Some Reality on Myth: DOs can't get highly sought after residencies

[lawmed]

I have heard that DOs are mostly relegated to residencies in Family Medicine (FM) or in Internal Medicine (IM). (Actually, either would be acceptable to me.)

On the other hand, I am interested in aneshesiology. I looked around at some local hospitals and found cases where the surgeon was a DO and cases where the anesth was a DO as well! Check out Dr. Patterson.

http://www.comhs.org/physician/view_full.asp?dbID=7131

So help me out. What gives with the DO v. MD battle for residencies/specialites? Was I able to bust the myth that DOs can't get sought after specialties by doing a cursory search of local hospitals that took 15 minutes OR am I just plain wrong about this?

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[lord_jeebus]

Many excellent anesthesiology residency programs will take well-qualified DO applicants. On the other hand, many other anesthesiology programs will not offer interviews to DO applicants. It's a disadvantage but should not keep you out of the field.

 

[JaggerPlate]

Go to the osteo forum and check out the 2010 match lists ... it will put your fears to bed.

 

[FrkyBgStok]

Many excellent anesthesiology residency programs will take well-qualified DO applicants. On the other hand, many other anesthesiology programs will not offer interviews to DO applicants. It's a disadvantage but should not keep you out of the field.

on top of this there are many decent anes and surge residency programs available to only DOs, so it nets out.

 

[lord_jeebus]

The consensus among the DOs in the anesthesiology forum is that a DO won't hurt your anesthesia career - but an osteopathic residency will.

 

[mmmcdowe]

I have heard that DOs are mostly relegated to residencies in Family Medicine (FM) or in Internal Medicine (IM). (Actually, either would be acceptable to me.)

On the other hand, I am interested in aneshesiology. I looked around at some local hospitals and found cases where the surgeon was a DO and cases where the anesth was a DO as well! Check out Dr. Patterson.

http://www.comhs.org/physician/view_full.asp?dbID=7131

So help me out. What gives with the DO v. MD battle for residencies/specialites? Was I able to bust the myth that DOs can't get sought after specialties by doing a cursory search of local hospitals that took 15 minutes OR am I just plain wrong about this?

No you did not (god I wish someone would settle it though and glue it to every pre-med's forehead). The "myth" is that DO's have more difficulty getting the MD residencies in competitive specialty. Difficulty doesn't equal impossibility. So finding a few DOs mixed in with a butt load of MD docs (especially since you aren't actually looking at where they did their RESIDENCY which might very well have been a DO spot) does not disprove that DO's have trouble getting MD residencies in competitive specialty. At the same time, however, it also does not prove it. You would need a lot more data and a lot more statistical correction (even for things as simple as the fact that there are more MDs than DOs) to prove or disprove this endless SDN debate.

 

[christina30]

And also to be considered: there will be very "few" DOs in a given program mixed with a "buttload" of MDs, but look at the number of graduates per year. There are 120+ allopathic medical schools and about 28 osteopathic schools, so of course most allopathic programs are going to be comprised mostly of MD residents.

 

[DrBowtie]

And also to be considered: there will be very "few" DOs in a given program mixed with a "buttload" of MDs, but look at the number of graduates per year. There are 120+ allopathic medical schools and about 28 osteopathic schools, so of course most allopathic programs are going to be comprised mostly of MD residents.

Hence why aggregate statistics from NRMP are the best to use for any comparison.

 

[slarveson]

I could be wrong, but the answer to the question lies in the statistics for residencies for both DO's and MD's that you can find on websites. Take the amount of a specific residency positions available for only DOs and add that too the amount of DO's that made it too the MD residency specialty and find out the percentage accepted from the number of DO applicants total. Do the same for MD's and you will have the answer to the question. I know for sure that all the information is available except not sure about the number of DOs who made it into a specific MD residency although im sure you could find it somewhere. I wish someone would take the time to do this because its the only way to know for sure. I kinda did it in my head for a random residency when i was looking at these residencies websites and it was about 3 to 1 in favor of MD although im sure its alot different for each specialty.

 

[DOwnage]

The consensus among the DOs in the anesthesiology forum is that a DO won't hurt your anesthesia career - but an osteopathic residency will.

So if you were a DO going into residency with your heart set on anesthesia and you could either go to an osteopathic residency OR an allopathic residency in a primary care field (FP, IM) as a fallback which you weren't too hot for in the first place, would it be best to just go the osteopathic route and not look back?

 

[JeetKuneDo]

So if you were a DO going into residency with your heart set on anesthesia and you could either go to an osteopathic residency OR an allopathic residency in a primary care field (FP, IM) as a fallback which you weren't too hot for in the first place, would it be best to just go the osteopathic route and not look back?

Wouldn't you not have a choice since the DO match comes first?

 

[christina30]

Wouldn't you not have a choice since the DO match comes first?

well i guess they meant if you fail to match said osteopathic program then the MD match would be your fallback.

 

[mmmcdowe]

b

 

[Instatewaiter]

well i guess they meant if you fail to match said osteopathic program then the MD match would be your fallback.

Unless you rank only one or two programs in the AOA match (ie limiting your possibilities), if you fail to match in the AOA match, you are probably not going to be competitive enough to match in the ACGME match either.

 

[christina30]

Unless you rank only one or two programs in the AOA match (ie limiting your possibilities), if you fail to match in the AOA match, you are probably not going to be competitive enough to match in the ACGME match either.

Was just trying to interpret what another user said - something about an ACGME FM residency acting as a fallback because the DO match comes first. I don't quite get the logic, but oh well. Haha

 

[Skippygonenuts]

The consensus among the DOs in the anesthesiology forum is that a DO won't hurt your anesthesia career - but an osteopathic residency will.

A DO gas residency will hurt ur career in terms of what? Seeking a pain management fellowship or employment opportunities as a anesthesiologist?

 

[JeetKuneDo]

A DO gas residency will hurt ur career in terms of what? Seeking a pain management fellowship or employment opportunities as a anesthesiologist?

You should go read the anesthesiology forum. I think it's the most interesting forum on this site.

 

[DOwnage]

Allow me to clarify: I am aware that the AOA match happens first, but lets say you knew you were competitive from your COMLEX for an osteopathic residency in a field like anesthesia, but maybe your USLME score wasn't as high as it should be for anesthesia in the ACGME residencies. You had a rough idea of your competitiveness ahead of time so you could either go with the the DO residency that is lower risk of not matching vs. the MD residency that is higher risk of not matching. Then at the same time, rank something like FP or IM as a the final fall back to avoid not matching period.

Someone who is risk averse may say take the DO residency, whereas someone who feels that DO residencies don't adequately prepare a resident may say take a gamble on the MD residency. What would most people advise in this situation? I mean if you didn't match in the AOA one at all, you could still rank the ACGME one I guess just for the heck of it...right?

The general concensus appears that DO residencies don't prepare people enough or something; I haven't heard any specific examples of these problems and I'm curious as to how real of a problem they may be. I'm not saying that they are not true, I'm just restating what I've been gathering from other people's testimonies. Anyone care to elaborate?

 

[dozitgetchahi]

The general concensus appears that DO residencies don't prepare people enough or something; I haven't heard any specific examples of these problems and I'm curious as to how real of a problem they may be. I'm not saying that they are not true, I'm just restating what I've been gathering from other people's testimonies. Anyone care to elaborate?

Go read the gas forum. Apparently some hospitals are awfully reluctant to hire DO anesthesiologists who completed osteopathic residencies. It doesn't seem to be a universal problem but DOs in this situation seem to have a harder time getting hired by some places.

 

[JaggerPlate]

Go read the gas forum. Apparently some hospitals are awfully reluctant to hire DO anesthesiologists who completed osteopathic residencies. It doesn't seem to be a universal problem but DOs in this situation seem to have a harder time getting hired by some places.

It's just way safer to higher a CRNA.

 

[JeetKuneDo]

It's just way safer to higher a CRNA.

Argh, CRNA's disgust me!!!!!!!!!!!!!!!!!!!!!!!!!!!

 

[mechanictodr]

Argh, CRNA's disgust me!!!!!!!!!!!!!!!!!!!!!!!!!!!

I know a couple who are both getting their CRNA right now. If I wasn't this far into becoming a physician I would totally go that route instead. It's a sweet job, and for the amount of school and hours per week worked it pencils out way better than med school. I think the biggest reason why physicians don't like them is because they get paid so well, but so does the MBA down the hall... who happens to kind of run the lives/schedules of the physicians where I'm from.

 

[christina30]

I know a couple who are both getting their CRNA right now. If I wasn't this far into becoming a physician I would totally go that route instead. It's a sweet job, and for the amount of school and hours per week worked it pencils out way better than med school. I think the biggest reason why physicians don't like them is because they get paid so well, but so does the MBA down the hall... who happens to kind of run the lives/schedules of the physicians where I'm from.

No, the problem with CRNAs is that they're doing the "same" work, despite having less education/training (and thus less knowledge abotu what they're doing) and much less responsibility. It's not only unfair, but it makes zero sense in terms of patient care/safety.

 

[mechanictodr]

No, the problem with CRNAs is that they're doing the "same" work, despite having less education/training (and thus less knowledge abotu what they're doing) and much less responsibility. It's not only unfair, but it makes zero sense in terms of patient care/safety.

I totally agree. It's most unfair to the unknowing patients. However, from the standpoint of an RN who wants to tripple (or more) their pay for scheduled hours and similar responsibility level as an ICU nurse this is an awesome career path. You'll make more than may physicians with a total of 7-9 years of training (including the critical care experience you need to get accepted to the programs). It's quite a tempting field from a financial and lifestyle standpoint.

 

[IndianVercetti]

No, the problem with CRNAs is that they're doing the "same" work, despite having less education/training (and thus less knowledge abotu what they're doing) and much less responsibility. It's not only unfair, but it makes zero sense in terms of patient care/safety.

I have similar sentiments, but there really is no other functional solution, other than to take in 5th path, Carib MD graduates to fill gaps - which again, lacks the regulation of US MD/DO and NP schools. And from the looks of it, American governing boards don't favor this solution.

edited my post - did not want to hijack thread.

 

[JaggerPlate]

No, the problem with CRNAs is that they're doing the "same" work, despite having less education/training (and thus less knowledge abotu what they're doing) and much less responsibility. It's not only unfair, but it makes zero sense in terms of patient care/safety.

Yup.

 

[DrMom922]

Does it help or hurt to take both USMLE and the COMLEX?

 

[mspeedwagon]

There is zero data to support that patient care/safety is compromised when anesthesia is provided by a CRNA. As a matter of fact there is plenty of evidence to support the contrary.

There have been a lot of studies by medical journals and nusring journals comparing CRNAs to anesthesiologies and they all have come to the same conclusion: "there is absolutely no difference." "Anesthesia, whether provided by Certified Registered Nurse Anesthetists (CRNAs) or anesthesiologists, is extremely safe, and there is no difference in safety between hospitals that use only CRNAs compared with those that use only anesthesiologists," according to the results of a new study published in a recent issue of Nursing Research (Vol. 56, No. 1, pp. 9-17). Similar articles can be found in medical journals as well.

I would strongly advice you study all the literature and read all the journals before making claims that have absolutely no basis. If it had been found that using CRNAs actually did compromise patient safety, they would be extinct by now (but they are thriving because they have been found to be as effective as anesthesiologists and do the same job for less pay).

No, the problem with CRNAs is that they're doing the "same" work, despite having less education/training (and thus less knowledge abotu what they're doing) and much less responsibility. It's not only unfair, but it makes zero sense in terms of patient care/safety.

 

[mechanictodr]

according to the results of a new study published in a recent issue of Nursing Research (Vol. 56, No. 1, pp. 9-17).

Wow, you read that? I'm sure that the publishers of the article were not biased in any way and that the "scientific studies" executed to obtain such a result were in no way set up to do just that.

I mean, this could be legit, but since I've been in the research business most of this decade I've seen how much we publish that's set up to give the results we want to present. I just don't buy it if
I can't reproduce it on my own anymore, and this kind of research can be easily skewed.

It's nice to see that Nursing Research feels this way, but I would have to see a few people from the ASA stand up make this claim before I took it to heart.

I still thinks it's a sweet career choice from a financial and lifestyle standpoint and it's a heck of a lot easier to reach than becoming an anesthesiologist so... I still give the career choice a

 

[mspeedwagon]

I'll post a link from one of the medical journals that essentially says the same thing (this one is free and easy to reference, the medical one is not free which is why I cited this one rather than the other, but I knew someone would question the source... I would have myself).

And, yes, I reading nursing as well as medical journals. I'm one of the idealists that believes that nursing is every bit as integral to the medical professional as doctors and PAs. I'm also one that would like to believe that each chose the path because it was their true passion.

But, yes I agree that CRNA is a sweet gig, though I'm not interested in anesthesia in the least (General peds / Peds ER medicine are my interests).

Wow, you read that? I'm sure that the publishers of the article were not biased in any way and that the "scientific studies" executed to obtain such a result were in no way set up to do just that.

I mean, this could be legit, but since I've been in the research business most of this decade I've seen how much we publish that's set up to give the results we want to present. I just don't buy it if
I can't reproduce it on my own anymore, and this kind of research can be easily skewed.

It's nice to see that Nursing Research feels this way, but I would have to see a few people from the ASA stand up make this claim before I took it to heart.

I still thinks it's a sweet career choice from a financial and lifestyle standpoint and it's a heck of a lot easier to reach than becoming an anesthesiologist so... I still give the career choice a

 

[JeetKuneDo]

There is zero data to support that patient care/safety is compromised when anesthesia is provided by a CRNA. As a matter of fact there is plenty of evidence to support the contrary.

There have been a lot of studies by medical journals and nusring journals comparing CRNAs to anesthesiologies and they all have come to the same conclusion: "there is absolutely no difference." "Anesthesia, whether provided by Certified Registered Nurse Anesthetists (CRNAs) or anesthesiologists, is extremely safe, and there is no difference in safety between hospitals that use only CRNAs compared with those that use only anesthesiologists," according to the results of a new study published in a recent issue of Nursing Research (Vol. 56, No. 1, pp. 9-17). Similar articles can be found in medical journals as well.

I would strongly advice you study all the literature and read all the journals before making claims that have absolutely no basis. If it had been found that using CRNAs actually did compromise patient safety, they would be extinct by now (but they are thriving because they have been found to be as effective as anesthesiologists and do the same job for less pay).

You should take this post over to the Anesthesia forum.

 

[mspeedwagon]

Thanks... I wasn't intending to argue per se, but hoping that people on here posted with more evidence. Given my level of interest in anesthesia, I think I'll spare myself from the forum.

Now back to the OPs question. I was going to comment about that too... another reason you might not be found in highly competitive specialties is because of the primary care focus of some of the schools and kind of students the schools draw. Granted, if you want to pursue it, I've pretty much found DOs in every specialty, so it can be done.

You should take this post over to the Anesthesia forum.

 

[JaggerPlate]

speedwagon,

If it's the same kind of data that the NPs use to say their care is just as satisfactory as FP/IM trained PCPs ... it's complete BS. In two different threads, NPs were trying to throw down "evidence." There data was this:

-First, all studies were done by some nursing agency, which referenced itself and older, just as flawed, studies they have done in the past

-In one study, it showed that their patients were just as healthy at the 6 month post visit mark as compared to PCPs. Med students and residents tore it apart by saying that any one can tell people to take their glucose and show the same results 6 months later (NPs refer all difficult cases to real doctors), and that 6 months simply isn't enough time for real increase/decrease in health to occur.

-The other study was done at the VA and showed that NPs had better patient satisfaction. Someone tore it apart by saying that a. They sent home a flier that like 40% even returned (surveys like this already create bias) b. something absurd like 90% of VA patients are men, and 70% of NPs are women ... you do the math on why the dude who chose to send in this survey liked the women better ().

Altogether, just completely flawed, worthless, studies. I can do a really quick study right now, that will be published in the journal of face palms and common sense, that proves, without a doubt, that a board certified gas man who has taken pre-med, performed on the mcat, made it through medical school, taken the appropriate USMLE/COMLEX steps, completed a gas residency, and has stayed BC/BE in the field is a far, far better choice than an RN who randomly took a few classes to become a CRNA. In fact, I think some of these classes can be taken online. Frankly, I don't need any data or studies to convince me. Anyone who tells you different is a nurse trying to get better rights for CRNAs or is a manager/admin with cost in mind.

/rant

 

[dancingDO14]

I know we were trying to get the thread back on track, but I couldn't resist giving my two cents:

I have no data or medical research to contribute, but I wanted to give my perspective as a patient. I had surgery last October, this past Monday, and am having another in a couple weeks. My anesthesia for BOTH my October surgery and this week's surgery was administered by a CRNA. Did I know this because she introduced herself as a CRNA? No. I knew because I had to search for her name badge with her title under her name. The way she introduced herself was "Hi I'm ___ and I'll be doing your anesthesia today."

Now I've worked with a lot of CRNA's in ORs before as well as anesthesiologists and I'm not sure where I stand in the CRNA vs. Dr debate because some of the CRNA's I've worked with have been extremely competent.

What I DO have a problem with is that the CRNA I had for my surgery did not identify herself as a CRNA and patients not familiar with the medical field would have without a doubt assumed she was the anesthesiologist. I do not think this is ethical at ALL, and furthermore, I have actually no idea if there actually was a gas man involved in my surgery at ALL. Granted, my surgery was relatively simple/quick and I've never had problems with anesthesia before, but I still felt discomfited with the fact that I had no idea whether a gas man was around at all or not. The only time I saw an anesthesiologist was after surgery in PACU when the nurses were trying to administer my pain meds and needed a gas man's input. He wasn't even in my OR as far as I know, unless he came in after the CRNA had already put me to sleep, so I don't know if he even knew my case. The CRNA was not around after my surgery, nor do I know if she would have been able to answer the PACU nurses questions like the anesthesiologist did.

For my next surgery, I am going to specifically ask the CRNA if an anesthesiologist will be at all present for my surgery, just for my own peace of mind. I do not think it's right at all to not make it clear to the patient who is administering what, and why. My surgeon clearly identified the residents and fellows who would be working with him, and didn't allow me to assume that they too were attendings, so why shouldn't the CRNA make it clear who he/she is?

 

[haberdash1]

In fact, I think some of these classes can be taken online. Frankly, I don't need any data or studies to convince me. Anyone who tells you different is a nurse trying to get better rights for CRNAs or is a manager/admin with cost in mind.

/rant[/QUOTE]

To be a CRNA you need to complete a 24-36 month graduate degree. These are extremely competitive, intense programs. This also usually requires like 5 years CICU or ICU experience.

Not as intense as a DO/MD residency, though not exactly online either.

 

[JaggerPlate]

Not as intense as a DO/MD residency

Frankly, that's all I need to hear. Why even bother?? Like great, I'm sure I was being a bit verbose saying they were online, but a 24 month program vs a board certified physician who completed, what, a 4 year residency??? Like why risk it, why bother, why even argue. The only people who would ever make this argument, ever are frustrated nurses who are trying to push their cred and hospital admins who have a budget to deal with.

Ask a patient ... ask ANY patient, I promise not a single one will choose a nurse who went through a 24 month program vs a BC Anesthesiologist for their care. Especially since people seem paranoid about the gas killing them anyway.

 

[JaggerPlate]

Did I know this because she introduced herself as a CRNA? No. I knew because I had to search for her name badge with her title under her name. The way she introduced herself was "Hi I'm ___ and I'll be doing your anesthesia today."

You should check out some of the threads about Anesthesiologists making it hospital policy to identify yourself properly, or the huge health care transparency act that organizations like the AMA, AOA, ASA, AAD, etc are trying to get through right now. This isn't an isolated incident.

Frankly, I'd like to give the nurse the benefit of the doubt ... but to me, it translates to someone who listened to a few jaded nurses complain about incompetent, lazy doctors, how they save their asses, could do their jobs, etc, then took the CRNA classes, and now feels he/she is equivalent to a doctor so wants to kind of skirt past the point that he/she doesn't have Dr. in front of their name. It's the same mentality the DNP movement is using right now. If things go their way ... this is what the future will look like:

"Hi, I'm Dr XX, I'll be doing your ____ today"
nametage: XX, DNP

 

[MalachiConstant]

To be a CRNA you need to complete a 24-36 month graduate degree. These are extremely competitive, intense programs. This also usually requires like 5 years CICU or ICU experience.

Not as intense as a DO/MD residency, though not exactly online either.

This isn't exactly an accurate representation either. I would say that of all the advanced practice nursing options, the CRNA route is the most rigorous, competitive and has the fewest online courses. However the average required experience is two years and some schools require as little as one year critical or acute care experience. In comparison to medical school, to refer to them as extremely competitive or intense is laughable, and yes, many of the required fluff courses are offered online.

I've known quite a few nurses who went on to CRNA school. Most were great and will probably be quite capable, but there were a couple who were absolute *****s with the minimum amount of experience and overinflated opinions of their own knowledge and abilities. The problem is, if a CRNA is doing your case, you don't know if they're good or if they struggled to maintain a 3.0 gpa, got a mediocre GRE score, put in a year in some podunk icu that sent out anything remotely complicated, then barely made it through one of the less reputable CRNA schools. Certainly there's individual variation between physicians as well, but at least with a real anesthesiologist, you know their skills and knowledge have been tested much more extensively.

 

[avatarftw]

a

 

[Slack3r]

I'll post a link from one of the medical journals that essentially says the same thing (this one is free and easy to reference, the medical one is not free which is why I cited this one rather than the other, but I knew someone would question the source... I would have myself).

And, yes, I reading nursing as well as medical journals. I'm one of the idealists that believes that nursing is every bit as integral to the medical professional as doctors and PAs. I'm also one that would like to believe that each chose the path because it was their true passion.

But, yes I agree that CRNA is a sweet gig, though I'm not interested in anesthesia in the least (General peds / Peds ER medicine are my interests).

So you're essentially saying that the training an anesthesiologist goes through is entirely superfluous and can be replicated by nurses with a 24 month program?