Should DO's Specialize?

[PACtoDOC]

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I got the idea for this thread after seeing so many recent threads that have been bashing the quality of Osteopathic specialty residencies. I might get a whole lot of hate mail from some of you, but I think we owe it to ourselves to answer this question.
Why would anyone bother to attend a DO school, where you spend hundreds of hours in the first 2 years learning OMM, only to attempt to match into some allopathic anesthesia, radiology, dermatology, ophthalmology residency? Doesn't this mean that you are basically an MD wannabe? I find it interesting, and personally I think it to be part of the reason we continue to have to defend why we are as capable as MD's. What really makes a DO different than an MD is one thing. OMM. So if you choose not to use it, then why did you want to become a DO? And do you think that DO hospitals can honestly provide a good enough education for someone wanting to become ultraspecialized? My personal opinion would be that DO's should all be primary care providers, and that MD's who want to practice primary care should learn OMM 🙂

 

[luckystar]

Originally posted by PACtoDOC
What really makes a DO different than an MD is one thing. OMM... My personal opinion would be that DO's should all be primary care providers, and that MD's who want to practice primary care should learn OMM 🙂

Wait, so then what would you say is the difference between an MD with OMM training, and a DO? Why is it that you think DOs should be limited to primary care, but MDs can do anything, with the extra training if they want to do primary care?

I don't think all DOs in primary care use OMM either.

Learning something for the sake of learning should be reason enough for someone to want to pursue osteopathic medicine. I went through four years of college having taken half my course load in subjects that I don't plan on ever revisiting or using for the rest of my life. But I am so glad I did have the chance to study all those things.

I'll be starting school this fall, so I don't know much about OMM yet, but I can say that having those classes would probably strengthen your palpation and touch sensory, so that it would help in many other areas, not just OMM per se.

I don't understand why there has to be such a bold line between DOs and MDs. Keep in mind that DOs aren't the only ones who get bashed. There are some people who absolutely abhor going to the doctor's, and don't have very nice things to say about them.

 

[Teufelhunden]

Originally posted by PACtoDOC
Why would anyone bother to attend a DO school, where you spend hundreds of hours in the first 2 years learning OMM, only to attempt to match into some allopathic anesthesia, radiology, dermatology, ophthalmology residency? Doesn't this mean that you are basically an MD wannabe?

First of all, most medical students have no clue as to what they want to specialize in when they're applying. I'm an MS-II and still don't know. As far as your MD-wannabe statement, well....personally I just wanted to ba a PHYSICIAN....period. Wasn't too concerned with what initials came after my name. I applied to both MD and DO schools, and was only accepted to DO school...how's that for an answer?

Originally posted by PACtoDOC
I find it interesting, and personally I think it to be part of the reason we continue to have to defend why we are as capable as MD's. What really makes a DO different than an MD is one thing. OMM. So if you choose not to use it, then why did you want to become a DO?

Again, I didn't necessarily want to become a DO (or an MD for that matter), I just wanted to become a physician, and never got really caught up in the MD vs. DO thing.

Originally posted by PACtoDOC
And do you think that DO hospitals can honestly provide a good enough education for someone wanting to become ultraspecialized?

In general, no. Luckily for me, I'm Navy HPSP, and all the Navy residencies are allopathic, so this isn't a concern for me. Even if I don't choose to do a military residency, I have every intention of applying only through the allopathic match.

Originally posted by PACtoDOC
My personal opinion would be that DO's should all be primary care providers, and that MD's who want to practice primary care should learn OMM 🙂

Uhh....that's just crazy. Glad you're not in charge. Why, again, should primary care MDs learn OMM? Are you telling me OMM is somehow necessary to be a good faimily practice doc? You're kidding, right? Most DO FP's I know don't use OMM.

Originally posted by PACtoDOC
Why would anyone bother to attend a DO school, where you spend hundreds of hours in the first 2 years learning OMM, only to attempt to match into some allopathic anesthesia, radiology, dermatology, ophthalmology residency?

Uhh....Why would anyone bother to take gross anatomy, where you spend hundreds of hours insertions/attachments of muscles, cord level innervations, the names of every square inch of fascia, etc...only to attempt to match into Psychiatry?

Why do we spend countless hours in medical school learning a whole plethora of stuff we'll never use?

Get it?

 

[DermRes]

Yes, DO should specialize...

 

[irish79]

I don't really get it. Why shouldn't a DO specialize? Because they learn OMM? I don't believe everyone who learns OMM in school is going to excel at, nor will they become so proficient that they should use it in their day-to-day practice. So then, should we all be required to take OMM residencies in addition to our "primary care only" residency (so that we truly learn to use this art)?

Another question: Don't DO's that specialize ALSO use OMM? I work for a DO in an interventional cardiology practice of 19 MD's and 1 DO and she said she uses OMM with quite a few of her patients (2 criteria: they must feel comfortable with her doing it and she must feel comfortable performing it on them). She, a DO, is my inspiration to specialize--not some underlying desire to be a MD.

Just my thought...

 

[Teufelhunden]

Originally posted by irish79
I don't really get it. Why shouldn't a DO specialize? Because they learn OMM? I don't believe everyone who learns OMM in school is going to excel at, nor will they become so proficient that they should use it in their day-to-day practice. So then, should we all be required to take OMM residencies in addition to our "primary care only" residency (so that we truly learn to use this art)?

Great point. We spend 2 hours a week doing OMM - that's barely nothing - ergo we suck at it. There are a few students who have taken it upon themselves to do extra clincial work with the OMM docs....they have their little OMM Club...so they get a lot more training and practice than the rest of us. Those will be the ones who may feel comfortable enough with OMM to use it in their practices.

Again, the little OMM training you get the 1st two years of DO school is grossly inadequate to prepare you for manipulative work in your practice. Chiropracters, on the other hand, who aren't bogged down by all that pesky "science" can spend countless hours practicing manip....and are therefore very good at it.

I have a feeling the poster is still pre-med, and doesn't yet realize how poorly OMM is taught at many DO schools....perhaps some schools do a better job than mine, but I doubt there's that much of a difference, being that all the DO schools face the same limitations of time...there's simply too much real medicine to learn = not much time left over for OMM.

Personally, if I chose to make OMM a major part of my practice, I would pursue some sort of additional post-graduate training in OMM.

 

[PACtoDOC]

Wow,
Thanks for all the replies, and thanks for keeping it professional. It was rather late last night when I started this thread, and I was a little down about the thread I had just read in the Allo forum about why DO's are "second rate citizens". Those threads always seem to come from pre-MD students who think they are so much better than us because they got it to an MD program. But they were raising some valid arguments.

I guess my original question was a little too broad. I really just wanted to hear what would make someone want to come to a DO program if they wanted to be a specialist in the beginning. But as one of you pointed out, most premeds don't know that they want to be any particular specialty. So that I understand. I just see many of my classmates who absolutely hate OMM, and talk about doing nothing but some allopathic medicine subspecialty. That just sort of bothers me, because I really just wish DO schools were full of people that wanted to be DO's.

But another poster also made a good point about how it enhances palpatory skills and knowledge of anatomy to go the DO route. That I absolutely agree. I doubt you will ever find an MD student or MD for that matter that knows whther ribs 11 and 12 have a transverse costal articulation, or how much range of cervical motion is provided in rotation by the OA joint.

And I am sorry to dissappoint the previous poster, but I am in medical school. Maybe you are having a bit of frontal lobe somatic dysfunction (error in judegment 🙂 All in good humor guys, and I thank you again for your responses.

But lastly, why is it that DO residencies outside of say FM or Peds are generally even regarded by all of us as inferior in quality. Is it just a misperception, or is it true? Maybe the KCOM derm resident can chime in and explain whether or not they feel their training is as good as their counterparts over at UTSW down the road.

My feeling is that the DO residencies of the future are going to become less "DO only" and will begin to merge with the allopathic residencies as more DO's get on their faculty. This is already happening for FM everywhere, and what do you think about this trend? I love the idea of being able to be dually board certified and to have my intern year count as a DO intern year. This to me is truly the best of both worlds. But will inevitibly happen to those DO only programs left back at DO only hospitals? Nobody wants to see them dissolve, but what can they do to keep people coming to them as more allopathic residencies become dually certified?

 

[irish79]

Let's try this again...

I guess my original question was a little too broad. I really just wanted to hear what would make someone want to come to a DO program if they wanted to be a specialist in the beginning. But as one of you pointed out, most premeds don't know that they want to be any particular specialty. So that I understand. I just see many of my classmates who absolutely hate OMM, and talk about doing nothing but some allopathic medicine subspecialty. That just sort of bothers me, because I really just wish DO schools were full of people that wanted to be DO's.

Why is it that you believe a DO should ONLY be in a primary care field? Why should we be limited to only one rung of the medical ladder? I want to be a specialist AND I want to be a DO--why shouldn't I be both? I believe in the teachings and principles of Osteopathic Medicine and I enjoy cardiovascular medicine (from what I?ve seen thus far). If anything, I think the ?primary care? basis of a DO education will make me a better specialist?it gives me something to build on. In my opinion, being a DO doesn't relegate me to a lower position in the medical world, nor should it limit my options on what I want to practice. If we as DO's don't think we are "worthy" or ?capable? of attaining specialty positions (osteopathic or allopathic), then it is no wonder many pre-MD's think the way they do.

DO's entering allopathic subspecialties have the potential of being very good for osteopathic medicine. Number one, it strengthens our numbers in the ENTIRE medical community. Number two, if we can become well educated and competent subspecialist, perhaps we can return to DO programs and help improve the osteopathic subspecialty residency and fellowship programs. Combining the knowledge of both disciplines will help to one day, I hope, make Osteopathic residencies a superior and preferred choice for those of us considering subspecialties.

But lastly, why is it that DO residencies outside of say FM or Peds are generally even regarded by all of us as inferior in quality. Is it just a misperception, or is it true? Maybe the KCOM derm resident can chime in and explain whether or not they feel their training is as good as their counterparts over at UTSW down the road.

I think the reason for this is because osteopathic medicine started as mainly primary care and has recently branched out into other specialties. Our postgraduate training in these areas might not be as good as the allopathic are, yet, but they continue to get better and will one day be equal. Of course, I really don't know much about this, it is just my rambling opinion (maybe hope). 🙂

Sidenote: I kind of consider osteopathic medicine and allopathic medicine similar to the Roman Catholic Church and the Eastern Orthodox Church. In our "bylaws" (i.e. Roman Catholic) we look at Eastern Orthodox Catholics as separate but the same. We share a common history and equal privileges--we just differ in a few beliefs and practices--but we can still live together as One, Catholic Church.

 

[DrSmiles]

Wait a minute, wait a minute...
There is much much more to osteopathic medicine than just OMM for crying out loud!
The previous poster touched on "philosophy and principles". I don't know about anyone else but what really sold me to go to the DO side was the philosophy, not whether I will be able to crack a few bones in my practice. The Osteopathic philosophy and the principles set forth by AT Still are really what makes this type of medicine unique.

 

[DermRes]

quote:
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But lastly, why is it that DO residencies outside of say FM or Peds are generally even regarded by all of us as inferior in quality. Is it just a misperception, or is it true? Maybe the KCOM derm resident can chime in and explain whether or not they feel their training is as good as their counterparts over at UTSW down the road.
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I certainly can't say that I am getting better training than UTSW down the road. What I do know, is that I am getting a good training.

We participate in the basic science lectures and grand rounds at UTSW as well as dermpath training. In addition, we have additional journal clubs and basic science with KCOM Missouri.

I'd like to think our training program is pretty good, no?

It is sad to see that people of our own DO profession think DO training programs are inferior simply because we are osteopathic residencies.