Ruh Roh Ross

[DocEspana]

Advertisement - Members don't see this ad

So I have been talking to a lot of program directors and they have been all amusingly pointing out to me that the ACGME/AOA merger conversations all discuss US MD students and DO students but never offshore students.

Let me make that more clear. They discuss AT LENGTH the impact this would have on physicians who are entirely foreign and practiced aborad and want to come to the US. And they talk at length about transfers from Europe. But they don't say a single thing about the caribbean students. I've been rather enjoying that every program director has said that because, on some perverse and embarrassing level, I get to say "what goes around comes around"

Well sounds like these schools, Ross specifically in this case, won't be forgotten so easily. I was talking with the Director of Medical Education at a hospital affiliated with my school. The hospital is chock full of AOA residencies but is also a pretty good sized training site for Ross students. He was telling me that Ross recently had one of their lawyers approach him and explain that seeing as they are paying x amount for their spots they expect all of their students to be compelled to go to the osteopathic lectures we get on OMM. Additionally they are offering all the money the hospital requires to form a formal month long OMM rotation that will be primarily for Ross students.

Why are Ross students suddenly investing into OMM? Oh thats the third detail, they implied that they fully expect that AOA residency to accept a certain percentage of ross students to thier FM, IM, and general surgery residencies if it is allowed at all by 2015 (no mention of he other four higher-end residencies at the hospital, but i think they were implied too). And if they didnt match these students I believe the implied threat was the school would pull thm and their money out of the hospital.

Ruh Roh.

 

[cliffhuxtableDO]

I don't foresee the AOA caving to Ross for omm lectures, but I could be wrong. As usual, money talks.

 

[Dr Yiot]

very disappointing. hopefully this idea can be shut down

 

[DocEspana]

I don't foresee the AOA caving to Ross for omm lectures, but I could be wrong. As usual, money talks.

Well its not the AOA as for the lectures. It's this hospital. We have semi-manditory lectures on OMT to keep our skills up. The Ross students sometimes come for the free breakfast, but generally they sit around in the call rooms with their thumbs up their asses because all of the residents are with the students as its required for them too, so no one is around on the services at those points.

And the rotation doesnt need AOA approval as far as I know. Its just a matter of getting the local OMT docs some unrestricted privileges and setting up enough of an infrastructure to support a handful of students wandering around myofascially releasing old dialysis patients and getting more frequent lectures within a formal OMT rotation format. Ross is paying this hospital (and likely others) to look into developing OMM curriculums for their students.

Now the fact remains that the ACGME/AOA merger still says zero about these offshore schools and most reads on that is that offshore is getting the least favored status. But this little thing I learned of today does show that Ross is not taking it laying down.

 

[cliffhuxtableDO]

So this implies, to me, that Ross is going to encourage or require all students matching in 2015 and beyond to sit for comlex. Comlex is one of the non-negotiables the AOA held onto in order to agree to the merger.

 

[DocEspana]

So this implies, to me, that Ross is going to encourage or require all students matching in 2015 and beyond to sit for comlex. Comlex is one of the non-negotiables the AOA held onto in order to agree to the merger.

Not really. Thats not how its gonna work as best as we know. The actual fact of the matter is that there is no "integrated AOA residency" coming in 2015 right now. I'm referring to MDs in AOA residencies very specifically. Its not agreed upon and will not happen at the same time as the other aspects unless an agreement can be reached on how to evaluate osteopathic competency.

But in the same breath, i think everyone accepts that it is a foregone fact that SOME method of evaluation will be found. Possibly by 2015, possibly one (or a few) years after that. But it will happen. The "retaining the comlex" is retaining it as the only method of graduate requirement required for DO students and making it "mandatory" to accept it for all residencies. (now do they throw it in the garbage after they accept it? Thats possible. But mandated to at least glance at it)

Ross's action here is 1) paying hospitals to create osteopathic competency for their MD students in anticipation of the highly likely 2015 AOA degree integration and 2) they are implying that if they arent given enough spots in prior AOA residencies they will pull their financial support.

 

[cliffhuxtableDO]

Hmm... Don't they realize the number of AOA spots doesn't even meet the number of DO grads. I understand they're bullying this hospital system, but it seems pretty pointless to me. Ross is still going to need training sites for their students, regardless if this proposed deal happens or not. Could this proposed idea really start a bidding war?

 

[JGimpel]

We all know what happens when the AOA starts to get tough with the Allopathic world, and tries to get their training for free just like they do with any rotation...they get an MMA-level smack-down. SGU got in the press big-time recently for paying a $100 million dollars to hospitals in NYC to make sure their students got spots. The AOA hasn't built a core DO hospital with any level of trauma service in years.

The next decision will be made behind closed doors and the COMLEX will be dropped along with the OMM requirements beyond the basics in DO residencies. I give it until the 2018 deadline for DO residencies to clean up any deficiencies in their programs when the pitiful ones we have to suffer through now don't make the cut. That's when the ACGME will strip COCA/AACOM/AOA and NBOME of whatever power they have left and make it a full union of the two shops on the same street offering the same thing. The AOA will be powerless to stop this as it has no leverage if it wants to have rotations and residencies open to its students. The end of an era will also mean the end of the arrogance of the ancient leaders of the DO world. They get a better retirement package than the President, so I don't think they'll mind if it comes a bit sooner.

 

[DocEspana]

We all know what happens when the AOA starts to get tough with the Allopathic world, and tries to get their training for free just like they do with any rotation...they get an MMA-level smack-down. SGU got in the press big-time recently for paying a $100 million dollars to hospitals in NYC to make sure their students got spots. The AOA hasn't built a core DO hospital with any level of trauma service in years.

The next decision will be made behind closed doors and the COMLEX will be dropped along with the OMM requirements beyond the basics in DO residencies. I give it until the 2018 deadline for DO residencies to clean up any deficiencies in their programs when the pitiful ones we have to suffer through now don't make the cut. That's when the ACGME will strip COCA/AACOM/AOA and NBOME of whatever power they have left and make it a full union of the two shops on the same street offering the same thing. The AOA will be powerless to stop this as it has no leverage if it wants to have rotations and residencies open to its students. The end of an era will also mean the end of the arrogance of the ancient leaders of the DO world. They get a better retirement package than the President, so I don't think they'll mind if it comes a bit sooner.

I think your missing the entire point of this thread. Did you even read it? Maybe I'm totally misunderstanding what you're saying? But I think I get what youre saying, but its so left field from the rest of the thread. (Not saying its wrong. Its just not germane)

the AOA isnt playing tough with anyone in the allopathic world here. This is about an island school, who seemed to be getting boxed out by the ACGME+AOA making an interesting move to try to make hospitals train their MD students in OMT just so any potential OMT requirements are covered (and a vague threat of forcing a certain island student match rate)

 

[cliffhuxtableDO]

We all know what happens when the AOA starts to get tough with the Allopathic world, and tries to get their training for free just like they do with any rotation...they get an MMA-level smack-down. SGU got in the press big-time recently for paying a $100 million dollars to hospitals in NYC to make sure their students got spots. The AOA hasn't built a core DO hospital with any level of trauma service in years.

The next decision will be made behind closed doors and the COMLEX will be dropped along with the OMM requirements beyond the basics in DO residencies. I give it until the 2018 deadline for DO residencies to clean up any deficiencies in their programs when the pitiful ones we have to suffer through now don't make the cut. That's when the ACGME will strip COCA/AACOM/AOA and NBOME of whatever power they have left and make it a full union of the two shops on the same street offering the same thing. The AOA will be powerless to stop this as it has no leverage if it wants to have rotations and residencies open to its students. The end of an era will also mean the end of the arrogance of the ancient leaders of the DO world. They get a better retirement package than the President, so I don't think they'll mind if it comes a bit sooner.

A bit off topic, but it's almost like inception.

 

[JGimpel]

A bit off topic, but it's almost like inception.

The AOA tries to get the most desperate hospitals all over, including those in the NYC war-zone areas that Ross and SGU put their students in.
The AOA tries to get all of their training hospitals to do this for little to nothing compared to other medical schools.
The AOA had little leverage before, but when faced with getting a fair amount of money to getting no money, the hospitals are going to pick the IMG/FMG programs as well as the USMD programs over the DO programs. The last I heard, the Caribbean schools were being lumped in with the IMG/FMG programs in terms of requirements, but this may have changed.
Loosing its last bit of leverage in getting students into these programs, the AOA will beg the AMA to step in and will have to give up the COMLEX to have the [former] DO hospitals take DOs again.
If they keep their accreditation as DO hospitals, they will make OMM curriculum mandatory for DO graduates only, with the rest giving some sort of lip-service to it.
The latest I could see this happening is 3-4 years after the carte-blanche full approval of all DO residencies, 2018-2019, when some DO residencies start getting their approvals cut by the ACGME for not coming up with the proper funding to keep themselves a teaching hospital.

I hope this clears my logic/hopes up.
Inception is one of my favorite movies; can't wait for the AOA "kick" on this topic.

 

[DocEspana]

The AOA tries to get the most desperate hospitals all over, including those in the NYC war-zone areas that Ross and SGU put their students in.
The AOA tries to get all of their training hospitals to do this for little to nothing compared to other medical schools.

DO schools generally pay more than MD schools for clinical education. I have no clue where the heck you think MD schools in the US are paying a single penny for this stuff, but their accreditation standards forbid it. DO standards allow for a very small educational offset.

The AOA had little leverage before, but when faced with getting a fair amount of money to getting no money, the hospitals are going to pick the IMG/FMG programs as well as the USMD programs over the DO programs. The last I heard, the Caribbean schools were being lumped in with the IMG/FMG programs in terms of requirements, but this may have changed.

Again. You're completely incorrect if you think MD schools pay for rotations. Its forbidden. There are loopholes, but the loopholes amount to 50-100 per student per month. Nowhere near the 750-1000 bucks pet student per month paid by offshore schools.

As for lumping, last you heard you heard wrong. Offshore students have always been treated legally as a separate category partially needing some foreign hoops jumped through and partially having some requirements eased since they are citizens.

Its not wrong to assume that fmg descriptions will apply to them, but given how explicitly detailed the acgme has been in various "classes" of foreign grad it is odd they say nothing at all about offshores.

Loosing its last bit of leverage in getting students into these programs, the AOA will beg the AMA to step in and will have to give up the COMLEX to have the [former] DO hospitals take DOs again.
If they keep their accreditation as DO hospitals, they will make OMM curriculum mandatory for DO graduates only, with the rest giving some sort of lip-service to it.
The latest I could see this happening is 3-4 years after the carte-blanche full approval of all DO residencies, 2018-2019, when some DO residencies start getting their approvals cut by the ACGME for not coming up with the proper funding to keep themselves a teaching hospital.

I hope this clears my logic/hopes up.
Inception is one of my favorite movies; can't wait for the AOA "kick" on this topic.

Wow.... this is shockingly poorly educated and has the implication of many incorrect assumptions and fallacies in it. I will come back and have a field day on this when I'm not about to go into surgery. There are plenty of reasons to heckle the aoa.... and you managed to name none of them correctly.

 

[JGimpel]

DO schools generally pay more than MD schools for clinical education. I have no clue where the heck you think MD schools in the US are paying a single penny for this stuff, but their accreditation standards forbid it. DO standards allow for a very small educational offset.



Again. You're completely incorrect if you think MD schools pay for rotations. Its forbidden. There are loopholes, but the loopholes amount to 50-100 per student per month. Nowhere near the 750-1000 bucks pet student per month paid by offshore schools.

As for lumping, last you heard you heard wrong. Offshore students have always been treated legally as a separate category partially needing some foreign hoops jumped through and partially having some requirements eased since they are citizens.

Its not wrong to assume that fmg descriptions will apply to them, but given how explicitly detailed the acgme has been in various "classes" of foreign grad it is odd they say nothing at all about offshores.



Wow.... this is shockingly poorly educated and has the implication of many incorrect assumptions and fallacies in it. I will come back and have a field day on this when I'm not about to go into surgery. There are plenty of reasons to heckle the aoa.... and you managed to name none of them correctly.

Sounds like a junior AOA Program Director in the making. That's probably the only way you got access to those figures.

OK, so Medicare is the only organization providing substantial funding for American medical STUDENTS and residents. Ross and SGU contribute chump change compared to this and the DO systems provide very little, if any, incentive to take their students. I bet the non-DO hospitals don't even charge any application fee for DOs to participate in their rotations; that would be unconscionable. Does this sound more accurate, or am I still in a dream within a dream?

Any other DOs hear the reasoning why the AOA went into the agreement with the ACGME/AMA as they did? For now, let's just assume I'm wrong again; I must need more coffee. For those that didn't know yet, that orange band on the coffee pot still means decaff, I'm truly at a loss as to why I must have picked it today.

Espanada, why not have a field day now? Propagating thousand post "discussions" is a feat you've never backed down from before.

 

[DocEspana]

Sounds like a junior AOA Program Director in the making. That's probably the only way you got access to those figures.

I would be as far from a jr AOA PD as possible. I am an outspoken critic of the AOA as an outdated dinosaur that needs large scale overhaul if it wants to live, or needs to just meld into the ACGME/LCME/AMA. Have been for close to 3 years on these boards now.

So where do I get the numbers from? The American Medical Association. I am quite deeply involved with them. and also happen to be personal friends with two different directors of the ACGME due to my AMA activity.

OK, so Medicare is the only organization providing substantial funding for American medical STUDENTS and residents.

Already wrong. Medicare gives $0.00 for student education nationally. As a matter of fact, except for some private charities/funds, no one pays any money for student education except for caribbean schools. (again: there are loopholes that some schools use to get $50-100 per student per month to the hospitals, but even that has very tight 'educational use only' strings attached). Clinical education has always been done for free for the sake of giving back and continuing the chain of education. Medicine is very ancient and archaiac in many ways (see: the residency structure is a guild structure; or the match process is clandestine), but this is one of the ways where that is a good thing.

Ross and SGU contribute chump change compared to this...

Again. Ross/SGU/AUA/AUC --> $750-$1,000 per month per student WITH INCENTIVES not counted in the base pay if above a certain gross number of students are rotating at a single facility.

US MD --> Overwhelmingly $0.00

US DO --> mostly $50-$100 with many doing $0.00

And your sly suggestion that we should compare the impact of students on the impact of residents is absurd. Because residents work for free. They are free labor. and ontop of that, hospitals get PAID to take on the free labor. (sure there is an argument to be made that they slow down surgeons, but I dont see any argument for them costing money in any other area of the hospital). This is like comparing apples to the worlds biggest f***ing fruit to ever exist.

and the DO systems provide very little, if any, incentive to take their students. I bet the non-DO hospitals don't even charge any application fee for DOs to participate in their rotations; that would be unconscionable. Does this sound more accurate, or am I still in a dream within a dream?

The "DO system" creates residencies. As a matter of fact they are the only source of new, non-pediatric, non-rural FM, residencies out there right now. So hospitals have a huge incentive to take their students. If the school is investing students, the school will help them make residencies. AOA residencies have a unique charcteristic that all residencies are quite closely tied with a DO school and only a DO school can formally apply for residency formation, not the hospital. So if they dont have a lot of good karma with the local DO school, they wont get the residency. and they wont get the residents. and they wont get the massive cash flow that residents represent.

As for applcation fees, you are off your rocker sir. A very good percent (not >50%, but quite large) do charge DOs application fees that they dont charge to the home students. Go on VISAS and look for yourself. It's not unconsciounable at all. That is the status quo. You are out of your damn gord to pluck a random thought out of your ass and not even think to look into what the situation on the ground is at many places.

Any other DOs hear the reasoning why the AOA went into the agreement with the ACGME/AMA as they did? For now, let's just assume I'm wrong again; I must need more coffee. For those that didn't know yet, that orange band on the coffee pot still means decaff, I'm truly at a loss as to why I must have picked it today.

Reasons given by AOA representatives at the conference meeting:
1) is the right thing to do (I'm starting with the least believable but most altruistic)
2) a huge percent of AOA residency spots go unfilled and now they will be filled
3) It proves parity with ACGME training when very few programs are closed/probationed after 2018
4) It allows people who trained AOA to be faculty at ACGME programs or MD schools. It allows people who trained at ACGME programs to be faculty on AOA programs.
5) It secures intership->residency and residency->fellowship lineage (werent we all losing our **** about this? How quickly we have forgotten)
6) Its f***ing fantastic PR for the AOA (and the ACGME)
7) The federal government has repeatedly asked for this to be done and both parties ignored that request until now

There are likely many other good reasons. But I am telling you which ones I heard with my own two damn ears from people representing AOA opinions on the debate while this was all under debate. Should I say again that I literally am close personal friends with people who made this decision and was talking with them the night before it became official? I've said it on here before when I broke the news on SDN before (I assume) anywhere else around knew about it.

which in hindsight, i probably should have held off on haha. But too late to rectify that.

Espanada, why not have a field day now? Propagating thousand post "discussions" is a feat you've never backed down from before.

Espanda? Espanda?If you can't even get the name right, why are we bothering with this. I think you've been thoroughly disproven here so far. I know for a fact you meant well. I do. I was the same person angrily lashing out at anything the AOA did. But you need to be *accurate* when you rip on them. Grumbles without facts or research just make us all look dumb and gullible. If you want to torch the AOA, do it over stuff it deserves criticism for... not for things that are completely detached from factual reality.

 

[DocEspana]

With that out of the way let me kindly remind everyone this threads, ideally, should be about their thoughts on Caribbean schools investing in OMM programs.

 

[cliffhuxtableDO]

It sounds surprising at first, but then when you consider that there MD schools in the states that offer some omm as electives maybe its not that far fetched. It may even become more common...?

 

[DocEspana]

It sounds surprising at first, but then when you consider that there MD schools in the states that offer some omm as electives maybe its not that far fetched. It may even become more common...?

True. I'd be very curious to see if this would cause an increase in OMM utilization.... or at least visability. I definitely never predicted that happening.

 

[DrBumblebee]

...
Again. Ross/SGU/AUA/AUC --> $750-$1,000 per month per student WITH INCENTIVES not counted in the base pay if above a certain gross number of students are rotating at a single facility.

US MD --> Overwhelmingly $0.00

US DO --> mostly $50-$100 with many doing $0.00

And your sly suggestion that we should compare the impact of students on the impact of residents is absurd. Because residents work for free. They are free labor. and ontop of that, hospitals get PAID to take on the free labor. (sure there is an argument to be made that they slow down surgeons, but I dont see any argument for them costing money in any other area of the hospital). This is like comparing apples to the worlds biggest f***ing fruit to ever exist.

The "DO system" creates residencies. As a matter of fact they are the only source of new, non-pediatric, non-rural FM, residencies out there right now. So hospitals have a huge incentive to take their students. If the school is investing students, the school will help them make residencies. AOA residencies have a unique charcteristic that all residencies are quite closely tied with a DO school and only a DO school can formally apply for residency formation, not the hospital. So if they dont have a lot of good karma with the local DO school, they wont get the residency. and they wont get the residents. and they wont get the massive cash flow that residents represent.

As for applcation fees, you are off your rocker sir. A very good percent (not >50%, but quite large) do charge DOs application fees that they dont charge to the home students. Go on VISAS and look for yourself. It's not unconsciounable at all. That is the status quo. You are out of your damn gord to pluck a random thought out of your ass and not even think to look into what the situation on the ground is at many places.

Reasons given by AOA representatives at the conference meeting:
1) is the right thing to do (I'm starting with the least believable but most altruistic)
2) a huge percent of AOA residency spots go unfilled and now they will be filled
3) It proves parity with ACGME training when very few programs are closed/probationed after 2018
4) It allows people who trained AOA to be faculty at ACGME programs or MD schools. It allows people who trained at ACGME programs to be faculty on AOA programs.
5) It secures intership->residency and residency->fellowship lineage (werent we all losing our **** about this? How quickly we have forgotten)
6) Its f***ing fantastic PR for the AOA (and the ACGME)
7) The federal government has repeatedly asked for this to be done and both parties ignored that request until now

There are likely many other good reasons.
...

Those are the biggest take homes for both MD and DO worlds. Thanks for sharing these stats and info, DocEspana.

 

[TeamZissou]

Are you not entertained?

 

[DocEspana]

 

[TeamZissou]

Well done, I was too lazy. Vacation = lazy TZ.

 

[Dharma]

Are you not entertained?

I'm not... these long ass responses are putting me to sleep...

But yeah, F Ross.

 

[NeuroLAX]

I was certainly entertained. I look forward to your breaking news updates in the future.

 

[JGimpel]

I would be as far from a jr AOA PD as possible. I am an outspoken critic of the AOA as an outdated dinosaur that needs large scale overhaul if it wants to live, or needs to just meld into the ACGME/LCME/AMA. Have been for close to 3 years on these boards now.

So where do I get the numbers from? The American Medical Association. I am quite deeply involved with them. and also happen to be personal friends with two different directors of the ACGME due to my AMA activity.



Already wrong. Medicare gives $0.00 for student education nationally. As a matter of fact, except for some private charities/funds, no one pays any money for student education except for caribbean schools. (again: there are loopholes that some schools use to get $50-100 per student per month to the hospitals, but even that has very tight 'educational use only' strings attached). Clinical education has always been done for free for the sake of giving back and continuing the chain of education. Medicine is very ancient and archaiac in many ways (see: the residency structure is a guild structure; or the match process is clandestine), but this is one of the ways where that is a good thing.



Again. Ross/SGU/AUA/AUC --> $750-$1,000 per month per student WITH INCENTIVES not counted in the base pay if above a certain gross number of students are rotating at a single facility.

US MD --> Overwhelmingly $0.00

US DO --> mostly $50-$100 with many doing $0.00

And your sly suggestion that we should compare the impact of students on the impact of residents is absurd. Because residents work for free. They are free labor. and ontop of that, hospitals get PAID to take on the free labor. (sure there is an argument to be made that they slow down surgeons, but I dont see any argument for them costing money in any other area of the hospital). This is like comparing apples to the worlds biggest f***ing fruit to ever exist.



The "DO system" creates residencies. As a matter of fact they are the only source of new, non-pediatric, non-rural FM, residencies out there right now. So hospitals have a huge incentive to take their students. If the school is investing students, the school will help them make residencies. AOA residencies have a unique charcteristic that all residencies are quite closely tied with a DO school and only a DO school can formally apply for residency formation, not the hospital. So if they dont have a lot of good karma with the local DO school, they wont get the residency. and they wont get the residents. and they wont get the massive cash flow that residents represent.

As for applcation fees, you are off your rocker sir. A very good percent (not >50%, but quite large) do charge DOs application fees that they dont charge to the home students. Go on VISAS and look for yourself. It's not unconsciounable at all. That is the status quo. You are out of your damn gord to pluck a random thought out of your ass and not even think to look into what the situation on the ground is at many places.



Reasons given by AOA representatives at the conference meeting:
1) is the right thing to do (I'm starting with the least believable but most altruistic)
2) a huge percent of AOA residency spots go unfilled and now they will be filled
3) It proves parity with ACGME training when very few programs are closed/probationed after 2018
4) It allows people who trained AOA to be faculty at ACGME programs or MD schools. It allows people who trained at ACGME programs to be faculty on AOA programs.
5) It secures intership->residency and residency->fellowship lineage (werent we all losing our **** about this? How quickly we have forgotten)
6) Its f***ing fantastic PR for the AOA (and the ACGME)
7) The federal government has repeatedly asked for this to be done and both parties ignored that request until now

There are likely many other good reasons. But I am telling you which ones I heard with my own two damn ears from people representing AOA opinions on the debate while this was all under debate. Should I say again that I literally am close personal friends with people who made this decision and was talking with them the night before it became official? I've said it on here before when I broke the news on SDN before (I assume) anywhere else around knew about it.

which in hindsight, i probably should have held off on haha. But too late to rectify that.



Espanda? Espanda?If you can't even get the name right, why are we bothering with this. I think you've been thoroughly disproven here so far. I know for a fact you meant well. I do. I was the same person angrily lashing out at anything the AOA did. But you need to be *accurate* when you rip on them. Grumbles without facts or research just make us all look dumb and gullible. If you want to torch the AOA, do it over stuff it deserves criticism for... not for things that are completely detached from factual reality.

You're working closely on top secret projects on double-secret probation with the AMA, maybe as a double-agent for the AOA. OK. I don't really care, but you may want to provide the rest of the eager med-students with links to this info, just to be sure.

I purposely capitalized STUDENTS to make a point that I knew you'd miss since you're so quick to post whatever's on your mind that will allow you to post another 3 posts (and counting) right after it. Everyone, especially residents, knows exactly how the antiquated Medicare system only pays for resident-level training and they also know that Ross and SGU pay many times what any other group pays for their STUDENTS to get rotations at hospitals in sunny NYC or balmy Alabama. I guess you could count a "5th semester" in Florida for some. You took a ton of extra lines to point out that I was wrong when I may have been going for sarcasm. I'm surprised that you didn't mention anything about me drinking decaff; that's the true tragedy.

Residents get a stipend/salary depending upon how you interpret the labor laws. I looked at quite a few in the last couple of years and the MD ones usually pay more than the DO ones, so the readers of this post should also consider this reality when seeing why students may go toward MD residencies. This money is mostly covered by Medicare and the fact that the attendings get a small army of residents to do a lot of the fact-finding and research on the patients they see and do see an increase in productivity as the resident gets more efficient. If the resident continues to be inefficient and actually drags his service down, he will be counseled and maybe not have his contract renewed the next year. And, NO you won't be able to post this often when you're on rotations or a resident.

The AOA creates far more graduating DOs than it does residencies, period. The vast majority of the ones created in the last few years have been FM and one-year Traditional Intern/Rotating positions. What happens when these are filled and Interns start looking at the real job market for their first year/PGY1 training? (the naming of this is misleading, but you're usually a Intern, then a first year resident at many programs.) They will have to look at an AMA/MD program since now the DO ones will be flooded with those that only have one year of training and there will still be as many or more students competing for the first year spots too. This could happen as soon as the next 2 years.

For every hospital/practice you visit that claims to be big on OMM, there are 20 that don't care and have residents texting or playing Angry Birds during OMM didactics. If it looks like you retained the concept of what a lever arm is from basic physics, you'll do fine in the rare "demo" portion of your GME OMM training. I'll let the med students already out there come back and comment on this.

Doc Enojada, as you alluded to, please don't bother with this or use this as a chance to increase your post count. The [literally] spin doctors have got you believing that the AOA didn't just get their clocks cleaned with the beginning of the end of the "separate but equal" policies and propaganda. Acknowledging the fact that around 50% of MD programs charge (I didn't know it was THAT many) DO students to even be a part of their rotations is the first step in seeing a possible trend here. The fees vary a lot with many around $100 with some bordering on ridiculous, specifically as disincentives for DO students to try and rotate there. I heard $500 for a 4-week rotation at one program, but the person didn't have any details to back it up, so I left it at that. Surely no national organization would allow such "bidding" for rotations to get that high, would it?

VSAS is only for senior electives and DOES NOT include a large number of hospitals (only 131, to be specific.) Also notice that some specifically say they do not accept DO students for rotations, no matter how much they pay. I'm a DO and I can tell you the vast majority of the ones we would be rotating or auditioning at in our 4th year are not on this list. If you wanted to get an away rotation for your third year, which is very important to Program Directors, or at hospitals not on the list of 131 on VSAS, you'll have to go out on your own and look to your rotation staff at your school for what's been done in the past.

These links are some of the extremes in VSAS, but are close to the norm for many hospitals NOT on VSAS that don't accept DOs without a check from them on the first day.
https://services.aamc.org/20/vsas/public/school/instID/10114/mode/main/from/public_schools
https://services.aamc.org/20/vsas/public/school/instID/14725/mode/main/from/public_schools
https://services.aamc.org/20/vsas/public/school/instID/191/mode/main/from/public_schools

We recently got locked out of MD residencies (making people start their Intern training over essentially has the same chilling effect) and have been unofficially locked out of their fellowships for years, but I'll let you do your research on that with your top-secret allies at the AOA and AMA. Let them explain these trends in contrast to those that came of this merger that were more out of dire necessity than for all the kittens and warm, fuzzy bunny rabbits they put in the press.

OK folks, let's see how many posts Doc Enojada can get in today! If we could see the rest of his avatar, it would be a pile behind the bull with the words "My thoughts" in the steam above it. See how you feel when you talk to some residents socially at the next OMED and get the real story. For now, put the shovel down and get back to studying for your first COMLEX. I don't really care about my post count, so I respond to Enojada in one or two longer posts that I actually put some time into
than
5
shorter
posts
that
get
him
more
points. (NOT)

 

[DocEspana]

Going out tonight to celebrate Christmas early. in transit right now actually. But I'll be back tomorrow and I'll be happy to make you look silly again (though unlike last time I'll be agreeing with some of your points, though definitely not the larger picture youre painting.) If you're going to just make up about 1/3 of what you say, of xkhrss I'm gonna be a pain in your ass and hold your feet to the fire to admit you embellished and fictionalized for a more sensational comment.

Also. .. it still has so little to do with the topic at hand.

 

[group_theory]

Also. .. it still has so little to do with the topic at hand.

Yep - agreed ... has gone off-topic many posts ago.

Closing.