Where do I stand with regard to specialties?

[dozitgetchahi]

Stats:

USMLE step 1 = 237. Don't have COMLEX results yet.

(Still hopping mad about the USMLE; last NBME was 249 - somehow blew it by 12 pts despite studying my brains out.) Have a ****ty feeling I didn't score up to potential on the COMLEX because I was simply burnt the hell out by that point.

Have one co-authored clinical journal article that just got sent out for review; additional articles based on the data from that study are also likely.

Probably interested in going allo (not 100% sure, however).

Potential interests: ROAD specialties, EM, IM, possibly neuro.

I understand derm, ENT, and urology are probably hopeless (didn't really care about derm but would've liked some shot at the others) and allo optho is probably a very long shot as a DO.

Questions:

- Do I stand any sort of chance at matching allo rads with this score?

- What's the deal with DO rads? I've heard some very mixed things about those programs.

- What tier of allo IM progs would be in reach for me?

- How competitive would I be for "top" MD anesthesia progs? Is DO anesthesia worth thinking about given that MD anesthesia is DO friendly?

If anyone can shed some light on these questions I'd be grateful.

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[DocEspana]

Stats:

USMLE step 1 = 237. Don't have COMLEX results yet.

(Still hopping mad about the USMLE; last NBME was 249 - somehow blew it by 12 pts despite studying my brains out.) Have a ****ty feeling I didn't score up to potential on the COMLEX because I was simply burnt the hell out by that point.

Have one co-authored clinical journal article that just got sent out for review; additional articles based on the data from that study are also likely.

Probably interested in going allo (not 100% sure, however).

Potential interests: ROAD specialties, EM, IM, possibly neuro.

I understand derm, ENT, and urology are probably hopeless (didn't really care about derm but would've liked some shot at the others) and allo optho is probably a very long shot as a DO.

Questions:

- Do I stand any sort of chance at matching allo rads with this score?

- What's the deal with DO rads? I've heard some very mixed things about those programs.

- What tier of allo IM progs would be in reach for me?

- How competitive would I be for "top" MD anesthesia progs? Is DO anesthesia worth thinking about given that MD anesthesia is DO friendly?

If anyone can shed some light on these questions I'd be grateful.

I'll run through how you stack up for everything

Allo EM: Highly overqualified.
Allo IM: SUPER overqualified.
Allo Neuro: They will drop to their knees and beg for you overqualified

Allo Derm: Qualified
Allo ENT: Within range, perhaps slightly below the mean
Urology: Above the mean (so yes. definitely qualified)
Allo Optho: with your score shouldn't be a problem
Allo Rads: With your score shouldn't be a problem (note: not rad-onc)
Allo Anesth: You'd be VERY competitive.

You'd be (likely) able to match, with high confidence into everything except for Plastic Surg, ENT, Rad-Onc, and Derm
You'll be (likely) able to match with decent confidence in ENT and Derm
You prob won't match in: Rad-onc and Plastic surgery.

Everything except for rad-onc and plastics are totally within reach and most are easy cakewalks for you, from a USMLE score alone.

 

[DocEspana]

Do your research. Look up "charting outcomes" released by the NRMP. Feel much better about yourself. They report the mean and confidence interval for every NRMP residency for both USMD grads and (separately) for DO/USIMG/FMG grads.

You're at or above the USMD mean for everything out there except for plastics.

 

[naus]

I'll run through how you stack up for everything

Allo IM: SUPER overqualified.
Allo Neuro: They will drop to their knees and beg for you overqualified.

Super overqualified only if you're applying to some community allo program. Otherwise I would say he's just qualified and would have a good shot.

You'd be surprised at the number of upper 230s interviewing at good academic programs in IM. IM is the pathway to more lucrative specialties. Top programs are still competitive as hell.

 

[DocEspana]

Super overqualified only if you're applying to some community allo program. Otherwise I would say he's just qualified and would have a good shot.

You'd be surprised at the number of upper 230s interviewing at good academic programs in IM. IM is the pathway to more lucrative specialties. Top programs are still competitive as hell.

What the NYC hospitals (which, collectively, must be the best out there. no offense to other cities with a few rockstar programs) say is they start viewing you as competitive 230. He's still above that. It's just a starting point, but it is the starting point for "competitive"

But the reality is that the huge majority of IM is 1) community or 2) not *quite* as pick as those in NYC even if it is a university hospital.

Its hard to generalize IM because nowheresville hospital in iowa is at one end of the spectrum and mayo clinic or NY-Presby is at the other end.

 

[group_theory]

I'll run through how you stack up for everything

Allo EM: Highly overqualified.
Allo IM: SUPER overqualified.
Allo Neuro: They will drop to their knees and beg for you overqualified

Allo Derm: Qualified
Allo ENT: Within range, perhaps slightly below the mean
Urology: Above the mean (so yes. definitely qualified)
Allo Optho: with your score shouldn't be a problem
Allo Rads: With your score shouldn't be a problem (note: not rad-onc)
Allo Anesth: You'd be VERY competitive.

You'd be (likely) able to match, with high confidence into everything except for Plastic Surg, ENT, Rad-Onc, and Derm
You'll be (likely) able to match with decent confidence in ENT and Derm
You prob won't match in: Rad-onc and Plastic surgery.

Everything except for rad-onc and plastics are totally within reach and most are easy cakewalks for you, from a USMLE score alone.

With all due respect,

Allo Derm, ENT, Ophtho, and Urology - while he may be "qualified", probably not competitive since he is coming from a DO school unless there are other unquantifiable factors that pushes in his favor. There will be plenty of US MD students with similar USMLE scores coming from US MD schools with more exposures to academic Derm/ENT/Ophtho/Uro (with good letters and research) that are in the same applicant pool.

 

[Doctor4Life1769]

With all due respect,

Allo Derm, ENT, Ophtho, and Urology - while he may be "qualified", probably not competitive since he is coming from a DO school unless there are other unquantifiable factors that pushes in his favor. There will be plenty of US MD students with similar USMLE scores coming from US MD schools with more exposures to academic Derm/ENT/Ophtho/Uro (with good letters and research) that are in the same applicant pool.

This.

Surgical fields and derm aren't DO friendly, nor will be, in the future.

Edit: definitely look into MD anesthesia programs. With your score, don't bother with DO ones. Not worth your time. I rotated at 2 and interviewed at a different 2, and didn't come out impressed. Went MD, instead.

 

[DocEspana]

With all due respect,

Allo Derm, ENT, Ophtho, and Urology - while he may be "qualified", probably not competitive since he is coming from a DO school unless there are other unquantifiable factors that pushes in his favor. There will be plenty of US MD students with similar USMLE scores coming from US MD schools with more exposures to academic Derm/ENT/Ophtho/Uro (with good letters and research) that are in the same applicant pool.

The DOs who get into these programs (specifically these programs) have identical-to-slightly-lower USMLE scores than their allo counterparts.

Its seems counter-intuitive, but its the fact and the NRMP agrees with its stat collection. I have a connection with an allo optho program and they feel that since they have such high score standards (unlike IM or gen surg, in their opinion) any DO that scores up to their standards is more than qualified, and they dont require you to "outscore" allopathic students. While my connection is n=1, it fits the data. Our assumptions dont fit the data. I'm inclined to believe a primary source that supports the data over logical, but contradictory to the reality of who gets accepted, assumptions.

EDIT: of note, I didnt want to make it seem like it would be a walk in the park for those highly competitive ones. But his score suggests that if he wanted one of those and interviewed broadly he *should* get in somewhere and not have a huge concern about not matching. Now not matching to his top 10 (or top 20) choice is a different matter.

 

[group_theory]

The DOs who get into these programs (specifically these programs) have identical-to-slightly-lower USMLE scores than their allo counterparts.

Its seems counter-intuitive, but its the fact and the NRMP agrees with its stat collection. I have a connection with an allo optho program and they feel that since they have such high score standards (unlike IM or gen surg, in their opinion) any DO that scores up to their standards is more than qualified, and they dont require you to "outscore" allopathic students. While my connection is n=1, it fits the data. Our assumptions dont fit the data. I'm inclined to believe a primary source that supports the data over logical, but contradictory to the reality of who gets accepted, assumptions.

EDIT: of note, I didnt want to make it seem like it would be a walk in the park for those highly competitive ones. But his score suggests that if he wanted one of those and interviewed broadly he *should* get in somewhere and not have a huge concern about not matching. Now not matching to his top 10 (or top 20) choice is a different matter.

As of 2009-2010

Out of 1080 ACGME dermatology residents, only 15 were DOs
Out of 1266 ACGME ophthalmology residents, only 11 were DOs
Out of 1406 ACGME otolaryngology residents, only 3 were DOs
Out of 1039 ACGME urology residents, only 8 were DOs

Source: JAMA. 2010;304(11):1255

 

[DocEspana]

As of 2009-2010

Out of 1080 ACGME dermatology residents, only 15 were DOs
Out of 1266 ACGME ophthalmology residents, only 11 were DOs
Out of 1406 ACGME otolaryngology residents, only 3 were DOs
Out of 1039 ACGME urology residents, only 8 were DOs

Source: JAMA. 2010;304(11):1255

The average allo score is in parenthesis

Average Step 1 for DO's in derm allo: 229 (242)
DO in allo ophtho: 231 (232)
DO in allo ENT: 231 (241)
DO in allo Urology: "235 or better" (235+)

source: NRMP - Charting outcomes 2009, urologymatch.com

I'd assume this is more of a self-selection, which is also what my relative in the ophtho program feels, rather than bias. Those who have high enough scores for this and want to do it will probably pick a AOA program first for the safety net of it all. Only the overly ambitious and/or a bit reckless will only aim for ACGME. At which point (according to my relative) DOs are considered total equals because you're dealing with people who scored remarkably high anyway, and many sneak in with lower scores because they start evaluating on a "well he scored high enough, what else does he have" type criteria.... within limits.

 

[dozitgetchahi]

With all due respect,

Allo Derm, ENT, Ophtho, and Urology - while he may be "qualified", probably not competitive since he is coming from a DO school unless there are other unquantifiable factors that pushes in his favor. There will be plenty of US MD students with similar USMLE scores coming from US MD schools with more exposures to academic Derm/ENT/Ophtho/Uro (with good letters and research) that are in the same applicant pool.

Yeah, this was exactly what I suspected. I agree that if I were an MD, I could potentially look at the "charting outcomes" data and rejoice since I'd essentially be "in range" for everything - but being a DO brings a host of other issues into play. For instance, optho is especially tricky for DOs because the SF match happens earlier than the other matches and few DO programs have home optho departments. Thus, it's hard to complete an outside optho rotation in time to submit rec letters, etc for the SF match. Plus, allo optho departments apparently highly value the "prestige" of applicants' medical schools - and obviously a DO applicant isn't going to be packing much of that.

It's also worth noting that many residencies in surgical subspecialties have never taken DOs etc...and it's not obvious as to whether DOs have never applied to these residencies to begin with or if they've just not matched in the past. I'm personally not going to gamble on the allo match with that much uncertainty.

Obviously if I attempted to tackle an ultracompetitive subspecialty I'd be happy to match anything on the allo side. For less competitive stuff, however, I'd be trying to aim a bit higher. With EM, neuro (and to a lesser extent, anesthesia) I think I'd be shooting more at the top-tier programs for sure (with some mid-tiers for backup, obviously).

Now as for IM - it's an oddball because the competitiveness span is so damn wide. I agree that I'm probably quite overqualified for community allo IM, but with a 237 I'd be aiming at mid-level academic IM programs at the very least - and potentially some Top 25 progs to boot. I'd also be trying for cities in which I have family (Chicago, Cleveland, Boston). I've been told academic IM is getting somewhat more competitive these days, and I'm just trying to get a feel for how viable that sort of plan is. (If I went with IM, I think I'd be trying to go for a fellowship in GI or allergy down the road.)

Allo rads is the big question mark. I know DOs have had some success matching rads recently, but it's still nothing like anesthesia in terms of DO friendliness.

 

[DocEspana]

Im just saying. Read the average acceptance USMLE scores for DOs in those fields. They are well below yours. IDK what other stuff they have in their CVs to pad it, but they are getting in at levels moderately below-to-right-at MD scores.

My connection in ophtho says that once you get the score level, they dont care about your USMLE, they care about what else you bring. At which point DOs can get in with lower scores (on average) as only the really brave/reckless/qualified skip over AOA optho, and those same people get into ACGME without any resistance or prejudice. 231 is the allo mean for DO's entering ophtho. The idea of a bias against them doesn't fit with them getting in at a lower score than MD students. It has to be the more nuanced explanation above.

 

[DrBowtie]

Im just saying. Read the average acceptance USMLE scores for DOs in those fields. They are well below yours. IDK what other stuff they have in their CVs to pad it, but they are getting in at levels moderately below-to-right-at MD scores.

My connection in ophtho says that once you get the score level, they dont care about your USMLE, they care about what else you bring. At which point DOs can get in with lower scores (on average) as only the really brave/reckless/qualified skip over AOA optho, and those same people get into ACGME without any resistance or prejudice. 231 is the allo mean for DO's entering ophtho. The idea of a bias against them doesn't fit with them getting in at a lower score than MD students. It has to be the more nuanced explanation above.

If anything, between both of your sets of numbers it shows not that scores matter more or less. Its that there was some intangible that made them one of the chosen ones to match. The # of DOs in those residencies speak for themselves. There are plenty of DOs who applied to those with higher numbers and didn't match obviously.

They either had an inside connection to the programs, serious networking, or serious research such that the board score would have been irrelevant. This is something that only a select few can obtain.

 

[Funky]

If anything, between both of your sets of numbers it shows not that scores matter more or less. Its that there was some intangible that made them one of the chosen ones to match. The # of DOs in those residencies speak for themselves. There are plenty of DOs who applied to those with higher numbers and didn't match obviously.

They either had an inside connection to the programs, serious networking, or serious research such that the board score would have been irrelevant. This is something that only a select few can obtain.

It's a great score but it's going to be tough to match into something like opth. I guess what you could do is try doing an away at a program and really try to shine there and who knows what could happen from there. But that's a pretty big gamble.

 

[JimT30]

Im just saying. Read the average acceptance USMLE scores for DOs in those fields. They are well below yours. IDK what other stuff they have in their CVs to pad it, but they are getting in at levels moderately below-to-right-at MD scores.

My connection in ophtho says that once you get the score level, they dont care about your USMLE, they care about what else you bring. At which point DOs can get in with lower scores (on average) as only the really brave/reckless/qualified skip over AOA optho, and those same people get into ACGME without any resistance or prejudice. 231 is the allo mean for DO's entering ophtho. The idea of a bias against them doesn't fit with them getting in at a lower score than MD students. It has to be the more nuanced explanation above.

Your connection should have also informed you that the Allo ophtho match is before AOA.

 

[Instatewaiter]

I'll run through how you stack up for everything

Allo EM: Highly overqualified.
Allo IM: SUPER overqualified.
Allo Neuro: They will drop to their knees and beg for you overqualified

Allo Derm: Qualified
Allo ENT: Within range, perhaps slightly below the mean
Urology: Above the mean (so yes. definitely qualified)
Allo Optho: with your score shouldn't be a problem
Allo Rads: With your score shouldn't be a problem (note: not rad-onc)
Allo Anesth: You'd be VERY competitive.

You'd be (likely) able to match, with high confidence into everything except for Plastic Surg, ENT, Rad-Onc, and Derm
You'll be (likely) able to match with decent confidence in ENT and Derm
You prob won't match in: Rad-onc and Plastic surgery.

Everything except for rad-onc and plastics are totally within reach and most are easy cakewalks for you, from a USMLE score alone.

I realize this is all hyperbole but you are off your rocker:

Super overqualified for allo IM? Maybe at a community program but a 237 is not competitive for top tier programs even as an MD student. Most wont even look at a DO student specifically because they don't have to. With a 237 you'll no doubt be able to match to a solid program but you will not be able to write your own ticket. I'm in IM and I doubt a single person in my program scored below a 240. It is a similar story for top tier neuro programs. I don't know about EM but I imagine a similar story.

ENT, ophtho, derm, uro, NS, rad onc and maybe even radiology are all going to be difficult, some more than others. Apply very broadly if you choose one of these. Have a backup plan if you apply as well.

As to the contention that DO students need lower scores, unfortunately, there is no DO student section to the data from the NRMP. It is "independent applicants", which means the DO students are mixed in with students from oxford, germany and the like.

Using your 2009 data: Derm: Indepenent applicants did score a 229. Of course only 1 DO matched derm in 2009

ENT: Again, indepenent applicants scored a 231, again 0 DOs matched in 2009. Sure those numbers are lower than US MDs but they have nothing to do with DOs

Ophtho and urology is going to be a similar story but it's a different match and I don't feel like looking it up. Someone can look it up and prove me right.

http://www.nrmp.org/data/resultsanddata2009.pdf (page 13)

https://www.aamc.org/students/download/62400/data/chartingoutcomes.pdf (also page 13)

OP, your scores are solid. Pick what you want to do, apply broadly and get good letters. That is all you can do. If you interview well, have strong letters and very good clinical grades, you probably will match well.

 

[Instatewaiter]

Stats:
Questions:

- Do I stand any sort of chance at matching allo rads with this score?

- What's the deal with DO rads? I've heard some very mixed things about those programs.

- What tier of allo IM progs would be in reach for me?

- How competitive would I be for "top" MD anesthesia progs? Is DO anesthesia worth thinking about given that MD anesthesia is DO friendly?

If anyone can shed some light on these questions I'd be grateful.

1) Maybe... depends on the rest of your application. My gues would be yes though.

2) Screw DO rads. With the exception of a few programs, the hospitals are not going to see the rare cases. You'd be much better at a mid-tier US allo program.

3) I break it up into
top tier: Hopkins Hospital, MGH, The Brigham, Duke, UCSF, Columbia etc
2nd tier- cornell, Chicago, Yale, UTSW, OHSU, Washington, WashU etc
Mid tier- most other university programs
Lower tier- community programs

You won't be competitive at top tier. I wouldn't even both applying unless it's not gonna cost much. I highly doubt you'll match.

2nd tier is a reach but I think worth applying to.

3rd tier is virtually a lock at one of those programs. Don't waste your time with lower tier.

4) No idea. I imagine though, since anesthesia and IMs average board scores (222) are the same, it would be a similar story for anesthesia. Who knows though...

 

[DocEspana]

I realize this is all hyperbole but you are off your rocker:

Super overqualified for allo IM? Maybe at a community program but a 237 is not competitive for top tier programs even as an MD student. Most wont even look at a DO student specifically because they don't have to. With a 237 you'll no doubt be able to match to a solid program but you will not be able to write your own ticket. I'm in IM and I doubt a single person in my program scored below a 240. It is a similar story for top tier neuro programs. I don't know about EM but I imagine a similar story.

ENT, ophtho, derm, uro, NS, rad onc and maybe even radiology are all going to be difficult, some more than others. Apply very broadly if you choose one of these. Have a backup plan if you apply as well.

As to the contention that DO students need lower scores, unfortunately, there is no DO student section to the data from the NRMP. It is "independent applicants", which means the DO students are mixed in with students from oxford, germany and the like.

Using your 2009 data: Derm: Indepenent applicants did score a 229. Of course 0 DOs matched derm in 2009

ENT: Again, indepenent applicants scored a 231, again 0 DOs matched in 2009. Sure those numbers are lower than US MDs but they have nothing to do with DOs

Ophtho and urology is going to be a similar story but it's a different match and I don't feel like looking it up. Someone can look it up and prove me right.

http://www.nrmp.org/data/resultsanddata2009.pdf (page 13)

https://www.aamc.org/students/download/62400/data/chartingoutcomes.pdf (also page 13)

OP, your scores are solid. Pick what you want to do, apply broadly and get good letters. That is all you can do. If you interview well, have strong letters and very good clinical grades, you probably will match well.

Except we know that 18 DOs matched derm and ENT (not the zero you cited) in 2009 and 19 matched ophtho and uro. the ACGME does publish this stuff. Im also aware of the number of FMGs in these positions being less than the number of DOs. So we can more or less treat the independent applicant number as the DO number for derm and ENT (yes, more or less means "not exactly" but if they dont do the exact calculations, this is close enough to use). Uro and SF both do measure DO numbers (for ****s and giggles?).

Also, idk what program you're involved with, but NY-Presby and Sinai would love someone with a 237. DO or otherwise, for their IM program, from first hand knowledge talking with them trying to arrange some early connections there now that i'm in clinicals. I believe they are both top 10 in the US. So I'd be curious where you go where you dont know anyone with less than a 240.

EDIT: didnt even notice before that you wrote the words "top tier neuro". I laughed. Are we kidding here? Unless the word "surg" follows the word "neuro" I cant even take that phrase seriously. No offense to neurologists, but its just not a hard field to get into, top to bottom, if we're using the USMLE as a measuring tool.

 

[DocEspana]

Your connection should have also informed you that the Allo ophtho match is before AOA.

I believe his point was they dont even bother with the application fees if they have a strong feeling they have an in with the AOA programs. Only the cocky/reckless even try... and they tend to get a spot.

 

[JimT30]

I believe his point was they dont even bother with the application fees if they have a strong feeling they have an in with the AOA programs. Only the cocky/reckless even try... and they tend to get a spot.

Actually since there are only 11 total AOA positions and many more applicants than that, the majority apply to SF match because there is no lose situation.

 

[DocEspana]

Actually since there are only 11 total AOA positions and many more applicants than that, the majority apply to SF match because there is no lose situation.

its a money loss situation and, at least in brooklyn, the rate of DO applicants is incredibly low. The anecdotal assessment is the few who do apply are "qualified and do well". They must be trying for the AOA spots.

I never asked if my relative has actually seen any DOs get in the program, but he's involved in the selection process for the residency. I'd actually assume he'd "pass" on them, personally, but he seems convinced that the degree is irrelevant and that he feels anyone who has the base score is on equal footing of being a "superior stuent" and thats where all the ECs and research come into play.

EDIT: there are 52 AOA spots, thats a pretty decent amount. Small, sure, but sufficient.

 

[JimT30]

its a money loss situation and, at least in brooklyn, the rate of DO applicants is incredibly low. The anecdotal assessment is the few who do apply are "qualified and do well". They must be trying for the AOA spots.

I never asked if my relative has actually seen any DOs get in the program, but he's involved in the selection process for the residency. I'd actually assume he'd "pass" on them, personally, but he seems convinced that the degree is irrelevant and that he feels anyone who has the base score is on equal footing of being a "superior stuent" and thats where all the ECs and research come into play.

EDIT: there are 52 AOA spots, thats a pretty decent amount. Small, sure, but sufficient.

11 total programs only 3 take 2 per year the rest take 1, there isn't even 52 over all 3 years

 

[DocEspana]

11 total programs only 3 take 2 per year the rest take 1, there isn't even 52 over all 3 years

actually no. most take 3. some take 7. one takes 9. I'm at the hospital that takes 9. I can go in on monday and take a picture of the roster for you if you want The ophthalmologists there are like flies. Its 52 per year.

 

[dbth77]

I'll run through how you stack up for everything

Allo EM: Highly overqualified.
Allo IM: SUPER overqualified.
Allo Neuro: They will drop to their knees and beg for you overqualified

Allo Derm: Qualified
Allo ENT: Within range, perhaps slightly below the mean
Urology: Above the mean (so yes. definitely qualified)
Allo Optho: with your score shouldn't be a problem
Allo Rads: With your score shouldn't be a problem (note: not rad-onc)
Allo Anesth: You'd be VERY competitive.

You'd be (likely) able to match, with high confidence into everything except for Plastic Surg, ENT, Rad-Onc, and Derm
You'll be (likely) able to match with decent confidence in ENT and Derm
You prob won't match in: Rad-onc and Plastic surgery.

Everything except for rad-onc and plastics are totally within reach and most are easy cakewalks for you, from a USMLE score alone.

You need to stop posting, it's one thing to give no help to someone but it's indefensible to give out bad advice. Saying a DO with a 237 is a lock for freaking derm because the five people who matched into it last year had on average lower board scores is such poor logic I almost can't even believe youre a med student

 

[JimT30]

actually no. most take 3. some take 7. one takes 9. I'm at the hospital that takes 9. I can go in on monday and take a picture of the roster for you if you want The ophthalmologists there are like flies. Its 52 per year.

http://opportunities.osteopathic.org/

Check it out for yourself.

Which hospital are you at?

 

[DocEspana]

You need to stop posting, it's one thing to give no help to someone but it's indefensible to give out bad advice. Saying a DO with a 237 is a lock for freaking derm because the five people who matched into it last year had on average lower board scores is such poor logic I almost can't even believe youre a med student

qualified and a lock are a whole different world. Especially when I admit I am solely measuring based on the USMLE score. I think everyone realizes connections and research will trump USMLE 100 times out of 100 if the scores are anywhere in the "strong applicant" range. But he asked if his score locks him out of x y and z. It most definitely does not.

 

[DocEspana]

http://opportunities.osteopathic.org/

Check it out for yourself.

Which hospital are you at?

Holy crapamole. I'm a ******. Didnt scroll down to the "OGME" lists and stopped at the paid positions per year line. Its still 20, but its not the 50+. And I'm at St. Johns, where the ophtho program is huge because we have the 7 or 8 residents in the AOA program and another 12-14 in an ACGME program affiliation with NSLIJ, so seeing a "7" seemed believable to me as a per-year number.

 

[r90t]

I did not take USMLE. Did reasonably well on COMLEX. Kicked ass in MS-1/MS-2 years, had great MS-3/4 letters of recommendation and matched rad onc. First DO in my program. Kicked ass there and opened the door for the second DO in the same program. It was broken down as MD/PhDx3, DOx2, MDx1 when I was chief resident. We tried to take another DO in the match, but she went to another program. As a staff DO, saw the first DO match at NCI.

Slayed the DO and MD boards.

My office mate is a DO rad onc who graduated 1 year after I did from another program.

I hear that it is near impossible to match into rad onc as a DO. I personally know (including myself) 5 DOs that have matched rad onc since 2002.

Look at the numbers and if you are in the bottom have of the boards, you will likely not match into a allopathic program that is highly sought after, but what do you really lose if you apply and don't get accepted other than a bruised ego??

Here is the kicker, I didn't get into med school the first year that I applied, as my undergrad grades were questionable!

Good luck.

 

[dozitgetchahi]

1) Maybe... depends on the rest of your application. My gues would be yes though.

2) Screw DO rads. With the exception of a few programs, the hospitals are not going to see the rare cases. You'd be much better at a mid-tier US allo program.

3) I break it up into
top tier: Hopkins Hospital, MGH, The Brigham, Duke, UCSF, Columbia etc
2nd tier- cornell, Chicago, Yale, UTSW, OHSU, Washington, WashU etc
Mid tier- most other university programs
Lower tier- community programs

You won't be competitive at top tier. I wouldn't even both applying unless it's not gonna cost much. I highly doubt you'll match.

2nd tier is a reach but I think worth applying to.

3rd tier is virtually a lock at one of those programs. Don't waste your time with lower tier.

4) No idea. I imagine though, since anesthesia and IMs average board scores (222) are the same, it would be a similar story for anesthesia. Who knows though...

Thanks for breaking the IM tiers down for me. Couple questions:

- What is the potential for matching decent fellowships out of the mid-tier programs? I've heard you can do well that way but I'd obviously like to hear a bit more about that.

- Is there anything I can do at this point (aside from honoring as many rotations as humanly possible) that might bump up my chances for 2nd tier IM programs? Nailing step 2? Dredging up more research publications? Getting extremely good rec letters?

- Which IM programs in Chicago and Boston fall into the mid-level category? By your breakdown, I'm assuming Northwestern is 2nd tier? In Cleveland, I'm assuming Case and CCF are mid-level?

Thanks.

 

[Instatewaiter]

Except we know that 18 DOs matched derm and ENT (not the zero you cited) in 2009 Im also aware of the number of FMGs in these positions being less than the number of DOs. So we can more or less treat the independent applicant number as the DO number for derm and ENT

And where is your source for the 18 DOs matching. Using the NRMP data:

out of 338 positions for Derm there was 1 DO who matched and 8 IMGs. For ENT out of 275 spots there were 0 DOs (5 IMGs)


So of the independent applicants for Derm and ENT, DOs make up 7.5%. Can't extrapolate anything from that. Please actually read the link before speaking:

http://www.nrmp.org/data/resultsanddata2009.pdf please see page 13

So to summarize, you are wrong.

Also, idk what program you're involved with, but NY-Presby and Sinai would love someone with a 237. DO or otherwise, for their IM program, from first hand knowledge talking with them trying to arrange some early connections there now that i'm in clinicals. I believe they are both top 10 in the US. So I'd be curious where you go where you dont know anyone with less than a 240.

You sure that is first had knowledge? You sure it isn't... nothing. So you are a current resident there? No? So they offered you a spot pre-match? No? But you must have already gotten your interview lined up? No?

Hate to break it to you but first, a 237 is not very competitive for Columbia's IM program. Second they dont have a single DO in their program. How many DOs are in IM at Columbia (ie NY-Presbyterian). Answer none.
http://www.columbiamedicine.org/education/r_staff.shtml

It seems sinai doesn't have a DO either but they don't list their schools out like Columbia does.

In short: you are wrong.

EDIT: didnt even notice before that you wrote the words "top tier neuro". I laughed. Are we kidding here? Unless the word "surg" follows the word "neuro" I cant even take that phrase seriously. No offense to neurologists, but its just not a hard field to get into, top to bottom, if we're using the USMLE as a measuring tool.

Just like every other specialty, the programs at the top have very, very competitive applicants. Not everyone with a 250 wants to do ortho. Some like neuro. Try matching to hopkins neuro with a 237. Prolly wont happen.

And finally... well you know the rest. You're wrong

 

[Instatewaiter]

Thanks for breaking the IM tiers down for me. Couple questions:

- What is the potential for matching decent fellowships out of the mid-tier programs? I've heard you can do well that way but I'd obviously like to hear a bit more about that.

- Is there anything I can do at this point (aside from honoring as many rotations as humanly possible) that might bump up my chances for 2nd tier IM programs? Nailing step 2? Dredging up more research publications? Getting extremely good rec letters?

- Which IM programs in Chicago and Boston fall into the mid-level category? By your breakdown, I'm assuming Northwestern is 2nd tier? In Cleveland, I'm assuming Case and CCF are mid-level?

Thanks.

1) Most university program have their own fellowships. Depending on what you want to do, your chances are probably pretty good. You wont be guaranteed to match GI or Cards but you would have a good shot. The "elite" programs tend to be very incestuous so if you didn't get in for residency, your chances for fellowship are low unless it is something non-competitive like rheum or endocrine.

2) Nailing step 2 is a good idea. It is a double edged sword though. If you take it early and do poorly, your chances are decreased. However, if you do well, you have strengthened your application.

Very good letters are a must. I am not saying that you wouldn't match to an excellent program, just that it is harder as a DO because while IM tends to be "non-competitive" that is averaged over the hundreds of programs, many of which are crappy community programs. The residents at the top places tend to have >240s (some in the IM forum say >250... I dont agree with that) and either all honors or almost all honors as well as a few publications.

3) I would say northwestern is 2nd tier. Case and CCF are right between midlevel and 2nd tier. CCF is good and bad. It is almost entirely fellow driven so the fellowships are great but the residency suffers as a consequence. That said, they do take 1 or 2 each year into some of their fellowships like CCF cardiology which is the top program in the country. Just from that standpoint it makes CCF better than mid-tier.

I don't know all of the chicago programs so I will let someone else comment but in Boston- BU and tufts are probably upper mid-tier.

 

[DocEspana]

And where is your source for the 18 DOs matching. Using the NRMP data:

out of 338 positions for Derm there was 1 DO who matched and 8 IMGs. For ENT out of 275 spots there were 0 DOs (5 IMGs)


So of the independent applicants for Derm and ENT, DOs make up 7.5%. Can't extrapolate anything from that. Please actually read the link before speaking:

http://www.nrmp.org/data/resultsanddata2009.pdf please see page 13

So to summarize, you are wrong.

Source: JAMA. 2010;304(11):1255. You're welcome. It was the same thing group_theory posted up before.

You sure that is first had knowledge? You sure it isn't... nothing. So you are a current resident there? No? So they offered you a spot pre-match? No? But you must have already gotten your interview lined up? No?

Hate to break it to you but first, a 237 is not very competitive for Columbia's IM program. Second they dont have a single DO in their program. How many DOs are in IM at Columbia (ie NY-Presbyterian). Answer none.
http://www.columbiamedicine.org/education/r_staff.shtml

It seems sinai doesn't have a DO either but they don't list their schools out like Columbia does.

In short: you are wrong.

Absolutely certain I have first hand knowledge. Scott Lorin, MD, program director at Sinai, is a family friend. He assures me anything 235+ they would love to have. And I know two IM residents out in columbia who, while admitting that other sites are easier to get into, say that 235+ is all you need to have a decent chance at NY-Presby as well. Dr. Lorin says that DOs haven't gotten in just due to dearth of applicants for their program. The residents at NY-Presby do admit it would be a challenge for a DO to get in, but that their director wouldn't rule out anyone with a score above the mid 230's.

As a personal note: I'm trying to line myself up (yes through pseudo-nepotism, rather than pure merit) to be that first DO at Sinai.

Just like every other specialty, the programs at the top have very, very competitive applicants. Not everyone with a 250 wants to do ortho. Some like neuro. Try matching to hopkins neuro with a 237. Prolly wont happen.

And finally... well you know the rest. You're wrong

And yes. one singular program, of which the most you could say was "prolly wont happen" does not a rule for the entire field make. I know us DOs like to be all gloom and doom, but the fact is that you *dont* have to be better than the MDs when you're competing at the high scoring positions. great scores are great scores no matter who gets them. Its the middle grounds (<230) where it appears you do need to have something special, or plain outcompete, MD applicants. Not *everything* is gloom and doom for DOs. I'm tired of hearing people who look at everything as giant negative viewpoints when the numbers and program directors tell different stories.

and yes. Im prob an oddball example since i come from a family of doctors who all practice in the NYC area and have tons of connections who come to family parties. Maybe I'm being fed sunny bull**** by my family friends because they'll do me favors or just like to get my hopes up, but I choose to believe otherwise. Perhaps incorrectly, idk. But someone has to give the positive spin out here, and im a numbers jockey. I will always end up being the counter-point to the prevailing pessimism in these threads.

 

[dozitgetchahi]

Absolutely certain I have first hand knowledge. Scott Lorin, MD, program director at Sinai, is a family friend. He assures me anything 235+ they would love to have. And I know two IM residents out in columbia who, while admitting that other sites are easier to get into, say that 235+ is all you need to have a decent chance at NY-Presby as well. Dr. Lorin says that DOs haven't gotten in just due to dearth of applicants for their program. The residents at NY-Presby do admit it would be a challenge for a DO to get in, but that their director wouldn't rule out anyone with a score above the mid 230's.

As a personal note: I'm trying to line myself up (yes through pseudo-nepotism, rather than pure merit) to be that first DO at Sinai.
And yes. one singular program, of which the most you could say was "prolly wont happen" does not a rule for the entire field make. I know us DOs like to be all gloom and doom, but the fact is that you *dont* have to be better than the MDs when you're competing at the high scoring positions. great scores are great scores no matter who gets them. Its the middle grounds (<230) where it appears you do need to have something special, or plain outcompete, MD applicants. Not *everything* is gloom and doom for DOs. I'm tired of hearing people who look at everything as giant negative viewpoints when the numbers and program directors tell different stories.

and yes. Im prob an oddball example since i come from a family of doctors who all practice in the NYC area and have tons of connections who come to family parties. Maybe I'm being fed sunny bull**** by my family friends because they'll do me favors or just like to get my hopes up, but I choose to believe otherwise. Perhaps incorrectly, idk. But someone has to give the positive spin out here, and im a numbers jockey. I will always end up being the counter-point to the prevailing pessimism in these threads.

Ok, now I see where you're coming from. I do appreciate the can-do attitude (which as you said is often rare among DOs), and I agree that there is a *degree* of self-selection and obsession with rockstar scores on SDN. However, a couple things stand out:

1) You're fortunate enough to know people like Scott Lorin personally.
2) It's not clear what Lorin's "we'd love to have anyone over 235" comment actually means.

#1 is huge. On the rare occasions that DOs have managed to match into programs of this caliber, personal connections have often played a major role. With solid scores, you might actually stand some reasonable chance of matching at NY-Presby. I don't have connections like this, so I'd imagine my position is much weaker than yours when it comes to matching a place like that.

#2 is interesting because it's not clear if he thinks of 235 as a "cutoff" of sorts, or if he really thinks 235 is a solid, competitive, "matchable" score. If 235 is a soft cutoff but there are plenty of 240-250+ MD applicants in the pool, then guess who's probably not getting in? Mr. DO 237 (barring special connections or anything else that adds "wow factor" to your app). However, his comment about the dearth of DO applicants to his program is interesting too. From what I've been told, it really is true that some competitive programs have never had (or had very few) DO applicants - and perhaps we DOs really would have a reasonable shot at some of these if we were otherwise competitive. Who knows. (Of course, there are also those places where a DO application is going in the trash even with a 270 - so yeah.)

Either way, the rest of my app is probably going to be similar (at best) to other applicants at many of these programs. I may be taking a closer look at anesthesia - apparently 230+ really does get your foot in the door at top anesthesia progs, and the level of DO friendliness seems to be an order of magnitude higher than with IM. I think I'd really enjoy doing anesthesia also. That said, it looks like I really did screw the pooch for some specialties by not hitting 250 (or at least 240) in line with my NBMEs - grrrrr. But there's nothing I can do at this point other than strengthen the rest of my app and keep my head up.

I've also enjoyed reading the discussion on this post - it's really informative and a range of viewpoints are being expressed. Keep it coming

 

[dbth77]

Ok, now I see where you're coming from. I do appreciate the can-do attitude (which as you said is often rare among DOs), and I agree that there is a *degree* of self-selection and obsession with rockstar scores on SDN. However, a couple things stand out:

1) You're fortunate enough to know people like Scott Lorin personally.
2) It's not clear what Lorin's "we'd love to have anyone over 235" comment actually means.

#1 is huge. On the rare occasions that DOs have managed to match into programs of this caliber, personal connections have often played a major role. With solid scores, you might actually stand some reasonable chance of matching at NY-Presby. I don't have connections like this, so I'd imagine my position is much weaker than yours when it comes to matching a place like that.

#2 is interesting because it's not clear if he thinks of 235 as a "cutoff" of sorts, or if he really thinks 235 is a solid, competitive, "matchable" score. If 235 is a soft cutoff but there are plenty of 240-250+ MD applicants in the pool, then guess who's probably not getting in? Mr. DO 237 (barring special connections or anything else that adds "wow factor" to your app). However, his comment about the dearth of DO applicants to his program is interesting too. From what I've been told, it really is true that some competitive programs have never had (or had very few) DO applicants - and perhaps we DOs really would have a reasonable shot at some of these if we were otherwise competitive. Who knows. (Of course, there are also those places where a DO application is going in the trash even with a 270 - so yeah.)

Either way, the rest of my app is probably going to be similar (at best) to other applicants at many of these programs. I may be taking a closer look at anesthesia - apparently 230+ really does get your foot in the door at top anesthesia progs, and the level of DO friendliness seems to be an order of magnitude higher than with IM. I think I'd really enjoy doing anesthesia also. That said, it looks like I really did screw the pooch for some specialties by not hitting 250 (or at least 240) in line with my NBMEs - grrrrr. But there's nothing I can do at this point other than strengthen the rest of my app and keep my head up.

I've also enjoyed reading the discussion on this post - it's really informative and a range of viewpoints are being expressed. Keep it coming

I think getting into the top 10 or so anesthesia programs will be an uphill battle with your score and being a DO but you'd probably slot in nicely in the next group of programs. Looking at charting outcomes around 250 US MD's outscored you so it's close. I interviewed at most of the top programs and did see one fellow interviewee who was a DO at one of them but I obviously don't know how good his/her numbers were

 

[Instatewaiter]

Source: JAMA. 2010;304(11):1255. You're welcome. It was the same thing group_theory posted up before.

So the data first posted was the data for those that matched in 2009. 1 DO matched Derm and 0 to ENT.

The Jama numbers are TOTAL residents in all ACGME programs in all years not those that matched in 2009. So that includes all PGY1, PGY2, PGY3 and PGY 4 years of derm residency and all 5 years of ENT training. So the 2009 charting outcomes in the match data is not applicable.

So again, there is literally no data that shows that DOs need to score lower than their MD counterparts and a huge amount of anectdotal evidence. The data however shows that IMGs/FMGs can score lower and match. This at least in part is probably 2/2 to them matching the crappier programs in the bunch.

As to your connections, we'll see where you match. You may be right but I suspect it is much, much more difficult than you realize or than they are telling you.

 

[Instatewaiter]

Also, idk what program you're involved with, but NY-Presby and Sinai would love someone with a 237. DO or otherwise, for their IM program, from first hand knowledge talking with them trying to arrange some early connections there now that i'm in clinicals. I believe they are both top 10 in the US. So I'd be curious where you go where you dont know anyone with less than a 240.

The top of medicine is more competitive than you think. Columbia and Sinai are included in those programs. Most would consider Columbia in the top 5 or 6 programs in the country and sinai somewhere around 15ish depending on who you talk to. Using charting outcomes in the match data: There are almost almost 1000 people who scored >240 and matched to IM in 2009. There were and about 415 who scored >250 or above. There are only about 30-40 residents each year in most top medicine programs. You do the math.

So, in the top 15ish programs there are 450 students who match each year. There are ~1000 who scored above a 240. ~415 who scored higher than 250. What do you think the top programs averages are given the numbers above?

 

[MedicineMike]

I currently work for the Dean at Sinai and he knows I will be attending DO school in a few days. Him and his colleagues are not ant-DO and have never said anything about not accepting DO students into residency program because they are DO. With that being said, there are plenty of DOs that work here and they are very encouraged to apply to fellowships here. I am not sure why they haven;t taken a DO for residency just yet (that I know of) but I am thinking about going to ask them today! It might just be that there is such an influx of highly qualified (on paper) MD students that get the spot first.

 

[MedicineMike]

Oh, and this DO did his residency at NYP-Columbia and was chief resident:

http://www.mountsinai.org/profiles/joseph-herrera

 

[DrBowtie]

Oh, and this DO did his residency at NYP-Columbia and was chief resident:

http://www.mountsinai.org/profiles/joseph-herrera

....in PM&R.

 

[DocEspana]

....in PM&R.

Yea. One thing that has to be admitted is that if you see a DO in PMnR, FM, ER or (maybe this is a stretch) anesth, you shouldn't be so surprised, even at elite hospitals. Just historically very good fields for the DO degree. For whatever reason IM at one of the big NYC places is the real benchmark. I've seen it at some of the minor manhattan hospitals and plenty of top notch brooklyn places. But Sinai, NY-P, and Bellevue (I believe) dont have any history that I know of. I think Cornell does have/did have DOs in various departments; but Cornell, for all that it has name value, isn't seen in the same light as the others.

My PCP did IM at Weil Cornell, said that the phrase there was "You go for the great 'A'partment, not the medical 'D'epartment"

 

[MedicineMike]

....in PM&R.

Yes but I thought the point was that no DO has ever done a residency at NYP

 

[DrBowtie]

Yes but I thought the point was that no DO has ever done a residency at NYP

No it was NY-P IM. You'll soon find out that there is a prestige hierarchy amongst specialties and within hospitals each department has its own level of competitiveness.

 

[MedicineMike]

No it was NY-P IM. You'll soon find out that there is a prestige hierarchy amongst specialties and within hospitals each department has its own level of competitiveness.

Oh sorry, I didn't realize we were only talking about IM. And I have already realized the hierarchy amongst certain specialties. More so at large academic institutions

 

[DrWBD]

Absolutely certain I have first hand knowledge. Scott Lorin, MD, program director at Sinai, is a family friend. He assures me anything 235+ they would love to have. And I know two IM residents out in columbia who, while admitting that other sites are easier to get into, say that 235+ is all you need to have a decent chance at NY-Presby as well. Dr. Lorin says that DOs haven't gotten in just due to dearth of applicants for their program. The residents at NY-Presby do admit it would be a challenge for a DO to get in, but that their director wouldn't rule out anyone with a score above the mid 230's.

Chuckle for the day. While I wouldn't mind ultimately being proven wrong by you when you match, I think you're being amazingly naive if you believe what you wrote here.

...But someone has to give the positive spin out here,.... I will always end up being the counter-point to the prevailing pessimism in these threads.

Why? I don't give patients false hope in grim situations (and neither should you, when the time comes). Why have you taken on the mantle of reflexive optimism when the facts do not support this point of view?

 

[NontradICUdoc]

Make an appt with Dr. Kreuger and talk to him about it. Then take what he says and look at the information on Freida and Osteopathic opportunities and put it together and mull it over.

You can apply to different types of programs just make sure that you are getting the proper LORs and writing the personal statements that show you are interested in the said field.

 

[r90t]

You guys are really stressing the "top" tier programs way too much. Apply to them, but don't worry about your future career if you don't match in a top 10 program.

I have worked with guys from "name brand" cancer centers who may have excelled in research, but not clinical skills. Others from smaller program, who were excellent oncologists. Residency is essentially what you make of it, i.e. Garbage in = Garbage out. You can go to a number 1 ranked program, work you minimum hours, and most importantly, don't read and unsurprisingly come out as a mediocre physician. You will have a great reputation based on training location, but your peers WILL recognize your clinical weaknesses.

BTW, the military gives DOs and MDs equal ground for residency matching. I have seen Gen Surg, Cards, IM, OB/GYN, Rads, GI, Pulmonary, all walking around my hospital this year as residents or fellows with DO on their coats. Lots of them. Residency selection is based on a points system from your achievements. It is an objective scoring system with a worksheet and points for each candidate. There is not a -1 for DO or +1 for MD. If you really want a specialty, and meet the objective requirements to beat out your competitors, then it is something to consider.

Good luck on the application process/interviews. It is a stressful year.

 

[SmokD]

Garbage in = Garbage out.

qft

 

[cliquesh]

I'm going to be a dick and high jack your thread:

What about a 251 on step 1 and top 20% of class?

What's the likelihood of matching:

Gas
IM (followed by heme/onc)
Path
Diag Rad (likely enough to even apply?)
Rad Onc (even possible?)

I realize my score is fine and if I were an MD I wouldn't be asking this question.

 

[DarkHorizon]

I'm going to be a dick and high jack your thread:

What about a 251 on step 1 and top 20% of class?

What's the likelihood of matching:

Gas
IM (followed by heme/onc)
Path
Diag Rad (likely enough to even apply?)
Rad Onc (even possible?)



I realize my score is fine and if I were an MD I wouldn't be asking this question.

Competitive for everything. Rad Onc will need you to have some research though.

 

[thepoopologist]

I'm a crack ho. What are my chances for cardio.