Surgery Sub-Specialty

[UTKpremed]

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Hey SDNers, I need some advice. I have been accepted to LECOM-B and VCOM-CC. I am leaning more toward LECOM because I love the PBL. I have been working in an OR for 2 years and I love surgery, especially urology and ENT. I would like to come back to my home state of Tennessee for residency. What do I need to do during my rotations in med school to ensure I can accomplish these things? Also, my dad is an MD and is totally opposed to me pursuing the DO route because he is afraid I will be destined for a life in primary care and will not be selected for any surgery residencies. What are your thoughts on this? Thanks so much!

 

[Everglide]

Good preclinical grades, 90th%ile boards minimum, do awesome on rotations. Then apply to all of the DO residencies, it's very unlikely to match ent/uro via the MD match as a DO.

Worth noting again... DOs do have ent/uro/gs residencies

 

[Brachyury]

Good preclinical grades, 90th%ile boards minimum, do awesome on rotations. Then apply to all of the DO residencies, it's very unlikely to match ent/uro via the MD match as a DO.

Worth noting again... DOs do have ent/uro/gs residencies

Not in Tennessee. Besides, the ratio of the number of DO residencies in these fields realtive to the number of DO students is decreasing: as SO schools expand like crazy, there has only been a minor increase in the number of residencies, especially in GS and surgical sub-specialties

BTW, there are 10 DO urology residencies (5 of which are in Michigan), and there are 19 ENT programs

OP, if you really have your eyes set on a surgical sub-specialty, it might be worth taking time off and improving your GPA/MCAT are aiming for allopathic. At the very least, even if you don't have the stats for ENT or uro, as an allopathic applicant, you're all but guarenteed to match GS somewehre

 

[UTKpremed]

Wow thats pretty discouraging from a DO standpoint

 

[jinobi]

It's the truth. DO subsurgical programs do exist, but most are not as highly regarded as their ACGME equivalents (some may be good, depending on the mix of patients and cases they receive). DO subsurgical programs are also more geographically limited, as Brachyury pointed out.

It will be much harder to match into ACGME Uro/ENT residencies within your home state. Easier to match DO Uro/ENT as a DO student, but you're still competing for an ever decreasing number of spots.

 

[UTKpremed]

Are any of you DO students? Which school do you attend?

 

[Brachyury]

Are any of you DO students? Which school do you attend?

Is this what you want to hear: "go to either of the schools: you'll totally be fine. Last year, there were over 200 urology spots that went unfilled". BTW, I'm an allo student

 

[jinobi]

Had my mind set on WesternU, but decided to move across the country to pursue my MD when the opportunity came. I did a lot of looking and comparison into both MD and DO. Equivalent education (minus OMM from DO, which I didn't care for anyways). However, non equivalent opportunities was what propelled me to the MD path.

 

[UTKpremed]

Edit

 

[UTKpremed]

Had my mind set on WesternU, but decided to move across the country to pursue my MD when the opportunity came. I did a lot of looking and comparison into both MD and DO. Equivalent education (minus OMM from DO, which I didn't care for anyways). However, non equivalent opportunities was what propelled me to the MD path.

What specialty are you wanting to pursue? Is every residency opportunity non equivalent?

 

[Brachyury]

What specialty are you wanting to pursue? Is every residency opportunity non equivalent?

It's more than just 'are the opportunities equivalent.' If you want to go into private practice OB/GYN, no, it really does not matter if you go MD or DO. If you want to do urology, it’s still possible to reach this goal via DO, but your chance of matching are better via MD. It's difficult to have an academic research career at a major hospital as a DO (mainly due to a lack of training than to the initials of your degree), and since most residencies are allopathic, it's easier to find a residency in the area of the country you want to settle in via the allopathic match. If you were interested in family practice, EM, or psych, you would not have any problem landing an allopathic residency as a DO, but trying to land one in ENT/Derm/uro/GS/Radonc is unlikely to happen.

At the end of the day, both MD and DO schools will provide excellent training, and 99% of your patients and coworkers will not care what your initials are. However, residencies do care, and your ability to land a residency will shape your entire career/life

Finally, two things to note: first, uro and ENT are very difficult to match into--regardless if you are MD or DO--and if you don't have the numbers, you aren't going to match. Second, most medical student change their minds about which specialty they want to go into: for all you know, you might enter med school wanting to do ENT/Uro and leave doing pathology.

 

[UTKpremed]

What specialty are you wanting to pursue? Is every residency opportunity non equivalent?

It's more than just 'are the opportunities equivalent.' If you want to go into private practice OB/GYN, no, it really does not matter if you go MD or DO. If you want to do urology, it’s still possible to reach this goal via DO, but your chance of matching are better via MD. It's difficult to have an academic research career at a major hospital as a DO (mainly due to a lack of training than to the initials of your degree), and since most residencies are allopathic, it's easier to find a residency in the area of the country you want to settle in via the allopathic match. If you were interested in family practice, EM, or psych, you would not have any problem landing an allopathic residency as a DO, but trying to land one in ENT/Derm/uro/GS/Radonc is unlikely to happen.

At the end of the day, both MD and DO schools will provide excellent training, and 99% of your patients and coworkers will not care what your initials are. However, residencies do care, and your ability to land a residency will shape your entire career/life

Finally, two things to note: first, uro and ENT are very difficult to match into--regardless if you are MD or DO--and if you don't have the numbers, you aren't going to match. Second, most medical student change their minds about which specialty they want to go into: for all you know, you might enter med school wanting to do ENT/Uro and leave doing pathology.

Thank you for responding....this is very helpful...Im just looking for all the info I can get to help me make the best decision.

 

[Brachyury]

I wasn't looking for you to stroke my ego or say what you think I want to hear. I'm applying to both MD and DO schools and I am weighing both options. And BTW if you're already in an allo school, why are you posting on a pre-osteo forum? Is writing DB comments to people looking for real answers the only way to build your confidence?

I have free time this afternoon (i.e. procrastinating). I occasionally post in the pre-allo forum (I usually don't come in here) because when I was applying, the advice from previous medical students helped me navigate the application process. In my three years of med school, there are many things I do not know, but there are some things I do know, and if I can share that information, then why not. None of my comments were meant to be DB comments; if they offended you, I apologize: that was not my intention

Take at look at these
http://www.nrmp.org/data/chartingoutcomes2011.pdf
http://www.nrmp.org/data/resultsanddata2011.pdf

. . . and these

http://www.opportunities.osteopathi...essionid=f030201de4378e9b100a6f70214a3e1e5227

http://www.ama-assn.org/ama/pub/education-careers/graduate-medical-education/freida-online.page

 

[drctother]

Brachyury gave you an honest answer

The opportunities are the same, unless you want to something very very competitive. Another VERY important thing regarding the DO route. Yes, it is possible to get competitive residencies......but keep in mind DO is huge in places like Michigan, California is not easy at all and spots are limited. This may or may not be desirable for yourself.

I really want to know now. As a premed, how could you know that you want be an ENT or Urologist? Those are so random. Do you even know anything about Urology? (I mean that in the nicest way) Im curious because most premeds usually say they want to go into "surgery, family medicine, EM" or the odd person who wants to make a lot of money will say "ive alway wanted to be a dermatologist or opthamologist" (they may claim they arent interested in those field as a premed for the money, but i call BS)

 

[IDFsoldierboy]

Good preclinical grades, 90th%ile boards minimum, do awesome on rotations. Then apply to all of the DO residencies, it's very unlikely to match ent/uro via the MD match as a DO.

Worth noting again... DOs do have ent/uro/gs residencies

just wondering how u get good pre-clinical grades if ur class is pass/fail like MSUCOM and many MD programs are starting to become more pass/fail or how that factors in if you only have pass on ur record and not an actual grade

 

[drctother]

I disagree with the good preclinical grades part. You dont have to have straight honors or anything. Reputation/Personality in 3rd/4th year + Boards >>>> Your preclinical grades

With that being said, if you fail classes that will look very bad. Also, some people believe if you dont get honors in preclinical courses, you probably wont ace your boards. Thats up for debate though and totally varies per individual.

 

[UTKpremed]

Brachyury gave you an honest answer

The opportunities are the same, unless you want to something very very competitive. Another VERY important thing regarding the DO route. Yes, it is possible to get competitive residencies......but keep in mind DO is huge in places like Michigan, California is not easy at all and spots are limited. This may or may not be desirable for yourself.

I really want to know now. As a premed, how could you know that you want be an ENT or Urologist? Those are so random. Do you even know anything about Urology? (I mean that in the nicest way) Im curious because most premeds usually say they want to go into "surgery, family medicine, EM" or the odd person who wants to make a lot of money will say "ive alway wanted to be a dermatologist or opthamologist" (they may claim they arent interested in those field as a premed for the money, but i call BS)

I agree, Brachyury did give an honest answer. Thats what I was looking for. My original question was what do I need to do to ensure I can come back to Tennessee for whatever residency I want to pursue. I had heard it is easier to get a residency where you did your rotations in med school. Also, in my original post, I said I have worked in an OR (observing and even scrubbing in) for awhile and I really like the specialties of ENT and uro. I have spent alot of time with doctors from both specialties (and several others such as ortho and gyn). So to answer your question, yes I do know a little about urology, especially for a premed.

 

[UTKpremed]

I disagree with the good preclinical grades part. You dont have to have straight honors or anything. Reputation/Personality in 3rd/4th year + Boards >>>> Your preclinical grades

With that being said, if you fail classes that will look very bad. Also, some people believe if you dont get honors in preclinical courses, you probably wont ace your boards. Thats up for debate though and totally varies per individual.

If I go to school in Florida at LECOM, should I try to get my rotations at hospitals in Tennessee (where I am from and want to return to)? I had heard that it would be easier to get a residency in the place you did your rotations because they already know you and what kind of a worker you are.

 

[LesBois88]

That would be totally dependent on a few factors- will the school approve them? if so, does the structure exist in TN for you to do what you need? will they take you there? what specialty? in most, it is not necessary for you to rotate at a particular institution in order to match there.

My opinion: get into medical school, figure it out after that. It will make more sense then.

 

[Instatewaiter]

Hey SDNers, I need some advice. I have been accepted to LECOM-B and VCOM-CC. I am leaning more toward LECOM because I love the PBL. I have been working in an OR for 2 years and I love surgery, especially urology and ENT. I would like to come back to my home state of Tennessee for residency. What do I need to do during my rotations in med school to ensure I can accomplish these things? Also, my dad is an MD and is totally opposed to me pursuing the DO route because he is afraid I will be destined for a life in primary care and will not be selected for any surgery residencies. What are your thoughts on this? Thanks so much!

There are no AOA (DO) residencies in ENT or urology in Tenn. The likelihood of matching ACGME (MD) urology or ENT as a DO is very, very low (in the last 5 years there have been 2 people who have matched any program in ENT.)

All you can do is try hard and see what happens.

 

[paolorossifan]

There are no AOA (DO) residencies in ENT or urology in Tenn. The likelihood of matching ACGME (MD) urology or ENT as a DO is very, very low (in the last 5 years there have been 2 people who have matched any program in ENT.)

All you can do is try hard and see what happens.

This is the best reponse you should get and its the only one that matters. Whether you decide DO or MD you must work hard and get the grades. Anything is possible with the right numbers and letters (usually)...you may find yourself among those 2 that got in. They faced the same hurdles you are contemplating at one point.

 

[Druggernaut]

If I go to school in Florida at LECOM, should I try to get my rotations at hospitals in Tennessee (where I am from and want to return to)? I had heard that it would be easier to get a residency in the place you did your rotations because they already know you and what kind of a worker you are.

The general rule of thumb, and this is apparently especially true in the DO world, is that you want to do elective rotations in the specialty you want to do at your top residency choices.

As for selecting between the two schools, I'd go with LECOM. Bradenton is the best of their three campuses, you'll get a good education, and it'll be inexpensive. You have to be able to shrug off some of the silly administrative things that happen at LECOM campuses, but all-in-all, I think it's one of the better osteopathic programs to be in.

But realize that you're stacking the deck against yourself for ENT and Urology, and allopathic surgery in general, by going the DO route. I think it's unlikely that I'll be going the surgical route, so it was an easy decision to take my DO acceptances rather than put more time and money into overcoming my early college indiscretions to try for an MD program. That's something you'll have to consider a bit more. I'd have a very difficult time passing up a sure thing.

That said, the neurosurgeon who headed up the group that handled the hospitals in the part of my home city where I worked was a DO, so competitive surgical programs are possible. You should be open to any location geographically, though (and apparently you'd have to be, since there are no programs in your home state). LECOM is friendly to setting up your rotations where you want them: as I understand it, you can do your electives essentially anywhere that will take you, and core rotations can be set up mostly anywhere as well, though they have to be willing to accept a whole group of students, rather than just you.

As for the talk of preclinical grades, they're regarded as far less important than clinical grades and the USMLE/COMLEX, but when you're going up against the top percentiles of those, you're going to want whatever edge you can get. And pass/fail schools can still have class ranks, even if they're not giving out A's and B's or honors.

 

[extenn]

UTKpremed:
How about LMU-DCOM in Tennessee. The match list for their 2011 inaugural class shows:
Residency/Internship, Students Placed, Class Percentage
.... ...
General Surgery, 7, 5.8%
Surgery-Preliminary, 3, 2.5%
Psychiatry, 3, 2.5%
Orthopedic Surgery, 8, 6.7%
Anesthesiology, 4, 3.3%
Physical Med &Rehabilitation, 2, 1.7%
Urological Surgery, 1, 0.8%
Neuromusculoskeletal/OMT, 1, 0.8%
Pathology, 1
Not bad for the very first DO class in Tennessee!!!

 

[DrMaximus]

UTKpremed:
How about LMU-DCOM in Tennessee. The match list for their 2011 inaugural class shows:
Residency/Internship, Students Placed, Class Percentage
.... ...
General Surgery, 7, 5.8%
Surgery-Preliminary, 3, 2.5%
Psychiatry, 3, 2.5%
Orthopedic Surgery, 8, 6.7%
Anesthesiology, 4, 3.3%
Physical Med &Rehabilitation, 2, 1.7%
Urological Surgery, 1, 0.8%
Neuromusculoskeletal/OMT, 1, 0.8%
Pathology, 1
Not bad for the very first DO class in Tennessee!!!

I have to say, with me being accepted here, I'm pretty stoked about that inaugural class placement. 😎

 

[corpsman33]

I have to say, with me being accepted here, I'm pretty stoked about that inaugural class placement. 😎

I second that Max! After attending the interview I was very stoked about LMU-DCOM's match rate.

Then I was even more excited to get accepted!

GO LMU-DCOM!!!!!

 

[UTKpremed]

I have to say, with me being accepted here, I'm pretty stoked about that inaugural class placement. 😎

I second that Max! After attending the interview I was very stoked about LMU-DCOM's match rate.

Then I was even more excited to get accepted!

GO LMU-DCOM!!!!!

I would love to stay in the Knoxville area since its close to home and it is where I did my undergrad. Although, Harrogate is so small and it will be hard for my husband to find a job. What is the curriculum like at LMU?

 

[DrMaximus]

I would love to stay in the Knoxville area since its close to home and it is where I did my undergrad. Although, Harrogate is so small and it will be hard for my husband to find a job. What is the curriculum like at LMU?

They messed with the curriculum for incoming students in regards to the second year. You learn the well-body your first year then second year you learn the pathologies along-side the systems with some systems taught at the same time as other systems that correlate. It's really interesting and I think it will excel at teaching us to think clinically. 👍

My wife is going to do a distance MBA program for the first two years, I believe, along with a part-time job.

I realize that was wordy and I apologize but that's the only way I could think of saying it. Lol.

 

[Iliketoytles]

They messed with the curriculum for incoming students in regards to the second year. You learn the well-body your first year then second year you learn the pathologies along-side the systems with some systems taught at the same time as other systems that correlate. It's really interesting and I think it will excel at teaching us to think clinically. 👍

My wife is going to do a distance MBA program for the first two years, I believe, along with a part-time job.

I realize that was wordy and I apologize but that's the only way I could think of saying it. Lol.

They do the same type of curriculum at Baylor. I guess it works well if a big name medschool like BCM does it!

 

[DrMaximus]

They do the same type of curriculum at Baylor. I guess it works well if a big name medschool like BCM does it!

Nice!! I didn't know that.

 

[Kuba]

There are no AOA (DO) residencies in ENT or urology in Tenn. The likelihood of matching ACGME (MD) urology or ENT as a DO is very, very low (in the last 5 years there have been 2 people who have matched any program in ENT.)

All you can do is try hard and see what happens.

Although I completely agree it is very difficult to match MD ENT as DO, I have to ask: how many tried to match? I'm sure the number isn't very high. Most don't even consider it.

 

[scpod]

Getting a surgical spot is very easily doable as a DO. Getting ENT... that's a different story whether you are an MD or DO. Either way, it will be a very hard journey. Doing a residency specifically in Tennessee, however, will be harder than anything.

If you truly want a surgical specialty, then you probably need to give up your dream of residency in Tennessee. You can come back there to practice when you are done. Limiting yourself to residencies there will severely curtail your chances.