The Truth: DO vs. MD and specializing

[Jeex]

Afternoon all,

I need to do some heavy academic grade raising, and DO is certainly attractive in this regard. I am curious though, of how a choice in DO vs. MD could possibly limit me from exploring different specialty opportunities in the future.

For those of you down the DO route, do you feel limited in where you can go or what you can practice or match for? It looks like the statistics show that most DO go to IM/Family/PCP route and I am not particularly interested in those.

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[deleted407021]

Isn't there a flamewar on the horizon over this very topic, in like 2 threads?

 

[mathnerd88]

Afternoon all,

I need to do some heavy academic grade raising, and DO is certainly attractive in this regard. I am curious though, of how a choice in DO vs. MD could possibly limit me from exploring different specialty opportunities in the future.

For those of you down the DO route, do you feel limited in where you can go or what you can practice or match for? It looks like the statistics show that most DO go to IM/Family/PCP route and I am not particularly interested in those.

There is a difference between the two degrees in terms of specializing, but also be realistic in your expectations. Even 40% of MD's go into primary care. If you aren't scoring really high on your boards or doing well in your classes, you may still end up in primary care, as it is less competitive than other specialties.

It is highly likely you'll go into primary care if you're going DO anyways, as traditionally, the GPA and MCAT are lower than that of MD schools. These students aren't statistically likely to be top in their class if they went to MD schools anyways, and still end up being in primary care as MD. There are always exceptions, but it is also important to be realistic.

 

[TUVIX]

Can we just close all threads like this going forward? The search function will bring up like 10^12 duplicates.

 

[Prairiepalmeri]

Can we just close all threads like this going forward? The search function will bring up like 10^12 duplicates.

...But the OP specifically asks for THE TRUTH

 

[TUVIX]

...But the OP specifically asks for THE TRUTH

Oh sorry I didn't realize this was going to be the one true conclusion to that discussion. My bad!

 

[AlteredScale]

Afternoon all,

I need to do some heavy academic grade raising, and DO is certainly attractive in this regard. I am curious though, of how a choice in DO vs. MD could possibly limit me from exploring different specialty opportunities in the future.

For those of you down the DO route, do you feel limited in where you can go or what you can practice or match for? It looks like the statistics show that most DO go to IM/Family/PCP route and I am not particularly interested in those.

You can get into basically any specialty you want as a DO. DO or MD, you will have to work your butt either way to get into them. If you are thinking surgical specialties outside of gen surg or ortho then you will be shooting for recently ACGME accredited AOA programs. It is VERY hard to get into academic ACGME neurosurgery, vascular surgery, ENT, cardiothoracic surgery as a DO grad because they are already very very competitive for MD schools and as it has been stated before, some program directors of ACGME programs feel that accepting DO's lowers the tier of their program.

Additionally because there is variability on the clinical rotations of many DO schools, some PDs (especially ones in surgery) don't want to take the risk of taking someone whose clinical experience is potentially subpar to that of an MD student who had a home base site (their own university hospital), learning from residents and not community preceptors, in which clerkship evaluations are trustworthy and clinical faculty are known amongst PD's. Finally, many of these programs require research that is lacking at many stand alone institutions (of which, many DO schools are).

So if you are considering a surgical subspeciality (which as a pre med is common, but 99.99999% sure you will change your mind when you 1- enter med school and see just how hard surgical residency is and 2- see your USMLE/COMLEX step 1 score, not YOU in particular but just generally speaking) be smart as to which schools you apply to, maximize your resources (do they have a solid surgical department with faculty conducting research? how much time do you get in 4th year to do sub-I's? how much family medicine is required in year 3?).

 

[deleted407021]

There is a difference between the two degrees in terms of specializing, but also be realistic in your expectations. Even 40% of MD's go into primary care. If you aren't scoring really high on your boards or doing well in your classes, you may still end up in primary care, as it is less competitive than other specialties.

It is highly likely you'll go into primary care if you're going DO anyways, as traditionally, the GPA and MCAT are lower than that of MD schools. These students aren't statistically likely to be top in their class if they went to MD schools anyways, and still end up being in primary care as MD. There are always exceptions, but it is also important to be realistic.

This is just incorrect. GPA is a poor predictor of licensing exam success and the MCAT is marginally more so. The only reason many MD schools have higher average matriculant stats than DO schools is due to the population that applies to those schools and the fact that it's a seller's market -- schools get to pick the best of the applicants applying to their schools. It's just that you have far more 3.7/31 folks applying MD and more 3.4/27 folks applying DO.

It's also incorrect to state that someone going to a DO school is "highly likely" to go into primary care. It's more likely that someone going to a DO or MD school will go into what they want. Look at match lists, and around SDN. I don't see any evidence that people feel like they don't have any options, with either degree. I would, however, agree with you if you made similar claims about the Caribbean, but that's an entirely different animal.

 

[Mad Jack]

If you've had subpar performance thusfar, expect that you will be a middle-of-the-road student, as it's unlikely you'll just become a superstar. A middle of the road student will fair far better out of an MD school than a DO school in regard to specializing. Use the search function to get thorough lists of what specialties are pretty much not happening (neurosurg, for instance, is almost impossible unless you're in the military, and most of the DO programs for neurosurg are likely closing post-merger, ACGME derm is not happening, and formerly AOA derm will be difficult to get your foot into, etc etc). I'm tired of re-writing the same post every four days, so I'm going to put the onus on you, OP, to go to google and do a search for: DO specializing site:studentdoctor.net

 

[Mad Jack]

This is just incorrect. GPA is a poor predictor of licensing exam success and the MCAT is marginally more so. The only reason many MD schools have higher average matriculant stats than DO schools is due to the population that applies to those schools and the fact that it's a seller's market -- schools get to pick the best of the applicants applying to their schools. It's just that you have far more 3.7/31 folks applying MD and more 3.4/27 folks applying DO.

It's also incorrect to state that someone going to a DO school is "highly likely" to go into primary care. It's more likely that someone going to a DO or MD school will go into what they want. Look at match lists, and around SDN. I don't see any evidence that people feel like they don't have any options, with wother degree. I would, however, agree with you if you made similar claims about the Caribbean, but that's an entirely different animal.

Several studies have found strong correlations between the MCAT and medical school performance. In fact, the MCAT is such a good predictor GPA can basically be factored out.

http://www.ncbi.nlm.nih.gov/pubmed/16186610

 

[deleted407021]

Several studies have found strong correlations between the MCAT and medical school performance. In fact, the MCAT is such a good predictor GPA can basically be factored out.

http://www.ncbi.nlm.nih.gov/pubmed/16186610

That's correct, and thanks for the link. I didn't want to minimize the importance of the MCAT, moreso communicate the multifactoral nature of how people succeed. If I'm not mistaken, rates of success don't increase appreciably past a 28 or so, making it so that one can be confident in even bottom tier applicants. Correct?

 

[AlteredScale]

Several studies have found strong correlations between the MCAT and medical school performance. In fact, the MCAT is such a good predictor GPA can basically be factored out.

http://www.ncbi.nlm.nih.gov/pubmed/16186610

But then the next study in Academic Medicine in 2013 states that uGPA IS a correlative factor (http://www.ncbi.nlm.nih.gov/pubmed/23478635) so as long as it's used in addition to the MCAT. IMO, because gpa keeps getting the yes and no for its predictive value, MCAT still stands out as the only thing to show as correlative to medical school performance.

 

[AlteredScale]

That's correct, and thanks for the link. I didn't want to minimize the importance of the MCAT, moreso communicate the multifactoral nature of how people succeed. If I'm not mistaken, rates of success don't increase appreciably past a 28 or so, making it so that one can be confident in even bottom tier applicants. Correct?

I remember this being cited, do you have the study? IMO, anything above a 25-26 and you'll be fine in getting through. But the thing is MD schools don't want people who will do fine, they want people who will DESTROY boards and go on to prestigious programs, returning during almuni day to speak of how amazing the school is and donate millions back (not sure about how true that last statement is).

Here's another interesting statement I found: "Almost 50% of matriculants in the sample received undergraduate degrees from “Research Universities – Very High Research Activity” institutions; graduates from other undergraduate-institution categories were more likely to have a suboptimal outcome. These findings suggest that student experiences in very high research-activity university settings may be associated with success in the medical school environment". (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2963622/)

 

[mathnerd88]

That's correct, and thanks for the link. I didn't want to minimize the importance of the MCAT, moreso communicate the multifactoral nature of how people succeed. If I'm not mistaken, rates of success don't increase appreciably past a 28 or so, making it so that one can be confident in even bottom tier applicants. Correct?

I pretty much said what mad jack and altered scale were saying... Unless you are a superstar in DO school, you won't get into a competitive residency. I'm not going to expect someone who gets a 3.4 gpa 27 MCAT to all of a sudden rock the boards, do research, and get high honors grades in all classes. What you do in your past is a great predictor of your future. That's one reason why DO mostly ends up in primary care, more so than MD. Those who do stellar are most likely in MD schools to begin with.

There are always exceptions, but generally this is the case. The ones in DO schools who get into good residencies are those who probably have high grades and/or MCAT and didn't get into MD schools even though they were qualified to get accepted there. They also rocked the boards and classes and made great connections in their elective rotations with outstanding recommendations.

 

[cliquesh]

Most of the surgical subspecialities (except aoa ortho and, perhaps, acgme ophthalmology), derm, and rad onc are hard for DOs. An average usmle score is good enough to get you in any other speciality, like anesthesia, pm&r, radiology, etc.

 

[Mad Jack]

But then the next study in Academic Medicine in 2013 states that uGPA IS a correlative factor (http://www.ncbi.nlm.nih.gov/pubmed/23478635) so as long as it's used in addition to the MCAT. IMO, because gpa keeps getting the yes and no for its predictive value, MCAT still stands out as the only thing to show as correlative to medical school performance.

GPA is correlative, but the correlation is so dwarfed by that of the MCAT it is hardly useful.

That's correct, and thanks for the link. I didn't want to minimize the importance of the MCAT, moreso communicate the multifactoral nature of how people succeed. If I'm not mistaken, rates of success don't increase appreciably past a 28 or so, making it so that one can be confident in even bottom tier applicants. Correct?

Your chances of passing the boards does not go up after a certain point, nor does your chance of failing out decrease. But higher MCATs predict higher grades and higher board scores- you're not just scraping by, you're excelling.

 

[AlteredScale]

GPA is correlative, but the correlation is so dwarfed by that of the MCAT it is hardly useful.

Your chances of passing the boards does not go up after a certain point, nor does your chance of failing out decrease. But higher MCATs predict higher grades and higher board scores- you're not just scraping by, you're excelling.

I'll admit I didn't even look at the p values.

 

[Jeex]

Can we just close all threads like this going forward? The search function will bring up like 10^12 duplicates.

...But the OP specifically asks for THE TRUTH

Oh sorry I didn't realize this was going to be the one true conclusion to that discussion. My bad!

Haha, SORRY!
I did a little searching already and the answers weren't really conclusive and just anecdotal. All the statistics I've seen point to DO being less worthy of a higher competitive specialty and I know the reasons aren't purely DO vs MD based, (it is easier to get into DO school so I think by logic it's probably harder for the bottom tier DO students to get higher in demand residencies) I do think it's important to know all the facts and then make a judgement based upon them.

 

[deleted407021]

I pretty much said what mad jack was saying... Unless you are a superstar in DO school, you won't get into a competitive residency. I'm not going to expect someone who gets a 3.4 gpa 27 MCAT to all of a sudden rock the boards and get high honors grades in all classes. That's one reason why DO mostly ends up in primary care, more so than MD.

There are many non-PCP specialties that are very accessible to DOs : rads, anes, PM&R, neurology, EM (some call this PC), IM subspecialties, etc. While I'll agree that grades play part of the role you suggest, I think self-selection is a powerful factor as well, as suggested by those in the know here on the forums.

 

[mathnerd88]

Haha, SORRY!
I did a little searching already and the answers weren't really conclusive and just anecdotal. All the statistics I've seen point to DO being less worthy of a higher competitive specialty and I know the reasons aren't purely DO vs MD based, (it is easier to get into DO school so I think by logic it's probably harder for the bottom tier DO students to get higher in demand residencies) I do think it's important to know all the facts and then make a judgement based upon them.

Well actually, the bigger question is, do you have the stats competitive enough enough to go MD? Do you have a choice between MD and DO schools? If not, there's really no point in this question right?

If you want to become a physician, get into a school. This question would make more sense once you have an actual choice between MD and DO...and even then, you would probably choose MD because it would give you statistically the safer route towards a residency you want.

 

[mathnerd88]

There are many non-PCP specialties that are very accessible to DOs : rads, anes, PM&R, neurology, EM (some call this PC), IM subspecialties, etc. While I'll agree that grades play part of the role you suggest, I think self-selection is a powerful factor as well, as suggested by those in the know here on the forums.

Yes, that is true, but the merger is going to have these spots also open up to MD applicants. Not sure what kind of impact that would happen on these residencies. I can only hope that they still primarily take DO's, like before.

 

[AlteredScale]

Yes, that is true, but the merger is going to have these spots also open up to MD applicants. Not sure what kind of impact that would happen on these residencies. I can only hope that they still primarily take DO's, like before.

The majority of previously AOA accred programs are going to still have OMM requirements (hence why there is an osteopathic committee board now on the ACGME). The only ones that will be completely converted are probably going to be the surgical programs (where one does not need to have some sort of base knowledge of OMM to succeed in the program). So MD grads will have two barriers to these new, non surgical ACGME programs: 1) OMM requirements (which MD grads will more than likely not take a year off to get certified in to go to some podunk community residency program) and 2) DO Program Directors who can simply say "I favor DO grad in my program more than I do MD" and choose to only interview DO's.

Also on top of that, MD students are not gunning to do IM at a community hospital with little to no research opps. Many MD students will shrug their shoulders and keep on going with the mid/top tier programs. At the very worst, it'll make it harder for DO grads to enter what were once AOA only surgery programs and are not totally open to MD grads now.

 

[Didierdrogba]

Allow me to comment on internal medicine specifically. I feel that even though DO's have a good chance to become internists, it is much harder to get into residency positions at a academic, university setting, which may cause potential issues if you plan on being a subspecialist in a highly competitive field such as GI or cardiology. Or, your resources may be limited if you plan to do research. Other than the aforementioned points, if you just want to do general IM (who knows if you will change your mind later on), being DO shouldn't be an issue.

 

[AnatomyGrey12]

I propose that any thread created including the words "MD, DO, SPECIALTY" in the same sentence automatically gets destroyed and the creator must take a two week course on how to use the google search bar. Then the creator must write a 10 page paper describing his grevious error and how it has disrupted the cosmic balance. This will be followed by a 6 month ban.

 

[Tommyguns89]

I propose that any thread created including the words "MD, DO, SPECIALTY" in the same sentence automatically gets destroyed and the creator must take a two week course on how to use the google search bar. Then the creator must write a 10 page paper describing his grevious error and how it has disrupted the cosmic balance. This will be followed by a 6 month ban.

Part of the reason this comes up so often, is that there is no straight answer. And there is a lot of speculation about the merger, and given that med schools these days select for overly neurotic, anxious students a lot of people are just assuming the worst without even knowing all the details(there is still a lot of information to be released).

 

[Oh_Gee]

Afternoon all,

I need to do some heavy academic grade raising, and DO is certainly attractive in this regard. I am curious though, of how a choice in DO vs. MD could possibly limit me from exploring different specialty opportunities in the future.

For those of you down the DO route, do you feel limited in where you can go or what you can practice or match for? It looks like the statistics show that most DO go to IM/Family/PCP route and I am not particularly interested in those.

we had a fun day on this thread today
http://forums.studentdoctor.net/thr...etween-md-and-do.1168174/page-4#post-17077745
there was input from some current residents and attendings

 

[Jeex]

thanks all.
i guess the true answer is: it depends on if you think you can be a top scorer in your exams and if your school will effectively prepare you for doing well on them.

 

[mathnerd88]

thanks all.
i guess the true answer is: it depends on if you think you can be a top scorer in your exams and if your school will effectively prepare you for doing well on them.

Well just not exams, but your clinical rotations too. You need to perform well on them so you can make inroads and connections. Many of them would rather take you into their residency program if you perform extremely well rather than someone else who they have never met before.

That's why rotations are important, and don't go to a DO school that doesn't have well-established rotations. There's a HUGE difference between DO schools in terms of quality of rotations. There's a reason why PCOM, CCOM, RowanSOM, etc "top-tier DO programs" consistently place students into really good residencies, and some of them are top ACGME programs. They also offer lots of research opportunities, which many DO schools do not have.

If you want to maximize your chances going into specialty, go to a well established DO school.

 

[costales]

2.86 Cumulative GPA from 6 years ago, dropped out due to not being able to secure my last year and a half worth of loans.

If my roof is falling down, I'd fix that first before worrying about Carrara vs. Calacatta marble for my vanity top.

 

[Jeex]

If my roof is falling down, I'd fix that first before worrying about Carrara vs. Calacatta marble for my vanity top.

Touche

 

[Seth Joo]

Afternoon all,

I need to do some heavy academic grade raising, and DO is certainly attractive in this regard. I am curious though, of how a choice in DO vs. MD could possibly limit me from exploring different specialty opportunities in the future.

For those of you down the DO route, do you feel limited in where you can go or what you can practice or match for? It looks like the statistics show that most DO go to IM/Family/PCP route and I am not particularly interested in those.

Yes, despite all this talk of the merger, you have more opportunity as an MD versus a DO, you can specialize still as a DO but you need to work a lot harder to get into the same residency with better board scores and excellent LORS. The problem with many DO schools is clinical education, many schools lack in that department, if you go to a school that is established like PCOM, Rowan, TCOM, CCOM, ie, one of the better DO schools, the chances are you will have a much better clinical education than you will at the newer or mid tier DO schools and will have a better chance at matching at a good residency program. Not all the DO schools have the same resources.

At the end of the day you will still be a doctor.

 

[AnatomyGrey12]

thanks all.
i guess the true answer is: it depends on if you think you can be a top scorer in your exams and if your school will effectively prepare you for doing well on them.

No this isn't it. This is just the first step. As a DO good board scores won't cut it like they do in the MD world. You must legwork the hell out of your desired field. Get to know people in high places and get stellar LORs. Fight tooth and nail to rotate at established places with solid residencies. Audition at places you really want to go. And then at the end of the day you have to accept that this might not be enough and you might have to do a field that isn't necessarily your first choice. If you can accept that fact then going DO will allow you to reach your goal of being a physician.

Oh and I agree with the above. You might want to focus on grade retakes before you worry about specialties. I used to do the same thing and then I realized that if I don't get in then it doesn't even matter.

 

[Goro]

Agree with my young colleague.

At my school, our students self-select for Primary Care, but if you simply look at the match lists for different DO schools, the ratio for grads is 2 Primary Care : 1 specialty. My grads tend to have pretty good success getting into ACGME specialties, and PC ones as well.

So if you want to specialize, you can. You might have to work harder for it, but you're not afraid of hard work, are you, OP?

It's also incorrect to state that someone going to a DO school is "highly likely" to go into primary care. It's more likely that someone going to a DO or MD school will go into what they want. Look at match lists, and around SDN. I don't see any evidence that people feel like they don't have any options, with either degree. I would, however, agree with you if you made similar claims about the Caribbean, but that's an entirely different animal.

 

[mathnerd88]

Agree with my young colleague.

At my school, our students self-select for Primary Care, but if you simply look at the match lists for different DO schools, the ratio for grads is 2 Primary Care : 1 specialty. My grads tend to have pretty good success getting into ACGME specialties, and PC ones as well.

So if you want to specialize, you can. You might have to work harder for it, but you're not afraid of hard work, are you, OP?

Are there any students who wanted to specialize ended up in primary care or didn't find a match? I'm just curious.

 

[Goro]

I remember one particular Class has a bad case of the "scrambles" after match because they made some very bad choices. Either aimed to high or had too few choices.

There always will be handful in any class who don't match, usually due to a number of red flags. They end up doing a Preliminary and have better luck matching the following years.

I'm sure we have wannabe surgeons who end up in PC because their Boards or evals just aren't good enough. The end result is that they still end up being a doctor.

But by and large, my grads end up with their 1st or 2nd choices. We poll them post-graduation so they have no reason to lie or inflate egos.

Are there any students who wanted to specialize ended up in primary care or didn't find a match? I'm just curious.

 

[arc5005]

Agree with my young colleague.

At my school, our students self-select for Primary Care, but if you simply look at the match lists for different DO schools, the ratio for grads is 2 Primary Care : 1 specialty. My grads tend to have pretty good success getting into ACGME specialties, and PC ones as well.

So if you want to specialize, you can. You might have to work harder for it, but you're not afraid of hard work, are you, OP?

Are there certain schools that do a better job at placing students into specialties? I'm not sure if I want to do PC or specialty, but I definitely don't want to be limited based on the school I would attend.

Is the answer just going to be the usual? The more established schools tend to have better success rates matching students into specialties? But, for example Tuoro-NY isn't that established yet had a very good match list, and even a Derm match 2 years in a row.

 

[Goro]

Match lists MUST be viewed with a skeptical eye, because you, as a pre-med, have no way of knowing what is a good program, and what isn't. Only the doctors who actually practice in those fields can tell you. As the wise @22031 Alum has commented, even Ivy-league med schools have programs that can barely get filled. But on paper, if you saw someone go to, say, Yale-New Haven Hospital, you'd think "ohmigawd, did she match good or what!!??"

But looking at the number of AOA vs ACGME, or PC vs specialties slots might tell you something, as a start.

Are there certain schools that do a better job at placing students into specialties? I'm not sure if I want to do PC or specialty, but I definitely don't want to be limited based on the school I would attend.

Is the answer just going to be the usual? The more established schools tend to have better success rates matching students into specialties? But, for example Tuoro-NY isn't that established yet had a very good match list, and even a Derm match 2 years in a row.

 

[cliquesh]

Are there any students who wanted to specialize ended up in primary care or didn't find a match? I'm just curious.

Some in my class wanted ortho or some other surgical speciality, but failed. I know a few of them went into EM and psychiatry. At least one did a surgical intern year and matched at a general surgery university program. Some wanted EM, but failed. Most of them ended up in internal medicine.

 

[snow529]

Isn't there a flamewar on the horizon over this very topic, in like 2 threads?

Can we just close all threads like this going forward? The search function will bring up like 10^12 duplicates.

...But the OP specifically asks for THE TRUTH

If it was so easy to find the information about DO vs. MD people wouldn't need to ask about it so often. I am a premed so still have a lot to learn, but it seems the answer becomes more nuanced as things change each year (like with the residency merger this year and new DO schools opening up of questionable quality). I have searched the forums and read discussions going back to 2008 and I still learn new information from these threads.

As someone already posted on here, this discussion going on concurrently over in pre-allo has a lot of helpful (new to me ) information:
http://forums.studentdoctor.net/thr...etween-md-and-do.1168174/page-4#post-17077745

 

[Prairiepalmeri]

People become DO's and practice all sorts of specialties, prescribe all sorts of drugs, and complete all sorts of fellowships. No one is going to care when your driving around in your 2030 BMW.

 

[W19]

DO are both physicians and chiropractors... They kill 2 birds with one stone.

 

[67552931811]

There is a difference between the two degrees in terms of specializing, but also be realistic in your expectations. Even 40% of MD's go into primary care. If you aren't scoring really high on your boards or doing well in your classes, you may still end up in primary care, as it is less competitive than other specialties.

It is highly likely you'll go into primary care if you're going DO anyways, as traditionally, the GPA and MCAT are lower than that of MD schools. These students aren't statistically likely to be top in their class if they went to MD schools anyways, and still end up being in primary care as MD. There are always exceptions, but it is also important to be realistic.

Going into peds/ fm/ im doesn't always equate to primary care as a plethora of people sub-specialize. Further, there is a bevy of fellowships in peds/ im that aren't competitive at all: literally numerous

 

[67552931811]

Most of the surgical subspecialities (except aoa ortho and, perhaps, acgme ophthalmology), derm, and rad onc are hard for DOs. An average usmle score is good enough to get you in any other speciality, like anesthesia, pm&r, radiology, etc.

You most definitely don't need a 230 to get into pm&r. Cmon doc

 

[cliquesh]

You most definitely don't need a 230 to get into pm&r. Cmon doc

I was listing other non primary specialities as examples.....you don't need a 230 for radiology or anesthesia, either. I think an average score on the usmle is good enough for a DO to match at a decent university program for most specialties open to DOs.