multiple schools outside of New York but I plan on coming back here for residency and for the rest of my career. What do you guys think?

 

[donkeykong1]

I also wondered the same thing at one point even though I haven't applied to schools just yet. However the logic is only true to certain extent. After shadowing physicians DO and MD, I've come to this conclusion:

The variety of networking opportunities and contacts made available to you by a med school in the state of residency of your choice is something that should not be taken lightly at all especially in the current residency matching climate. This is not to say that you can't land the residency of your choice in NY by for example going to a school like NSUCOM over NYCOM, rather its going to require a bit more legwork and time than going to a school that makes ny residency networking a bit easier. The NSUCOM vs. NYCOM example I just gave you is exactly what the NYCOM grad I shadowed had to decide over. Ultimately he chose NYCOM, and he says he was glad with the decision since he got his residency of choice by practically getting a contract offer after spending a ton of time rotating at the hospital and building a relationship with the institution.This is the kind of stuff that sometimes can't be explained by glancing at a matchlist. On the other hand, with hard work anything is possible
Best of luck wherever you end up matriculating.

 

[jinobi]

After talking to residents, program directors, and looking up topics in the DO forum, here's my take.

It's a bit naive to think that hard work will get you anywhere you want to go. Just look at the NRMP match data - while DO USMLE scores have not been wholly accounted for into the NRMP trend data, DOs and FMGs have a higher chance of going unmatched compared to MD candidates with similar board scores. Board scores and clinical grades matter quite a bit, but there are also many factors that account for which residency programs will take you.

- Some ACGME programs have never taken a DO, so you can expect some initial resistance unless you're a superstar candidate.
- Rotation quality can be a factor, especially with DO schools who don't typically have a university-owned tertiary care center. Quality of rotations can vary greatly depending on school, and programs want to know that you have experience in working with inpatient ward-based programs that are staffed with residents; you don't want your experience to be based solely from preceptor-based one-on-ones, and have your first inpatient experiences when you begin your PGY-1 year.
- Staying in NY would make it easier to schedule away rotations at places you want to go to for residency. But this can be done regardless of where you attend medical school. DO schools also may not be individually well known to programs; my anesthesia program would be hard pressed to recognize any DO schools beyond Western and perhaps Touro.
- Think of what kind of specialty may want to pursue. MD students interested in pursing primary care fields have been steadily declining over the years, making it easier for DO students to successfully match into ACGME programs. DO students also have plentiful AOA primary care residencies, and many DO schools' rotation schedules are heavy on internal medicine/family medicine/peds rotations during 3rd and 4th year. On the flip side, DOs have more of an uphill battle matching into specialties; there are less AOA specialty residency programs, and ACGME specialty programs are more difficult to get into.

My take? I'm going to MD and DO interviews because I want to become a physician. However, if I choose to go into a competitive specialty, an MD degree would provide me a less difficult path to follow. This doesn't mean I wouldn't be happy attending a DO school - I just know that I would have to work harder that I would have to (i.e. taking USMLE and COMLEX, scheduling away rotations to more centers, securing research opportunities outside of my school).

*caveat: I'm planning to seek out ACGME residency programs, rather than AOA. There are just many more ACGME programs on the West coast, and that's where I want to live for residency.

 

[group_theory]

School matter - don't let any premed or med students tell you otherwise. It isn't the only factor BUT it does factor in. School matter because of its available resources, its established clinical rotations, its REPUTATION, its alumni association and networking opportunity, etc.

With the increase in DO schools, increase in class size of established MD schools, and openning of new MD schools, residencies are getting more applications. Across the board for my field, there is a huge increase in US MD applicants (as well as DO and FMG applicants).

Nothing you can do about it once you pick your school besides work hard, network, do your best, make sure you get the best clinical opportunities, etc. But if you think the playing field is equal once you start medical school, then there's a rad-onc residency at Mayo I want to offer you ... all you have to do is outcompete the Harvard, Yale, and Duke students for that spot 😀

 

[cliquesh]

Just look at the NRMP match data - while DO USMLE scores have not been wholly accounted for into the NRMP trend data, DOs and FMGs have a higher chance of going unmatched compared to MD candidates with similar board scores.

If you look at NRMP the average board scores for Independent applicants (FMGs and, maybe, DOs) matching ACGME residencies are actually lower than their MD counterparts for the same specialty (except for anesthesiology). However, I don't think those numbers apply to osteopathic medical students because I don't think NRMP receives USMLE data for DO applicants.

The reason why I think that is because

1): "Almost all of the applicants who did not have Step 1 scores were osteopathic medical school seniors and graduates who either take an alternative examination (the Comprehensive Osteopathic Medical Licensing Examination, or COMLEX-USA) or who take the USMLE exams but whose data are not shared with the AAMC."

2): If you look at the number of people that match with "unknown scores" and compare it to the number of DOs that matched, the numbers are about the same.

So, in 2009, for instance:

There were 169 people with unknown scores that matched EM and 171 DOs matched EM

There were 237 people with unknown scores that matched Fam medicine and 244 DOs matched Fam Medicine.

There were 32 people with unknown scores that matched Gen. Surgery and 31 DOs match Gen. Surgery.

There were 108 people with unknown scores that matched OB/gyn and 108 DOs matched OB/Gyn.

This holds true for every specialty.

So compare http://www.nrmp.org/data/chartingoutcomes2009v3.pdf to http://www.nrmp.org/data/resultsanddata2009.pdf if you want to see what your chances are.

So, I guess, if this is true, no one knows how well you need to do as a DO.

 

[cliquesh]

It's a bit naive to think that hard work will get you anywhere you want to go. Just look at the NRMP match data - while DO USMLE scores have not been wholly accounted for into the NRMP trend data, DOs and FMGs have a higher chance of going unmatched compared to MD candidates with similar board scores. Board scores and clinical grades matter quite a bit, but there are also many factors that account for which residency programs will take you.

If you look at NRMP the average board scores for Independent applicants (FMGs and, maybe, DOs) matching ACGME residencies are actually lower than their MD counterparts for the same specialty (except for anesthesiology). However, I don't think those numbers apply to osteopathic medical students because I don't think NRMP receives USMLE data for DO applicants.

The reason why I think that is because

1): "Almost all of the applicants who did not have Step 1 scores were osteopathic medical school seniors and graduates who either take an alternative examination (the Comprehensive Osteopathic Medical Licensing Examination, or COMLEX-USA) or who take the USMLE exams but whose data are not shared with the AAMC."

2): If you look at the number of people that match with "unknown scores" and compare it to the number of DOs that matched, the numbers are about the same.

So, in 2009, for instance:

There were 169 people with unknown scores that matched EM and 171 DOs matched EM

There were 237 people with unknown scores that matched Fam medicine and 244 DOs matched Fam Medicine.

There were 32 people with unknown scores that matched Gen. Surgery and 31 DOs matched Gen. Surgery.

There were 108 people with unknown scores that matched Ob/gyn and 108 DOs matched Ob/gyn.

This holds true for every specialty.

So compare http://www.nrmp.org/data/chartingoutcomes2009v3.pdf to http://www.nrmp.org/data/resultsanddata2009.pdf if you want to see what your chances are.

By the way, what school you attend matters. If you go to a DO school and mess up, you are going to have limited options, and if you do great you are not going to have as many options as a MD counterpart. You will have plenty of options, however, so don't be too discouraged, but it is the truth.

I know a brother and sister that attended medical school at the same time. The brother was a DO and the sister was an MD. They both got the exact same board scores. They both applied to ACGME Gen Surgery. The sister got twice as many interviews and her interviews, in general, were at better programs. Some of their interviews were at the same places, however. They both ended up at university programs.

 

[MedMan25]

It definitely matters which school you go to. I go to our state's public MD school. We have a few DO schools in the state and hearing the experiences they have had with their school makes me realize what a big difference there really is between going to a school with established affiliations with major hospitals in the state where you get to see serious pathology and rub shoulders with numerous physicians from numerous specialties on a daily basis versus going to a school where the majority of your rotations are going to be in small, private clinics where you get to know maybe 1 or 2 docs.

 

[cliquesh]

It definitely matters which school you go to. I go to our state's public MD school. We have a few DO schools in the state and hearing the experiences they have had with their school makes me realize what a big difference there really is between going to a school with established affiliations with major hospitals in the state where you get to see serious pathology and rub shoulders with numerous physicians from numerous specialties on a daily basis versus going to a school where the majority of your rotations are going to be in small, private clinics where you get to know maybe 1 or 2 docs who are just going to have you shadow them all day because the more time they waste teaching you the less time they get to spend seeing patients and the less money they take home.

And to top all that off, tuition at the DO schools in our state are twice what they are at the MD school. They pay much more and get much less IMO. Bottom line, there is a huge difference between schools.

I don't disagree completely, but that is kind of an exaggeration. I, for instance, will be doing all of my rotations (except for OMM) at teaching hospitals, although none of the hospitals are the biggest or the best in the city, hah.

And about tuition. Are you talking about private MD schools in Arizona?

 

[MedMan25]

I don't disagree completely, but that is kind of an exaggeration. I, for instance, will be doing all of my rotations at teaching hospitals, although not the biggest or the best in the city.

Again, it depends on you're school. I don't know what all DO schools are like, I can only tell you that according to the DO students I have rotated with, they have very little opportunity to rotate at the major hospitals for their core rotations. The major hospitals here in the valley only accept a limited number of students and with the enormous class sizes of the DO programs here there is fierce competition amongst the DOs to land a core rotation at a major hospital. At our school, everyone does their rotations at the major hospitals.

I just think it's funny how pre-meds love to make the claim that you can go to any med school on the planet and it makes no difference. The fact is, going to a school where they are going to stick you in private clinics out in the middle of nowhere when you want to become a plastic surgeon in an urban setting is going to prove to be a huge disadvantage for you.

 

[MedMan25]

And about tuition. Are you talking about private MD schools in Arizona?

Our state's MD school charges ~$26K/year. The DO schools here run closer to $50K

 

[hawkeye pierce]

State schools will almost always be cheaper than private schools. Hence, not a fair comparison. Also, all DO schools should not be lumped together in terms of quality of rotations and prestige.

 

[cliquesh]

Again, it depends on you're school. I don't know what all DO schools are like, I can only tell you that according to the DO students I have rotated with, they have very little opportunity to rotate at the major hospitals for their core rotations. The major hospitals here in the valley only accept a limited number of students and with the enormous class sizes of the DO programs here there is fierce competition amongst the DOs to land a core rotation at a major hospital. At our school, everyone does their rotations at the major hospitals.

I just think it's funny how pre-meds love to make the claim that you can go to any med school on the planet and it makes no difference. The fact is, going to a school where they are going to stick you in private clinics out in the middle of nowhere when you want to become a plastic surgeon in an urban setting is going to prove to be a huge disadvantage for you.

Very true.

Comparing a private school's tuition to a state's school tuition isn't really fair, but, yeah, DO schools are expensive.

 

[MedMan25]

State schools will almost always be cheaper than private schools. Hence, not a fair comparison. Also, all DO schools should not be lumped together in terms of quality of rotations and prestige.

I was just trying to make the point that not all medical schools are equal in terms of quality and value. I am not necessarily trying to make generalizations here other than the fact that the problem of having rotations outside major hospitals is mostly a DO school issue. I have never heard of an MD school here in the US that didn't have affiliations at the major hospitals. I'm not saying all DO schools are that way and I'm not saying it's necessarily a disadvantage to do your rotations in private/community clinics. If you want to become an outpatient family doc then it would be advantageous to do most of your rotations in that sort of setting.

I'm simply trying to point out here that placing a blanket statement over all schools by saying that it doesn't matter what school you go to is simply not true. Rotating at big hospitals makes a huge difference when it comes to obtaining letters, applying for residency, etc.

 

[angryazn88]

I just want to thank everyone for their input. I'm still having trouble deciding which school I would like to attend because of the issue I have with wanting to return to New York for my residency. I haven't heard anything from NYCOM which is my top choice so right now, my top option is ATSU-SOMA since I can return to NYC for years 2-4. The only doubt I have about ATSU-SOMA is how their students do when it comes time to matching since this yr will be its first graduating class. I really liked the school.

 

[hawkeye pierce]

Angryazn88, I'm fairly sure you should be able to get a residency in new york if you are willing to go into primary care fields.

 

[TheSeanieB]

.

 

[christina30]

I just want to thank everyone for their input. I'm still having trouble deciding which school I would like to attend because of the issue I have with wanting to return to New York for my residency. I haven't heard anything from NYCOM which is my top choice so right now, my top option is ATSU-SOMA since I can return to NYC for years 2-4. The only doubt I have about ATSU-SOMA is how their students do when it comes time to matching since this yr will be its first graduating class. I really liked the school.

Of course you can probably score a residency in NYC if you really work at it and do well on your boards, etc.

But, going to NYCOM would make it much easier to match in New York - simply because they have probably the largest network of affiliated hospitals/osteopathic residency programs among the DO schools (thus making it easier to rotate at and subsequently match into said programs). NYCOM also has a good reputation in the New York metro area, so that can't hurt either.

Otherwise, I would definitely agree that the prestige/name of the school doesn't matter much - the individual student matters so much more.

 

[gatorfann14]

Of course you can probably score a residency in NYC if you really work at it and do well on your boards, etc.

But, going to NYCOM would make it much easier to match in New York - simply because they have probably the largest network of affiliated hospitals/osteopathic residency programs among the DO schools (thus making it easier to rotate at and subsequently match into said programs). NYCOM also has a good reputation in the New York metro area, so that can't hurt either.

Otherwise, I would definitely agree that the prestige/name of the school doesn't matter much - the individual student matters so much more.

Look up the residents for Ortho at Mass. General. There are only 1 or 2 students over the last decade not from a very top medical schools like Harvard or Penn. Where you go seems to matter. Then again the students at places like Harvard probably are better applicants than most.

 

[zac16125]

Look up the residents for Ortho at Mass. General. There are only 1 or 2 students over the last decade not from a very top medical schools like Harvard or Penn. Where you go seems to matter. Then again the students at places like Harvard probably are better applicants than most.

I think "reputation" of a school is exceedingly overrated, at least when it comes to DO schools? As I've said in this forum before, I've talked to a number of program directors about what they look for in applicants and not one has mentioned "school attended" as one of the things on their list. That being said, if you are looking to train at Hopkins or an Ivy League program, then they are probably going to be influenced by which medical school you went to. But I certainly don't think random program X will care if you went to NYCOM or Kirksville or PCOM etc. Of course, its always helpful to rotate at the place you want to land a residency so if a certain school is affiliated with a hospital where you want to train, then in that sense it might help you get your foot in the door to be considered for the residency. As far as name/reputation alone though, I don't think that matters at all in the DO world.

 

[christina30]

Look up the residents for Ortho at Mass. General. There are only 1 or 2 students over the last decade not from a very top medical schools like Harvard or Penn. Where you go seems to matter. Then again the students at places like Harvard probably are better applicants than most.

We're not talking about Mass. General or specific Ivy League/ultra-competitive programs in this thread, are we? We're talking specifically about matching to residencies in the New York area. My assertion was that school attended doesn't matter much, meaning that other factors (board scores, grades/evals from clinical years, etc.) are much, much more important to the vast majority of PD's than the name of the school you attended.