Poliscidoc

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I failed COMLEX level 1 last year and retook it and passed. Just got my step 2 score back and scored a few points shy of 600. I didn't take USMLE and was planning on applying strictly AOA.

My grades from the first two years are average as compared to the rest of my class. 3rd year grades are mainly high pass with a few honors sprinkled in. I have 4 research projects/posters and 2 publications pending.

My goal was OBGYN but I'm almost certain I shot myself in the foot with a failure on level 1.

Since I retook my comlex my school required that I sit out a year so right now I am planning my 4th year audition rotations and will graduate in 2018.

So I guess giving my stats and the current trends what are my options in terms of specialties? Or is it pretty much FM only?




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Goro

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Primary Care; ER. But one of my all time worst students ever made it as an anesthesiologist. He's probably killing patients somewhere in the Northwest right now.
 

ToKingdomCome

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Primary Care; ER. But one of my all time worst students ever made it as an anesthesiologist. He's probably killing patients somewhere in the Northwest right now.
Goro, you would say AOA EM is not competitive? Everything I've read on this forum says its fairly competitive. The same goes with anesthesia for both ACGME/AOA
 

jaguar33

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Here is a picture from the 2014 AOA GME match report showing the percentage of students per specialty who passed 1st try.

I'm assuming the ones close to 100% aren't likely to take a student with a failure.

Good aways, who you know and other factors could increase your chances. I recommend downloading the report so you can make an informed and realistic decision on which specialty to pursue.
 

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hallowmann

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I failed COMLEX level 1 last year and retook it and passed. Just got my step 2 score back and scored a few points shy of 600. I didn't take USMLE and was planning on applying strictly AOA.

My grades from the first two years are average as compared to the rest of my class. 3rd year grades are mainly high pass with a few honors sprinkled in. I have 4 research projects/posters and 2 publications pending.

My goal was OBGYN but I'm almost certain I shot myself in the foot with a failure on level 1.

Since I retook my comlex my school required that I sit out a year so right now I am planning my 4th year audition rotations and will graduate in 2018.

So I guess giving my stats and the current trends what are my options in terms of specialties? Or is it pretty much FM only?

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Its possible you'll still get AOA OB, but given the redflag, you really should have a backup lined up. If you're interested FM and a maternal health/high risk delivery fellowship as a backup would really fit if you want primarily OB procedures. You can look into OB heavy FM programs and ones with in-house fellowships.

Obviously if you absolutely hate FM then something else would be good. Be honest with programs when you are on auditions. If they like you and are willing to overlook the Level 1 that'll give you the best shot.
 

Goro

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I don't have my charts in front of me on where my grads ended up, but I seem to recall that EM is currently more competitive than it used to be. I think that gas seems to be getting somewhat easier.


Goro, you would say AOA EM is not competitive? Everything I've read on this forum says its fairly competitive. The same goes with anesthesia for both ACGME/AOA
 
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235009

Here is a picture from the 2014 AOA GME match report showing the percentage of students per specialty who passed 1st try.

I'm assuming the ones close to 100% aren't likely to take a student with a failure.

Good aways, who you know and other factors could increase your chances. I recommend downloading the report so you can make an informed and realistic decision on which specialty to pursue.
Wow only 56% passed on first try in pm&r. Yikes!


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Drrrrrr. Celty

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Wow only 56% passed on first try in pm&r. Yikes!


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And apparently half of the AOA programs ( of which there are 6) are dual accredited AOA/ACGME residencies.
 
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235009

That graph is actually quite interesting. Essentially a DO who fails COMLEX level 1 was only really truly shut out of surgical subspecialties and derm. Goes to show you how robust the safety net was for DOs with these protected AOA programs. After the "merger" this 10% cohort that failed the COMLEX will feel the greatest hurt without these guaranteed spots.


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ToKingdomCome

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I don't have my charts in front of me on where my grads ended up, but I seem to recall that EM is currently more competitive than it used to be. I think that gas seems to be getting somewhat easier.
Goro from your school stats, do you know what score range would put a student in a good position to match AOA EM? I wish AOA had better metrics unlike the ACGME match
 

Goro

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I don't have access to that data. There are way too many confounders to add to that as well.

Goro from your school stats, do you know what score range would put a student in a good position to match AOA EM? I wish AOA had better metrics unlike the ACGME match
 

jaguar33

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Goro from your school stats, do you know what score range would put a student in a good position to match AOA EM? I wish AOA had better metrics unlike the ACGME match
From the same report I took a picture from above, EM had a mean score of 513 with a standard deviation of 66. Median was 515. Highest COMLEX score was 734 and lowest was 329 (on first attempt). COMLEX 2 information, research, volunteer, publications, work experience and other data are also available for EM in addition to all other AOA specialties.

Here is the link to the full report provided by Rowan so you don't have to enter in your email at the AACOM website to get it. It may not be exactly what you are looking for, but I guarantee it provides more of the information you seek than anecdotal evidence.

http://www.rowan.edu/som/education/CTL/documents/DO_GME_match_2014.pdf
 

ToKingdomCome

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From the same report I took a picture from above, EM had a mean score of 513 with a standard deviation of 66. Median was 515. Highest COMLEX score was 734 and lowest was 329 (on first attempt). COMLEX 2 information, research, volunteer, publications, work experience and other data are also available for EM in addition to all other AOA specialties.

Here is the link to the full report provided by Rowan so you don't have to enter in your email at the AACOM website to get it. It may not be exactly what you are looking for, but I guarantee it provides more of the information you seek than anecdotal evidence.

http://www.rowan.edu/som/education/CTL/documents/DO_GME_match_2014.pdf
Thanks. That's definitely helpful. NRMP data lists score ranges though and what percentage of applicants matched within that score range. Wish There were stats like that but I'm guessing if you're within 25-30 points of the average you should be okay
 

jaguar33

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That graph is actually quite interesting. Essentially a DO who fails COMLEX level 1 was only really truly shut out of surgical subspecialties and derm. Goes to show you how robust the safety net was for DOs with these protected AOA programs. After the "merger" this 10% cohort that failed the COMLEX will feel the greatest hurt without these guaranteed spots.
It's pretty interesting information. I agree that the bottom of the barrel DO applicants will certainly feel the pain after the merger is in effect. It's anyone's guess to what extent though.

I found another interesting report from the 2015 match that breaks down how many students scrambled into an AOA spot after the match (7.36%). I think this number is around the maximum theoretical decrease in DO placement once the safety net is removed.

I think the moral of the story for all students, especially DO, is to work hard so you don't put yourself in that position.

http://www.aacom.org/docs/default-source/archive-data-and-trends/2015-matchreport.pdf?sfvrsn=6
 
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235009

I found another interesting report from the 2015 match that breaks down how many students scrambled into an AOA spot after the match (7.36%). I think this number is around the maximum theoretical decrease in DO placement once the safety net is removed.
This isn't sound logic. Some of those folks scrambling into AOA spots gambled on the ACGME match and failed while some of the programs currently serving as a safety net will be forced to shut down. It's hard to predict precisely what's going to happen or the extent of it. Safe to say though that that the "merger" is pulling the rug out from under DOs who are scraping by.


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Drrrrrr. Celty

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This isn't sound logic. Some of those folks scrambling into AOA spots gambled on the ACGME match and failed while some of the programs currently serving as a safety net will be forced to shut down. It's hard to predict precisely what's going to happen or the extent of it. Safe to say though that that the "merger" is pulling the rug out from under DOs who are scraping by.


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Who really knows. All we know is that in the years to come DOs across the board will need to be applying smartly and broadly. The ones at the top who formerly stayed in AOA land, may find the ceiling breaking, while those at the bottom may end up only having options in states like Michigan or in Rural areas, or ending up doing TRI or 1 year internships before going into FM.

In either case, I'm happy that I'm in medical school now and not 5 years down the line.
 
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hallowmann

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Who really knows. All we know is that in the years to come DOs across the board will need to be applying smartly and broadly. The ones at the top who formerly stayed in AOA land, may find the ceiling breaking, while those at the bottom may end up only having options in states like Michigan or in Rural areas, or ending up doing TRI or 1 year internships before going into FM.

In either case, I'm happy that I'm in medical school now and not 5 years down the line.
That's pretty much where they are now. AOA programs are heavily focused in the midwest and rural locations in the first place, i.e. locations that are classically less desirable and in turn less competitive. The vast majority of post-NRMP scrambleable programs are FM (which comprise one of the biggest sets of AOA programs) and TRIs. Most people that scrambled into a TRI are either staying on in their TRI program or matching FM elsewhere.

The biggest issue will be that they (and certainly all DOs) will need to apply much more broadly with backups, as opposed to rolling the dice knowing they have a safety net. I'm honestly more concerned with the ever-expansion of DO schools with no placement requirement. Even if the current population of DOs would be OK now with a full merger, when you add the thousands more applicants that'll be coming through after 2020 from new schools, who knows how they'll skew the match/placement rates. My guess is that the ceiling will get higher, but the floor will also get deeper

That graph is actually quite interesting. Essentially a DO who fails COMLEX level 1 was only really truly shut out of surgical subspecialties and derm. Goes to show you how robust the safety net was for DOs with these protected AOA programs. After the "merger" this 10% cohort that failed the COMLEX will feel the greatest hurt without these guaranteed spots.

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Yeah, there were only 3 (now there are 4) PM&R programs that accepted a total of 12 spots in 2014. Most DOs who apply PM&R do so in the NRMP, because the field is so DO friendly. It's safe to say that any that were left to the DO programs either really liked one of those 3 programs/locations or they didn't get enough ACGME interviews (i.e. they had huge redflags) to skip the AOA match.

Everyone should also keep in mind that the report being talked about is from 2014. The DO population has changed significantly in that time. Not only did matriculant stats change between 2010 and 2013 (that class and current 4th years), but even just the number of DOs has increased by about 1200. Assuming half will be in the AOA match, which is typical, that's 600 and OGME programs have only increased by around 300 spots. Its more competitive now, backups are essential, and the goal should be to match, not to scramble.


EDIT: So I was curious, and I wondered what data from NRMP would be like in this case. I mean its still hard to compare, because the AOA match is so much smaller than the NRMP, and you're already dealing with a population that will have an over-representation of the Level 1 failures due to half of them doing AOA due to the redflag, but even so.

Unfortunately the NRMP doesn't publish such data, but here's what I have from the last Charting outcomes in 2014 for US MDs:

Anes - 5 out of 11 between 181-190 applied and matched
Child Neuro - none below 191 applied
Derm - none below 191 applied
DR - 2 between 181-190 applied and matched
EM - 9 out of 11 between 181-190 applied and matched
FM - 34 out of 40 between 181-190 applied and matched
GS - none below 191 applied 100%
IM - 29 out of 40 between 181-190 applied and matched
IM/P - 1 between 181-190 applied and matched
NS - none below 191 applied 100%
Neuro - 3 out of 4 between 181-190 applied and matched
OB/Gyn - 11 out of 21 between 181-190 applied and matched
Ortho - none matched below 191 100%
ENT - 1 between 181-190 applied and matched
Path - 3 between 181-190 applied and matched
Peds - 19 out of 28 between 181-190 applied and matched
PM&R - 2 out of 4 between 181-190 applied and matched
Plastics - none below 191 applied 100%
Psych - 18 out of 21 between 181-190 applied and matched
RadOnc - none below 191 applied 100%
VS - none below 191 applied 100%

So with the exception of the ultra-competitive/surgical fields (Child Neuro, Derm, GS, NS, Ortho, Plastics, RadOnc, and VS) pretty much every US MD with a Step 1 score between 181-190 (passing at the time was 188) had close to 50% or higher chance of matching in the remaining specialties. Interestingly, the fields correlate to the DO data pretty well. Again though, these numbers are small, so its difficult to extrapolate a ton of info from them. Just satisfied my curiosity.
 
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ortnakas

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This isn't sound logic. Some of those folks scrambling into AOA spots gambled on the ACGME match and failed while some of the programs currently serving as a safety net will be forced to shut down. It's hard to predict precisely what's going to happen or the extent of it. Safe to say though that that the "merger" is pulling the rug out from under DOs who are scraping by.


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True. But I think the merger will help a good chunk of DO students. My theory is this:
1) it hurts the minority of students who are scraping by and rely on AOA residencies as backup
2) it hurts the minority of students who were rockstars and applying to AOA specialty residencies like ortho, but will now have to compete with MD students
3) it helps the majority of students in the middle of the curve, who can now rank ACGME programs they're shooting for and now-AOA programs as a backup all in one match.

You've mentioned #1 and #2 a lot, and unfortunately, I think you're right, but I think the more optimistic #3 is going to happen too.
 
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True. But I think the merger will help a good chunk of DO students. My theory is this:
1) it hurts the minority of students who are scraping by and rely on AOA residencies as backup
2) it hurts the minority of students who were rockstars and applying to AOA specialty residencies like ortho, but will now have to compete with MD students
3) it helps the majority of students in the middle of the curve, who can now rank ACGME programs they're shooting for and now-AOA programs as a backup all in one match.

You've mentioned #1 and #2 a lot, and unfortunately, I think you're right, but I think the more optimistic #3 is going to happen too.
I agree with #3 as well. I said in a recent post that this is the only positive thing to come out of the merger for DOs. Not sure that's gonna be the "majority" though. I think the majority will be unaffected with regards to match outcome. I do think this is overall a bad deal for DOs but a step in the right direction for the profession as a whole.

One thing that has been said by others (especially @Goro) which is categorically false is that this will usher in a new era where DOs are equal to MDs in the match and glass ceilings will shatter. There is absolutely no indication that this will be the case and it's a completely illogical argument to be making.


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ortnakas

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@MeatTornado I think the majority of DOs will actually continue to match where they're matching right now. I didn't word my post quite right. My thought is that at least, with a unified match, we'll be able to rank our reach programs in the same list as the normals and the safeties-- without having to worry about the risk of not matching at all in by choosing ACGME and forgoing AOA. I think this will lead to some cracks in the glass ceiling by individuals who historically would have been more risk averse, but I don't think it's going to shatter.

So essentially I agree with you, I'm just a little more optimistic about it.

Edit: fixing a typo
 
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racerwad

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I agree with #3 as well. I said in a recent post that this is the only positive thing to come out of the merger for DOs. Not sure that's gonna be the "majority" though. I think the majority will be unaffected with regards to match outcome. I do think this is overall a bad deal for DOs but a step in the right direction for the profession as a whole.

One thing that has been said by others (especially @Goro) which is categorically false is that this will usher in a new era where DOs are equal to MDs in the match and glass ceilings will shatter. There is absolutely no indication that this will be the case and it's a completely illogical argument to be making.


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I think @ortnakas's assessment is spot on, especially about the distribution of affected students.

As someone who has made it quite clear they are not a DO, I'm not sure you're that familiar with what the average DO class looks like in terms of aspirations and academic success. My limited anecdotal evidence is exactly like what ortnakas is describing: some students at the top will be affected because now they have more competition for limited spots in competitive specialties, some students at the bottom will be affected because they are academically challenged and will now have to compete against a larger pool for less-competitive programs, and most students in the middle of the bell curve will find that they can rank more reach and safety programs into a single list than having to choose to go safe (AOA first) or go big (ACGME). Personally, I certainly fell into the 3rd group described and I would have liked to have more safety programs to add, if I wanted to make that an option. You are right when you say that the merger will not make "glass ceilings shatter." It will just allow the majority of DOs more control over their list and cull weak programs to everyone's benefit.
 
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I think @ortnakas's assessment is spot on, especially about the distribution of affected students.

As someone who has made it quite clear they are not a DO, I'm not sure you're that familiar with what the average DO class looks like in terms of aspirations and academic success. My limited anecdotal evidence is exactly like what ortnakas is describing: some students at the top will be affected because now they have more competition for limited spots in competitive specialties, some students at the bottom will be affected because they are academically challenged and will now have to compete against a larger pool for less-competitive programs, and most students in the middle of the bell curve will find that they can rank more reach and safety programs into a single list than having to choose to go safe (AOA first) or go big (ACGME). Personally, I certainly fell into the 3rd group described and I would have liked to have more safety programs to add, if I wanted to make that an option. You are right when you say that the merger will not make "glass ceilings shatter." It will just allow the majority of DOs more control over their list and cull weak programs to everyone's benefit.
I agree with everything you said and had agreed with most of the previous post too. It's useless arguing how many will be affected but the way I look at it is that a sizable number of DO students already succeed in the ACGME match so they will essentially be unaffected by this since there's no reason their match outcome will change. Once you take out the group at the very top and very bottom you get a minority that will actually benefit from this. We are essentially in complete agreement though.


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Mad Jack

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That graph is actually quite interesting. Essentially a DO who fails COMLEX level 1 was only really truly shut out of surgical subspecialties and derm. Goes to show you how robust the safety net was for DOs with these protected AOA programs. After the "merger" this 10% cohort that failed the COMLEX will feel the greatest hurt without these guaranteed spots.


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I think that is more a function of the low number of PM&R positions than anything. One applicant makes a big difference in a field with less than 40 positions per year.