Who Here is Choosing a DO School Over an MD Acceptance?

[MLT2MT2DO]

From what I can tell, the guys who make legitimate money doing OMM are the ones who are the absolute gurus, charge hundreds of dollars per hour in cash ONLY (I crunched some numbers one time with a fellow SDNer who had just returned from an OMM appointment with a busy doc who charges 360 an hour, 8 hours a day, 5 days a week no prob), and are the only people in the area doing it.

My problem with this, is in my area we don't have very many DOs yet the ones we do have take insurance for OMM. So they get my $25 copay plus whatever my insurance ponies up. I can only imagine it is harder to set up a cash based OMM practice in Missouri or pretty much anywhere in the Midwest.

Of course if one is exceptionally good at their trade than I'm sure they would have no problem going cash only. I also think being business savy goes a long way, but that can be said in many fields of medicine.

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[Lewist02]

OP, if you have an interest in learning OMM and the DO school has other positives for you (location, tuition, etc) then you would not be crazy to give up MD acceptances. If you don't have too much interest in OMM, why go to Osteopathic School even if it is just for the other positives. 1/5th of the complex will cover osteopathic medicine, so it wouldn't be worth it in that case.

And it seems a lot of people (not here but in general) are confused on the "Philosophy" of Osteopathic Medicine. Yes you can learn to treat a patient "holistically" whether you're an MD, DO, NP, PA, etc. This old philosophy started during a time when Allopaths were still using toxic treatments on patients that were proven to be less effective than Osteopathy during the Spanish flu. Today, Osteopathic Medicine is more centered mainly on the laying of hands on the patient to diagnose (and occasionally treat). For example, if a patient comes into the ER with a diagnosed MI, and you treat the MI, but they still have a Chapman's reflex over the Pec maj due to the MI, they will still suffer from chest pain that is unrelated to angina but that many doctors would confuse with angina and treat with nitrates, instead of some soft tissue or rib raising.

Many D.Os do not use manipulative medicine in practice, but no matter what your specialty, it could be used effectively. I think many students put it in the back of their mind when focusing on the main curriculum, which is unfortunate given all of the Evidence Based Medicine in favor of Osteopathic treatment. No matter what your degree though, it is nice to have practicing D.Os who have an additional tool, as well as MDs who may have more experience with other areas of research. The focus should be on medical staff acting as a team and utilizing all resources available.

 

[Instatewaiter]

Today, Osteopathic Medicine is more centered mainly on the laying of hands on the patient to diagnose (and occasionally treat). For example, if a patient comes into the ER with a diagnosed MI, and you treat the MI, but they still have a Chapman's reflex over the Pec maj due to the MI, they will still suffer from chest pain that is unrelated to angina but that many doctors would confuse with angina and treat with nitrates, instead of some soft tissue or rib raising.

Sigh

I think many students put it in the back of their mind when focusing on the main curriculum, which is unfortunate given all of the Evidence Based Medicine in favor of Osteopathic treatment.

double sigh

 

[Hoya2011]

OP, if you have an interest in learning OMM and the DO school has other positives for you (location, tuition, etc) then you would not be crazy to give up MD acceptances. If you don't have too much interest in OMM, why go to Osteopathic School even if it is just for the other positives. 1/5th of the complex will cover osteopathic medicine, so it wouldn't be worth it in that case.

And it seems a lot of people (not here but in general) are confused on the "Philosophy" of Osteopathic Medicine. Yes you can learn to treat a patient "holistically" whether you're an MD, DO, NP, PA, etc. This old philosophy started during a time when Allopaths were still using toxic treatments on patients that were proven to be less effective than Osteopathy during the Spanish flu. Today, Osteopathic Medicine is more centered mainly on the laying of hands on the patient to diagnose (and occasionally treat). For example, if a patient comes into the ER with a diagnosed MI, and you treat the MI, but they still have a Chapman's reflex over the Pec maj due to the MI, they will still suffer from chest pain that is unrelated to angina but that many doctors would confuse with angina and treat with nitrates, instead of some soft tissue or rib raising.

Many D.Os do not use manipulative medicine in practice, but no matter what your specialty, it could be used effectively. I think many students put it in the back of their mind when focusing on the main curriculum, which is unfortunate given all of the Evidence Based Medicine in favor of Osteopathic treatment. No matter what your degree though, it is nice to have practicing D.Os who have an additional tool, as well as MDs who may have more experience with other areas of research. The focus should be on medical staff acting as a team and utilizing all resources available.

[YOUTUBE]http://www.youtube.com/watch?v=y5FdDwbtdjU[/YOUTUBE]

 

[Sinfest]

[YOUTUBE]http://www.youtube.com/watch?v=y5FdDwbtdjU[/YOUTUBE]

The end of the video

 

[Lewist02]

Sigh




double sigh

That's unfortunate that you portray such a negative perspective. If anyone is genuinely interested in some research articles regarding OMT in addition to common care practices, I'd be happy to help.

 

[Charles_Carmichael]

That's unfortunate that you portray such a negative perspective. If anyone is genuinely interested in some research articles regarding OMT in addition to common care practices, I'd be happy to help.

Can you cite some well-done phase II/III trials please? What are considered seminal RCTs supporting OMM? I'm genuinely interested since I've never really taken the time to read osteopathic literature before and I'm curious as to why most DOs (based on what I read on SDN) don't practice OMM if there's a lot of evidence behind it.

 

[Instatewaiter]

For example, if a patient comes into the ER with a diagnosed MI, and you treat the MI, but they still have a Chapman's reflex over the Pec maj due to the MI, they will still suffer from chest pain that is unrelated to angina but that many doctors would confuse with angina and treat with nitrates, instead of some soft tissue or rib raising.

So while you give the patient a back rub, I'll be cathing them. We'll see whose patient comes out better. To be fair, neither of our patients will have chest pain... yours because he's dead.

 

[JeetKuneDo]

Can you cite some well-done phase II/III trials please? What are considered seminal RCTs supporting OMM? I'm genuinely interested since I've never really taken the time to read osteopathic literature before and I'm curious as to why most DOs (based on what I read on SDN) don't practice OMM if there's a lot of evidence behind it.

I agree, there has to be a reason why most DO's outside of omm specialist don't use it in the field. It has to be way too time consuming, among other things.

 

[Lewist02]

I agree, there has to be a reason why most DO's outside of omm specialist don't use it in the field. It has to be way too time consuming, among other things.

You're absolutely right. Many osteopathic techniques can be time consuming, which is why the majority of them aren't seen outside of a manipulative specialist. There are some very useful techniques that can be done efficiently, though, and that I have seen done even in a hospital icu setting (Post operative ileus, rib raising, lymphatic pumps). The point that I am trying to make is that OMT can be used as a supplement when appropriate. It is by no means meant to be used in place of the standard care of medicine, but if a small amount of manipulation can make a patient more comfortable without increasing a medication, or get them out of the hospital sooner, it is very useful. You will also see a good amount of D.Os that matriculate without having interest in OMT. There are a lot of students even at PCOM who have had no interest in Osteopathic Medicine from the beginning...and would I expect them to use it in the field? If they aren't interested now...I don't see why that would change. And they will still be great doctors, but they just won't use OMT as a supplement to their work.

My dad was in the cardiac ICU for 8 weeks after an out of hospital cardiac arrest, and developed pneumonia 3 days in. One of the neurology residents was a DO from KCOM and he used thoracic pump and pedal pump on my dad a few days after the onset of pneumonia (and obviously my dad was on antibiotic therapy). My dad was coughing up a lot more sputum than before the treatment.

 

[Lewist02]

So while you give the patient a back rub, I'll be cathing them. We'll see whose patient comes out better. To be fair, neither of our patients will have chest pain... yours because he's dead.

You're a very ignorant doctor if you really believe a competent D.O would use OMT in an emergency setting before using the standard of care. Especially considering a doctor is only allowed 90 minutes from the time a patient enters an ER with an acute MI to the time they get to a cath lab, whether they have to be flown or not, before it is considered a delay of care, at least in PA.

And incase you misunderstood the purpose of my reply, Chapman's reflexes exist more than 80% of the time after an acute MI, and the point I was making was that AFTER the standard of care is executed, OMT can be used to supplement any further dysfunction the patient may have. This is obviously following any cath, ekg, medication therapy, or surgery that needs to be preformed.

 

[Lewist02]

So while you give the patient a back rub, I'll be cathing them. We'll see whose patient comes out better. To be fair, neither of our patients will have chest pain... yours because he's dead.

In terms of seminal research, a lot of the ground work of OMM has obviously been from AT Still’s time throughout maybe the 80’s. J Travell has some good seminal research regarding trigger points (later work will cover using trigger points diagnostically). Louise Burns provided pivotal work on Somatic dysfunction and manipulation regarding tissue texture changes and the effects on the musculoskeletal system. Korr & Denslow provided research on facilitated segments (“the neurologic lens”) and the effects on axoplasmic flow (later research uses this basis for diagnosis and treatment of Visceral somatic and Somatic visceral pain reflexes). The majority of the research that I have come across recently always has a foundation of previous research. The JAOA is a great resource though. If you don’t mind I’m just going to list some interesting current articles I have read.

Noll DR, Shores JH, Gamber RG, et al. Benefits of osteopathic manipulative treatment for hospitalized elderly patients with pneumonia
*Noll has a lot of published work on OMT supplemental care in pneumonia

Gamber RG, Shores JH, Russo DP, Jimenez C, Rubin BR. Osteopathic manipulative treatment in conjunction with medication relieves pain associated with fibromyalgia syndrome: results of a randomized clinical pilot project. J Am Osteopath Assoc, 2002,102:321–325.
*There is on-going research at PCOM under Dr. Hartman using Korr and Denslow’s research of facilitated segments in the care of Fibromyalgia.

Wells MR, Giantinoto S, D'Agate D, Areman RD, Fazzini EA, Dowling D, et al. Standard osteopathic manipulative treatment acutely improves gait performance in patients with Parkinson's disease. J Am Osteopath Assoc. 1999;99(2):92 -98
*I know this is from ’99 but Dr. Burns did some further research at NYCOM, but I couldn’t find the article.

Guiney PA, Chou R, Vianna A, Lovenheim J. Effects of Osteopathic Manipulative Treatment on Pediatric Patients with Asthma. J am Osteopath Assoc. 2005;105(1):7-12
*Showed OMT helped to improve Peak Expiratory Flow

There are a lot of well done research studies on use of OMT in pain maintenance, but I figured that they are the most well known. I wanted to put some other interesting ones up. Lots of good studies on use of OMT for Insomnia, Depression, Infantile Colic, Post-operative pain, Tension headache (I don’t take Excedrin anymore after learning these techniques!). Great study done by a Dr from PCOM on “The Dirty Half Dozen” with the military. Couldn’t find the link from it, but I went to a discussion on it.

Again, all of these studies are going to show that OMT is a great supplement to the standard of care. In pneumonia for example, lymphatic pumps help to push the antibiotics through the system more effectively, therefore decreasing the amount needed, and increase the rate of discharge from the hospital. I do not think OMT should be used in place of our standard care practices, unless you are talking about acute and chronic pain management. Many of these studies have been funded by the backers of hospitals to find ways to decrease financial costs. Insurance companies started covering OMT in hospital care settings due to a lot of this research. Hope some of this sheds some light….I have to get ready for the Bahamas!!!!! ☺

 

[DrBowtie]

Haven't read the studies yet, but anything NOT published in JAOA?

 

[MSmentor018]

DO's can indeed apply to both MD & DO residency programs. However MD's have program's which will not accept any DO applicants and have an extreme advantage in terms of the more competitive residencies.

unfortunately very very true

But frankly.. knowing how most medical students on this board are.. you're more than likely going to stop attending class after the first year and simply study in your home/apt. As such your love of your school will be very unimportant.

that's how I felt so going to a non lecture med school (PBL) was my choice

 

[Instatewaiter]

In terms of seminal research, a lot of the ground work of OMM has obviously been from AT Still’s time throughout maybe the 80’s. J Travell has some good seminal research regarding trigger points (later work will cover using trigger points diagnostically). Louise Burns provided pivotal work on Somatic dysfunction and manipulation regarding tissue texture changes and the effects on the musculoskeletal system. Korr & Denslow provided research on facilitated segments (“the neurologic lens”) and the effects on axoplasmic flow (later research uses this basis for diagnosis and treatment of Visceral somatic and Somatic visceral pain reflexes). The majority of the research that I have come across recently always has a foundation of previous research. The JAOA is a great resource though. If you don’t mind I’m just going to list some interesting current articles I have read.

Noll DR, Shores JH, Gamber RG, et al. Benefits of osteopathic manipulative treatment for hospitalized elderly patients with pneumonia
*Noll has a lot of published work on OMT supplemental care in pneumonia

Wells MR, Giantinoto S, D'Agate D, Areman RD, Fazzini EA, Dowling D, et al. Standard osteopathic manipulative treatment acutely improves gait performance in patients with Parkinson's disease. J Am Osteopath Assoc. 1999;99(2):92 -98

Guiney PA, Chou R, Vianna A, Lovenheim J. Effects of Osteopathic Manipulative Treatment on Pediatric Patients with Asthma. J am Osteopath Assoc. 2005;105(1):7-12
*Showed OMT helped to improve Peak Expiratory Flow

Regarding: Noll DR, Shores JH, Gamber RG, et al. Benefits of osteopathic manipulative treatment for hospitalized elderly patients with pneumonia

I have already commented on this terribly designed study either in this thread or another. First an N of 58... more importantly there were MAJOR flaws which invalidate the findings because no standardization was made:
1) No initial vitals to stratify or compare. How do you not compare the vitals on admission? What we do know is that the white count was 3,000 points higher on the control group. We cannot tell who was initially sicker based on SIRS. MASSIVE FLAW
2) No standard course of Abx was decided upon as first line. This is not even commented on what type were chosen. Was therapy appropriate? Looking at the rest of the treatment one can assume no, the therapy was probably not.
3) No standardized metric created to decide when people should come off of Abx or be discharged
4) Standards of care were definitely NOT followed. For instance COPD patients did not get steroids. This draws into question who was treating these patients and was their therapy appropriate
5) Questionable treatment practices like repeating x-ray after 5 days of treatment. Any idiot knows resolution of infiltrate doesn't happen for weeks
6) No comparison to other modalities like chest PT
How these glaring flaws in methods got past the editors is beyond me... probably because it was published in a journal that had some conflict of interest.


Regarding: Osteopathic manipulative treatment in conjunction with medication relieves pain associated with fibromyalgia syndrome: results of a randomized clinical pilot project. J Am Osteopath Assoc, 2002,102:321–325.
- I'm not going to read this one because quite frankly I want to stay as far away from fibromyalgia as possible. Let's assume it was a good study.


Regarding: Standard osteopathic manipulative treatment acutely improves gait performance in patients with Parkinson's disease
1) They took the patients off of their parkinson's meds... how can you assess it's efficacy with medication... you can't. Who is going to take a pt off meds to treat them with OMM? What is the use of this... probably because they tried it without taking the meds off and didn't see a difference.
2) the sham procedure made people get worse. What on earth were they doing?
3) The OMM consists of stretching the rigid muscles of the parkinsonian pt while the sham just did ROM. Why not stretch the muscles but not using OMM? The pt is already off of their dopamine agonist.
4) Finally and most importantly, this study was essentially clinically useless. It didn't assess the impact on the patient far enough away from the treatment or with meds. Who cares if the pt has better strides 10 minutes after the procedure but goes right back to normal within an hour. In that case the procedure is completely worthless.

In the end, not exactly a well designed or clinically useful study. It is definitely suspect since the patients got worse with the sham procedure in every metric.


Regarding: Effects of Osteopathic Manipulative Treatment on Pediatric Patients with Asthma.

Touted as showing that OMT may significantly improve pulmonary function for pediatric patients with asthma ... the only problems, is it has 2 major flaws which invalidate the study:
- Most importantly is that the conclusion is wrong since the change in peak flow was clinically insignificant (change of 12, when a normal peak flow is 400... big whoop, 3% change. If you have an asthmatic do the peak flow multiple times in the course of 10 minutes you will routinely have at least a 5% change). Thus the change is within the error of the test.
- the doctors taking the reading were the OMM docs who weren't blinded

I will agree though that for low back pain, and some muscular pain that it works

 

[NYEMMED]

Unless you are planning on going to Family Med or wanna be OMM specialist, picking DO school doesn't make sense over MD.

Lets take a look at this. Lets look at NYCOM's 2008 match list, b/c I have a paper copy in front of me... Ill write the amount matched in specialties, and highlight some programs I think stand out:

11- Anesthesiology @ Montefiore, U.Mass, U. Rochester( x3)

1- Pediatric Neurology @ Bostons Childrens' Hosp.

3 Dermatology @ Montefiore

9 Diagnostic Radiology @ Yale-NewHaven Hospital, Beth Israel, Hartford,

35 Emergency Med. @ Jacobi, Mt. Sinai Med Center

3 Combined EM-FP

2 Combined EM-IM

Fam. Med. @ Georgetown-providence hospital, Columbia-NYP, Stamford hosptial/Columbia, Long Beach CA,

14 General Surgery

IM @ Beth Israel, Johns Hopkins-Bayview, Northwestern, Sinai Grace Hospital, USC cali

5- Neurology

3- Neurosurgery

OB/GYN @ Albany, Beth Israel, NY Downtown, NY Methodist, Stamford Hospital/Columbia

2- Ophthalmology

10- Orthopedic Surgery

3- Pathology @ Mayo Clinic

Pediatrics @ U.Conn(x2), U.Rochester, U.FL, Robert-wood Johnson

19 PM&R @ Montefiore, NYU(X5), U.Wash, U.Penn

Psych @ NYU

1- oto-plastic Surgery

Not Including Military

51% of graduating class specialized (IE: not Primary Care I included OB/GYN, Peds, Psych, FM, IM, as primary care)
50% went Allopathic

NYCOM has match lists like this year after year, its very good, and has many "unreachable" spots on it every year...

 

[SFO-IST]

OP, if you have an interest in learning OMM and the DO school has other positives for you (location, tuition, etc) then you would not be crazy to give up MD acceptances. If you don't have too much interest in OMM, why go to Osteopathic School even if it is just for the other positives. 1/5th of the complex will cover osteopathic medicine, so it wouldn't be worth it in that case.

And it seems a lot of people (not here but in general) are confused on the "Philosophy" of Osteopathic Medicine. Yes you can learn to treat a patient "holistically" whether you're an MD, DO, NP, PA, etc. This old philosophy started during a time when Allopaths were still using toxic treatments on patients that were proven to be less effective than Osteopathy during the Spanish flu. Today, Osteopathic Medicine is more centered mainly on the laying of hands on the patient to diagnose (and occasionally treat). For example, if a patient comes into the ER with a diagnosed MI, and you treat the MI, but they still have a Chapman's reflex over the Pec maj due to the MI, they will still suffer from chest pain that is unrelated to angina but that many doctors would confuse with angina and treat with nitrates, instead of some soft tissue or rib raising.

Many D.Os do not use manipulative medicine in practice, but no matter what your specialty, it could be used effectively. I think many students put it in the back of their mind when focusing on the main curriculum, which is unfortunate given all of the Evidence Based Medicine in favor of Osteopathic treatment. No matter what your degree though, it is nice to have practicing D.Os who have an additional tool, as well as MDs who may have more experience with other areas of research. The focus should be on medical staff acting as a team and utilizing all resources available.

Are you referring to the COMLEX?

 

[JaggerPlate]

So while you give the patient a back rub, I'll be cathing them. We'll see whose patient comes out better. To be fair, neither of our patients will have chest pain... yours because he's dead.

You're a very ignorant doctor if you really believe a competent D.O would use OMT in an emergency setting before using the standard of care. Especially considering a doctor is only allowed 90 minutes from the time a patient enters an ER with an acute MI to the time they get to a cath lab, whether they have to be flown or not, before it is considered a delay of care, at least in PA.

You're absolutely right, and instate knows this. No competent DO (especially one trained in an ACGME/AOA ER program WORKING as an EM physician in an ER) is going to do this.

 

[JaggerPlate]

Just as an aside ... OMM is, and has always been, slow when it comes to research. Frankly, I think it has more to do with the fact that what it treats (effectively) is pretty basic stuff and a lot of people aren't going to take the time to perform and publish big studies just to prove (again) that it works effectively for back pain (like the studies in the NEJM and the Journal of OB/GYN).

As far as the other studies are concerned ...

1. OMM (and manual medicine in general) is a notoriously tricky subject to research. It doesn't lend itself well to research when it's nearly impossible to create a double blind scenario from the beginning and when the 'sham' (placebo) treatments are subject to more of a reaction than a simple psychological effect created by a sugar pill in some other study.

2. Having said that ... it's still not an excuse. If we do want better integration, better usage, less irritating arguments, we really do need to push for effective, sound research.

3. Half the reason why some of these studies are subject to such error is because they are conducted by the people who want to believe that OMM can cure cancer and complex AI diseases ... not the good clinicians who see it as a valid treatment for MSK issues and an adjunct to good primary care. Any researcher who's grasping for something outside the realm of reality is going to run into issues somewhere (IMO)

4. HOWEVER ... I do feel like people are overtly critical when it comes to OMM studies. You could take a study from almost any 'eh' journal out there and find multiple flaws if you were subjective, really looked for them, etc. I had to do this MANY times in undergrad science journals (for some research based classes) and this holds true for even some of the very valid publications. However, it makes me wonder whether or not some of the people in this threads would hold other studies to the same standard or if they may be more willing to simply blindly accept what it has to state because it doesn't involve DOs or OMM.

 

[SLUser11]

I had to skip the majority of this thread due to its length.

To the OP: Pick the MD school. If you are accepted to a US allopathic medical school, there are very few things in the world that should persuade you to go DO or IMG.

This is coming from a chief surgical resident who, unlike the majority of people in this thread, actually has a lot of experience with the match, as well as both MD and DO students, and MD and DO residents (and lots of MD and DO attendings). I've seen it all, and I've seen a lot of situations not work out for people because of their DO education.

The bias against DOs never goes away. It affects match and residency, job opportunities, promotion, referrals, etc. Even if it's not fair, it's definitely there, and people who say it's not are trying to justify their decision, and are almost never impartial.

Seriously, just pick the MD school....even if it is twice as expensive (which it's not).

I'm sure there will be witty replies to this, so I want to say that:

1. I have many DO friends that I believe are excellent residents and physicians, and sometimes superior to their MD colleagues.

2. I am unlikely to check back at this thread, as I was pulled in from the SDN main page and I don't check the Pre-DO forums.




Pick the MD school, pick the MD school, pick the MD school.

 

[JaggerPlate]

I had to skip the majority of this thread due to its length.

To the OP: Pick the MD school. If you are accepted to a US allopathic medical school, there are very few things in the world that should persuade you to go DO or IMG.

This is coming from a chief surgical resident who, unlike the majority of people in this thread, actually has a lot of experience with the match, as well as both MD and DO students, and MD and DO residents (and lots of MD and DO attendings).

ACGME surgery is notoriously DO unfriendly. I understand that you're far along in this entire process, but honestly, this perspective puts a LOT of bias in your OPINIONS (imo) and should be noted.

I've seen it all, and I've seen a lot of situations not work out for people because of their DO education.

So you're involved with residency selection at your program and you've seen highly qualified MD candidates picked above DO candidates. Shocking. Like I said, you're in a relatively competitive field that notoriously unfriendly toward DO applicants.

I suggest that people look at the objective ACGME data and make opinions from there.

The bias against DOs never goes away. It affects match and residency, job opportunities, promotion, referrals, etc. Even if it's not fair, it's definitely there, and people who say it's not are trying to justify their decision, and are almost never impartial.

This is absurd and absolutely untrue. You're going to sit here and tell me that a DO who trained in an ACGME residency stands any less chance at a position than an MD from the same program? Simply untrue.

If this was true, in any way, shape, or form, you simply wouldn't see DOs on staff at hospitals, DOs succeeding in private practice, DOs obtaining new patients, etc, etc, etc. Despite what some may claim, the vast majority of medical fields aren't suffering from any sort of shortage, and if this horrendous bias (which you claim) were true, then the DOs in this field would be in the food stamp line, not running successful private practices. Dangerously false information.

If you want to say that DOs have a rough time matching into ACGME surgery (specifically at your program), then that's fine (and doesn't even take the AOA g-surg spots into account), but to say that it will affect your referrals, upward mobility, and well being just isn't true (and demonstrates extreme tunnel vision)

Seriously, just pick the MD school....even if it is twice as expensive (which it's not).

I don't think I've ever told someone to simply pick DO over MD. I have told people to analyze the situation and make a decision based on a lot of personal factors. If people want the MD degree or would feel more comfortable with the matching prospects coming from an MD school (ie: fits personal preferences) ... God bless. Go and do well.

1. I have many DO friends that I believe are excellent residents and physicians, and sometimes superior to their MD colleagues.

This reminds me of when people preface a statement by saying "I'm not racist, I swear, I have minority friends, but" ... and then go on to say something ignorant, foolish, and true of their honest beliefs, but outside of the accepted social norm.

Your mindset/opinions are disappointing.

people who say it's not are trying to justify their decision, and are almost never impartial ... I am unlikely to check back at this thread, as I was pulled in from the SDN main page and I don't check the Pre-DO forums.

1. It's hilarious that you believe you're impartial - oh wait, you have DO friends who are kewl ... nevermind

2. This strategy always makes for a strong, valid argument - If you disagree with me, it's because you're justifying ... OH, and I won't come back to argue this again so "inwiththelastword" BYE!!!


Listen, we all appreciate the input from a resident, and clearly you have more knowledge on the subject, but it's abundantly clear that a. you're biased b. you're in a situation where the "discrimination" is notorious (ACGME surgery - ask around, it's the consensus) and c. you're making claims that are above your own personal pay grade here, and just sound absurd.

Thank you for the input, but for anyone else reading this (who is lured by the 'resident' title), just be aware of the bias.

 

[JaggerPlate]

UGH, I just realized that, by involving myself, I will be battling in this thread, wasting countless hours a day, until it's inevitable lock.

Any mods want to do me a solid and lock it now (and save me an infraction for "insulting other members")????

 

[tkim]

DO grad, MD residency.

Lowest tuition uber alles.

Unless you want super competitive surgical specialty. Then pick MD.

If you don't know what you want, pick MD, so when you decide you want to do super competitive surgical specialty, you won't have a bunch of old white men crapping on your app come residency time.

Simple.

 

[mrpuff26]

Well I don't know if the OP is still reading this, but I saw this thread on the main page and I thought I'd respond...

I was faced with the same decision last year as well.

http://forums.studentdoctor.net/showthread.php?t=701288

Please read the above thread as it goes through a ton of the same arguments as is going on in this thread.

Ultimately I ended up choosing TCOM over a MD school and you know what? I couldn't be happier.

Good luck with your decision. Try not to let the guys on here get to you too badly. You, yourself, have to ultimately decide what is best.

 

[Drrrrrr. Celty]

Texas content is not applicable to this situation. TCOM = any other Texas state institute in the eyes of Texas residencies. Not to mention TCOM is 8k a year.

 

[NurWollen]

I can't say I'd go DO over MD, I don't currently plan on applying MD, so I'll never know. I do think DO is genuinly a better fit for some people.

To paraphrase a DO surgeon I shadowed, a lot of the 'DO difference' is kind of a cultural one. This DO said he felt like his DO residency had more of a humane atmosphere. They were more supportive of the fact that his family came before work, etc. They still worked him into the ground, and he feels he surgical skills are just as sharp as if he had done and ACGME residency, but that they were just more humane.

I infer that this means less, "Instead of going home now to your family why don't you scrub in with me at 2:00 AM and hold the retractor for me just because I'm a resident/attending and you're an intern and I said so."

This was just on DO's comment, though, so it is just anecdotal. It might have had more to do with his program than anything else.

 

[NurWollen]

Texas content is not applicable to this situation. TCOM = any other Texas state institute in the eyes of Texas residencies. Not to mention TCOM is 8k a year.

Ironic then that they are so intent on starting a parallel MD school.

 

[Drrrrrr. Celty]

Ironic then that they are so intent on starting a parallel MD school.

I think TCOM want's to simply expand. But overall this really only continues to benefits the Texas student as they get another school which will accept only 5%> non-Texans.

 

[NurWollen]

I think TCOM want's to simply expand. But overall this really only continues to benefits the Texas student as they get another school which will accept only 5%> non-Texans.

A few years ago when I started undergrad, my parents were thinking of moving from California. I tried to get them to go to Texas for this very reason.

 

[Drrrrrr. Celty]

A few years ago when I started undergrad, my parents were thinking of moving from California. I tried to get them to go to Texas for this very reason.

I wouldn't mind being a Texas resident. The climate is nice and the medical schools rock. Who cares that the people outside the cities would likely crucify me?

 

[Guek]

I can't say I'd go DO over MD, I don't currently plan on applying MD, so I'll never know. I do think DO is genuinly a better fit for some people.

To paraphrase a DO surgeon I shadowed, a lot of the 'DO difference' is kind of a cultural one. This DO said he felt like his DO residency had more of a humane atmosphere. They were more supportive of the fact that his family came before work, etc. They still worked him into the ground, and he feels he surgical skills are just as sharp as if he had done and ACGME residency, but that they were just more humane.

I infer that this means less, "Instead of going home now to your family why don't you scrub in with me at 2:00 AM and hold the retractor for me just because I'm a resident/attending and you're an intern and I said so."

This was just on DO's comment, though, so it is just anecdotal. It might have had more to do with his program than anything else.

I'd like to echo this sentiment. I freely admit that I might be completely wrong here, but the overriding feeling I seem to get is that DO schools feel less competitive among students and that community and cooperative learning are very important. I've heard horror stories about MD programs where they lay on the pressure so thick that some students refuse to study together because they don't want to give their classmates any edge. A lot of pro-MD people on this board also seem to be saying that most students just study at home and don't even go to lecture. This just did not seem to be the overall attitude at the schools I interviewed and toured.

Of course, that could have all been a false representation of those schools. That would be surprising though because the student communities at those DO schools felt really really strong. I personally find that approach to teaching to be far more appealing than the hyper-competitiveness at MD schools.

But this is just my impression and I may be totally off base here. I'm not trying to say that any specific MD school doesn't have a strong student community. In fact I'm sure I'm wrong at least on a few cases.

 

[TornadoChaser]

Well I'll tell you what, I may only be applying to one MD school. If I get in, I'll probably go there (state school). If not, I'll likely end up at a DO school for a few reasons.

1. I'm a non-trad, and my undergrad gpa is not that great. I may not even make the cut to have my app considered at a lot of MD schools. However, if any of them can look past this, I think they'll find I'm fully capable of being a top student at any school.

2. Since I only have one state school, if I don't get in there, I'm looking at out of state tuition. Most of the DO schools are private schools, and while tuition might be more than my state school, for most of them it is significantly less than out of state tuition at a state-run MD school.

3. Like I said I am a non-trad, and from what I've read the DO schools seem to be very non-trad friendly.

Ultimately my decision will be based on the school itself, and I'll just throw out whether it is MD or DO. My state school has a great reputation, and I'd probably put it above any DO school, and a lot of other MD schools for that matter.

 

[SFO-IST]

I can't say I'd go DO over MD, I don't currently plan on applying MD, so I'll never know. I do think DO is genuinly a better fit for some people.

To paraphrase a DO surgeon I shadowed, a lot of the 'DO difference' is kind of a cultural one. This DO said he felt like his DO residency had more of a humane atmosphere. They were more supportive of the fact that his family came before work, etc. They still worked him into the ground, and he feels he surgical skills are just as sharp as if he had done and ACGME residency, but that they were just more humane.

I infer that this means less, "Instead of going home now to your family why don't you scrub in with me at 2:00 AM and hold the retractor for me just because I'm a resident/attending and you're an intern and I said so."

This was just on DO's comment, though, so it is just anecdotal. It might have had more to do with his program than anything else.

I have always been uneasy as I hear things like this (nothing personal NurWollen!) on SDN's osteopathic section. While work life balance is great and I appreciate it's contribution to optimal function and learning, there is a reason why residencies are so intense beyond "this is how it was for us, so we're making it difficult for you". Residencies are this intense to give the residents MORE EXPERIENCE. I want my attending surgeon to come from a residency where s/he was forced to stay up at 2am to hold the protractors at that one surgery where the patient had that rare complication. I want my surgeon to be a BAD-ASS who developed the strength to stay up at that hour so that if my surgery goes on longer than planned, s/he has the stamina and experience to take care of the complications.

NurWollen, I want to again emphasize that this is not personal, but for your own operation, would you honestly prefer the attending surgeon who went to the crazy intense residency or the one who went to the one with less exposure when you are about to get under the knife? I will end by mentioning that I once heard an interviewing applicant talk about Osteopathic physicians "carrying themselves differently" and "more humanistically" once while in a group interview at an Osteopathic Med School. The poor applicant was torn to pieces by the interviewers, who pointed out that the statement basically insulted the MD's that made up some of the faculty at the SOM! Be warned....

 

[Doctor4Life1769]

Honestly, if you have an MD acceptance and especially if it's instate... take it. Sure, you can succeed as a DO, as I have (pending Thurs) but there was a lot of headache and heartache involved along the way.

 

[cliffhuxtableDO]

Honestly, if you have an MD acceptance and especially if it's instate... take it. Sure, you can succeed as a DO, as I have (pending Thurs) but there was a lot of headache and heartache involved along the way.

isnt that just the nature of medical school anyway?

 

[SLUser11]

I'm glad I bookmarked this thread.

This is absurd and absolutely untrue. You're going to sit here and tell me that a DO who trained in an ACGME residency stands any less chance at a position than an MD from the same program? Simply untrue.

Now you accuse me of being biased....I would argue that you are being naive. You have much more dog in this fight than I do. The presence or absence of a bias against DOs won't really affect me.

DOs who trained in ACGME programs are still at a disadvantage when it comes to fellowship placement and academic job opportunities. The numbers don't lie, and you can look at the nrmp website if you want some cold hard facts.

If this was true, in any way, shape, or form, you simply wouldn't see DOs on staff at hospitals, DOs succeeding in private practice, DOs obtaining new patients, etc, etc, etc. Despite what some may claim, the vast majority of medical fields aren't suffering from any sort of shortage, and if this horrendous bias (which you claim) were true, then the DOs in this field would be in the food stamp line, not running successful private practices. Dangerously false information.

DOs can do just fine, but they simply won't have the same pound-for-pound opportunities as their allopathic competition. The DO will have to be at the top of his class to compete with MDs in the middle of their class....so why should the OP handicap himself before he even knows what specialty he'll pick?

If you want to say that DOs have a rough time matching into ACGME surgery (specifically at your program), then that's fine (and doesn't even take the AOA g-surg spots into account), but to say that it will affect your referrals, upward mobility, and well being just isn't true (and demonstrates extreme tunnel vision).

Tunnel vision? Who is more qualified to comment on something like this, you or me? I've actually seen what life is like after med school. I've been friends with a lot of DO graduates, and we've discussed their struggles and triumphs.

As far as my program goes, I think we're relatively "DO-friendly," having 2 current residents who are DO, both of whom are at the top of their PGY class as far as academics and clinical skills.

Referrals will be affected in areas where there are primarily MDs in primary care, because they will often have this unfair bias that you've already mentioned. If you choose to practice in an area where DOs make up a large portion of the the FPs, then it will be less of an issue. Here in Wichita, there are a lot of DOs in FP, and there are a handful of DO surgeons in town....one group in particular does very well, while the other does primarily trauma and have very few general surgery referrals.

As far as upward mobility, this primarily has to do with academic medicine and surgery. This is also regional, but most places I've trained and interviewed at have very few DOs on faculty, and I've never met a DO chairman yet. I'm sure they exist, but it would be silly to think their title is not a hindrance to their professional mobility.

This reminds me of when people preface a statement by saying "I'm not racist, I swear, I have minority friends, but" ... and then go on to say something ignorant, foolish, and true of their honest beliefs, but outside of the accepted social norm.

Your mindset/opinions are disappointing.

1. It's hilarious that you believe you're impartial - oh wait, you have DO friends who are kewl ... nevermind

2. This strategy always makes for a strong, valid argument - If you disagree with me, it's because you're justifying ... OH, and I won't come back to argue this again so "inwiththelastword" BYE!!!

I wasn't trying to make it seem like I was chummy with a bunch of DOs to eliminate bias. The fact is that Kansas is jam-packed with DOs, and there are many inside and out of surgery that I am friends with, others I dislike, etc. That's irrelevant.

My point was that I don't think DO is an inferior education, and in fact the 2 DOs in my program are very strong. I guess it was to point out that overall I think the bias against DOs is unfair.

Listen, we all appreciate the input from a resident, and clearly you have more knowledge on the subject, but it's abundantly clear that a. you're biased b. you're in a situation where the "discrimination" is notorious (ACGME surgery - ask around, it's the consensus) and c. you're making claims that are above your own personal pay grade here, and just sound absurd.

Thank you for the input, but for anyone else reading this (who is lured by the 'resident' title), just be aware of the bias.

Well, you're kind of illustrating my point. My main statement in the previous post is that there is a severe bias against DOs, and that unfortunately that bias never completely goes away. You guys can tell yourselves all day that once you're in residency (and then practice) that nobody will care, but it's simply wrong.

If you don't have a choice, then I think a DO education is great, and you can become an excellent physician. However, choosing a DO school over a US allopathic school is handicapping yourself. You can still do very well, but it will be more of an uphill battle....and there will ultimately be some doors that will be closed to you, which is bad if you don't know exactly what you want to be when you grow up.


As far as my comment about not re-checking this thread, it was because I was afraid I was going to be attacked by people like you, and solicited by pre-meds for more information. The truth is, I am a total "last word freak" and as hard as I tried, I had to come back and check this thread again.

Please don't misinterpret my posts to mean that I think MDs are better than DOs. I've just been around for a while, and I know that unfair biases exist. Since the OP had a choice, I told him to go with the easier road. It doesn't mean the other road is a bad one....just more uphill.

 

[Asianboy]

Nice argument. It's a beauty in a freedom country. People can freely express their idea and advocate it. You guys both have a point.

I'm glad I bookmarked this thread.



Now you accuse me of being biased....I would argue that you are being naive. You have much more dog in this fight than I do. The presence or absence of a bias against DOs won't really affect me.

DOs who trained in ACGME programs are still at a disadvantage when it comes to fellowship placement and academic job opportunities. The numbers don't lie, and you can look at the nrmp website if you want some cold hard facts.





DOs can do just fine, but they simply won't have the same pound-for-pound opportunities as their allopathic competition. The DO will have to be at the top of his class to compete with MDs in the middle of their class....so why should the OP handicap himself before he even knows what specialty he'll pick?



Tunnel vision? Who is more qualified to comment on something like this, you or me? I've actually seen what life is like after med school. I've been friends with a lot of DO graduates, and we've discussed their struggles and triumphs.

As far as my program goes, I think we're relatively "DO-friendly," having 2 current residents who are DO, both of whom are at the top of their PGY class as far as academics and clinical skills.

Referrals will be affected in areas where there are primarily MDs in primary care, because they will often have this unfair bias that you've already mentioned. If you choose to practice in an area where DOs make up a large portion of the the FPs, then it will be less of an issue. Here in Wichita, there are a lot of DOs in FP, and there are a handful of DO surgeons in town....one group in particular does very well, while the other does primarily trauma and have very few general surgery referrals.

As far as upward mobility, this primarily has to do with academic medicine and surgery. This is also regional, but most places I've trained and interviewed at have very few DOs on faculty, and I've never met a DO chairman yet. I'm sure they exist, but it would be silly to think their title is not a hindrance to their professional mobility.



I wasn't trying to make it seem like I was chummy with a bunch of DOs to eliminate bias. The fact is that Kansas is jam-packed with DOs, and there are many inside and out of surgery that I am friends with, others I dislike, etc. That's irrelevant.

My point was that I don't think DO is an inferior education, and in fact the 2 DOs in my program are very strong. I guess it was to point out that overall I think the bias against DOs is unfair.




Well, you're kind of illustrating my point. My main statement in the previous post is that there is a severe bias against DOs, and that unfortunately that bias never completely goes away. You guys can tell yourselves all day that once you're in residency (and then practice) that nobody will care, but it's simply wrong.

If you don't have a choice, then I think a DO education is great, and you can become an excellent physician. However, choosing a DO school over a US allopathic school is handicapping yourself. You can still do very well, but it will be more of an uphill battle....and there will ultimately be some doors that will be closed to you, which is bad if you don't know exactly what you want to be when you grow up.


As far as my comment about not re-checking this thread, it was because I was afraid I was going to be attacked by people like you, and solicited by pre-meds for more information. The truth is, I am a total "last word freak" and as hard as I tried, I had to come back and check this thread again.

Please don't misinterpret my posts to mean that I think MDs are better than DOs. I've just been around for a while, and I know that unfair biases exist. Since the OP had a choice, I told him to go with the easier road. It doesn't mean the other road is a bad one....just more uphill.

 

[87DO15]

Edit: Not worth it.

 

[MLT2MT2DO]

edit: Not worth it.

+1

 

[Bravetown]

So while you give the patient a back rub, I'll be cathing them. We'll see whose patient comes out better. To be fair, neither of our patients will have chest pain... yours because he's dead.

This is going to insight a pre-med trying to school a resident comment, but oh well. Dude that is some truly ignorant **** man and your previous comment about a Top DO applicant and a mediocre MD applicant getting the same residency, you see the irony in this yes. Even when the DO is a better physician the MD still feels superior.

On another topic, why does everyone get so up in arms about having a better chance at a particular specialty when half of the MD applicants end up doing primary care, I guess better location or residency program, but all the people on here who want to do derm this is going to be you
[YOUTUBE]http://www.youtube.com/watch?v=J8YMgQc6I4U[/YOUTUBE]

 

[JeetKuneDo]

This is going to insight a pre-med trying to school a resident comment, but oh well. Dude that is some truly ignorant **** man and your previous comment about a Top DO applicant and a mediocre MD applicant getting the same residency, you see the irony in this yes. Even when the DO is a better physician the MD still feels superior.

On another topic, why does everyone get so up in arms about having a better chance at a particular specialty when half of the MD applicants end up doing primary care, I guess better location or residency program, but all the people on here who want to do derm this is going to be you
[YOUTUBE]J8YMgQc6I4U[/YOUTUBE]

I think he does have some valid points though. It's not just the derm though. It's been said numerous times on SDN that MD surgery is pretty hard for DO to enter, though not impossible. Since no one knows for sure what field they want to enter, given this situation, choosing the MD over the DO is probably the safer choice. Say if somehow at the end of the 3 years you have the scores to compete at "top" surgery programs, I think it would be a shame to let initials after your name dictate whether you get in or not. I think that MD will leave more doors open, but both degrees will have to work hard either way.

 

[Bravetown]

I agree, but at the end of year 3 if you don't have the scores then it won't matter for either MD or DO, but ya I get what your saying about MD surgery residency competitiveness. Lets face it though, everyone thinks they have the stuff to get that residency in year 1, which sounds a lot like most pre-meds we knew when we all started out and look how that worked out.

 

[christoferreeve]

Normally I don't comment on these blogs simply because most people aren't going to change their views anyway. But I'll throw in my perspective because a lot of these ideas seem too "pre-med" atated.

Anyways to the OP and anyone else considering it, you should choose the program that fits you best. It is true that choosing a DO route will limit your residency prospects in the future. I currently work in a department which has a residency program that has never taken a DO and probably never will, so I know this occurs. But, by choosing a program simply because its MD could hinder your performance. For example, say you don't mesh well with the curriculum or perhaps their review of step 1 and 2 aren't adequate enough. Your scores will suffer and so will your residency placement. Also consider this. In every med school someone has to finish at the bottom of their class. Sure, finishing last at Harvard still probably looks respectable, but if you enter a program in which you are overrun with gunner elitists, your class rank has a chance of suffering alas your residency placement suffers. Picking a school in which you don't mesh will ultimately affect your residency as much as choosing a DO route. In any thought, we all know that MD and DO both can produce wonderful and wonderfully ****ty physicians. So, my thoughts are pick whatever is best for you.

 

[SLC]

I'd just like to say that I don't want any part of a residency that would deny a highly qualified DO to take a less qualified MD simply because of the letters behind his/her name. I wouldn't want to participate in that program regardless of whether I was a DO or MD student. In my view it's a matter of principle as the program is essentially putting style over substance there. Unfortunately it's the patient that get's shafted in the end when prejudice keeps the best equipped doctors away.

 

[NurWollen]

I'd just like to say that I don't want any part of a residency that would deny a highly qualified DO to take a less qualified MD simply because of the letters behind his/her name. I wouldn't want to participate in that program regardless of whether I was a DO or MD student. In my view it's a matter of principle as the program is essentially putting style over substance there. Unfortunately it's the patient that get's shafted in the end when prejudice keeps the best equipped doctors away.

Out of curiosity, you being from Salt Lake, I recently heard that there are rotations at the U of U that explicitly state that no osteopathic students are eligible to rotate there. Do you know anything about that? It's that kind of elitism that I am talking about. I think medicine would be healthier for patients, doctors, and the American taxpayers without such attitudes.

 

[SLC]

Out of curiosity, you being from Salt Lake, I recently heard that there are rotations at the U of U that explicitly state that no osteopathic students are eligible to rotate there. Do you know anything about that? It's that kind of elitism that I am talking about. I think medicine would be healthier for patients, doctors, and the American taxpayers without such attitudes.

To be honest I'm unaware if this is the case or not. I have seen osteopathic students rotating with U of U med-students, but that was outside of the U of U hospitals and clinics system. The U of U puts a lot of students in IM and Peds rotations at my clinic. Our Pediatrician is a triple board certified wonder woman, she really knows her stuff. She still claims to this day that her best student she ever precepted was a guy who came through last year from KCOM.

For another example, a friend of mine, who attended DMU, rotated anesthesiology in Ogden, Utah at an IHC (Intermountain Health Care) facility. Same place many U of U students elect to rotate anesthesiology. When I worked at the University of Utah hospital, I saw Ross and SGU students rotating in EM too (though they're Allopathic I suppose). I'm interested to know though, so I'm going to have to look into this further. I will also add that a former neighbor of mine was a PM&R resident at the U of U, she graduated from CCOM so I'm sure it's not an institutional problem with the U.

If I were wanting to come home for an elective rotation, it'd definitely be with IHC rather than at the U of U though. IHC is by far the better system, even the U of U students know that.

 

[Maybeknot]

I'm a pretty quantitative-type of guy, so I like to look at the hard numbers. From the NRMP's own stats, in 2010, 14992 out of 16070 allopathic seniors matched -- 93.3%. That same year, 1444 out of 2045 osteopathic seniors matched to ACGME residencies -- 70.6%. Note that this is active applicants, so excludes those that matched in the AOA match. This also doesn't take into account confounding factors like USMLE scores, away rotations, quality of LOR's, etc. This doesn't mean you should ignore the fact that the odds ratio for NOT matching is 4.33 if you're a DO applicant compared to an MD applicant.

I don't believe that being a DO makes you less qualified as a physician than an MD; I am saying that being a DO makes you less likely to get into an ACGME residency, which by even the AOA's reports is more sought after by DO grads. The reasons for this, IMO, are multifactorial. It's easy to chalk this up to blind prejudice and say "Oh I don't want to go to those programs anyways." If you believe the statistics.... odds are, you will be singing a different tune when you apply for residencies in 3.5 years.

 

[Bravetown]

I'd just like to say that I don't want any part of a residency that would deny a highly qualified DO to take a less qualified MD simply because of the letters behind his/her name. I wouldn't want to participate in that program regardless of whether I was a DO or MD student. In my view it's a matter of principle as the program is essentially putting style over substance there. Unfortunately it's the patient that get's shafted in the end when prejudice keeps the best equipped doctors away.

I agree with the "we need to get rid of MD/DO discriminating residencies", but even DO's have residency programs that are DO only, so honestly they need to change as well, but I get what you're saying.

 

[JuliaJulia]

MD>DO when it comes to getting a residency

 

[drctother]

yes juliajulia we are all aware that your friends grandmas stepsons uncle is an MD and he says DOs arent real people

same old ****, different toilet