Care to elaborate?
The only benefit I see is no longer having to rank AOA programs and thus forfeiting the ACGME match out of insecurity
There are numerous benefits.
1) The combined match is a pretty big one, and its not just a matter of insecurity, its a matter of logistics. Lots of people lose money and time interviewing at programs they'll never even be ranking because of the split match. Its not like you know which programs are going to invite you for an interview, so you apply AOA and ACGME, with the intent to drop one if things don't work out. AOA invites and interviews happen earlier, because the app cycle starts 2 mos earlier, so basically you have to either go on interviews or hold off. Even if you decide you'll only apply ACGME, its still costly, because basically you have to apply Sept 15th to all the programs you need to apply to guarantee sufficient interviews, which means you're applying to more programs than you normally would.
2) Eligibility for ACGME PGY 2 advanced residencies and for ACGME fellowships. This was on the chopping block prior to the merger agreement. Basically if you attended an AOA TRI or an AOA residency, your training wouldn't be recognized by a residency that starts in PGY2 (e.g. Neuro, Rads, Anesthesia, etc.) or a fellowship.
3) Standardization/improvement of AOA GME. There were literally AOA Derm programs in private Derm clinics that either paid <$30k/yr for residents or even didn't pay residents at all. Those can't exist anymore.
4) Securing ~28% of the voting seats on the ACGME board for DO organizations (AOA and AACOM) in a time when >50% of DO graduates trained ACGME, but had 0 representation or input into the ACGME.
5) Establishment of OMM and NMM RRCs under the ACGME in order to widen the potential practitioners of it to include MDs and as a result open the fields up to further research and standardization.
Those are probably the biggest benefits. There's also the fact that with all DOs applying ACGME, a lot more programs are going to get DO apps, become more familiar with DOs, be more likely to match them, and as a result open doors for future DOs in those programs. That of course is more of a long-term pro.
It is good for the profession overall for the reasons mentioned above, but it will be a rough go for those aiming for competitive fields that aren’t superstar applicants. I’m completely ok with that. Honestly I am far more concerned with the increase in competition overall due to the rapid increase of US medical students.
Yeah, it only really affects the marginal applicants in Gen Surg and Ortho and those at the very bottom of the DO classes.
All the other specialties that are actually impacted by the merger only had 1-2 dozen spots a year. With frequent doublings of DO matriculants, pretty soon those same DOs that will miss out with the merger would miss out because they aren't competitive enough.
Only time will tell how many fewer DOs will actually end up in surgery or the surgical subspecialties after the merger, but my guess is that it won't be a huge number.
The anti-DO bias is largely rooted in lower admission standards for matriculating students and lower accreditation standards for new institutions. The merger doesn't address that at all...
Yeah, DO bias is based primarily in 2 things:
1) A historical belief in significantly lower matriculant standards. The average DO student right now is within a standard deviation of the mean of MD students with regards to matriculant stats (in other words right around the lower tier MD schools). Those that still cite this are either using it as an excuse or basing their info on a time when MD averages were 3.5 and 28-29 and DO were 3.0 and 20-21 (i.e. its been a while).
2) Clinical training. This varies widely school to school and even student to student.
So the merger means more apps to ACGME programs from DOs. This means more programs seeing DO apps, including good ones. This will ultimately mean more DO students being interviewed, and more matching into different programs. This isn't something that will happen overnight, but gradually it will.
I say this because its what we've seen with DO expansion forcing more DOs to apply and go ACGME. That's pretty much why we are seeing a higher percentage of DOs matching ACGME year to year despite an increasing number of them having to apply.
Will there still be programs that don't touch DO apps? Of course, but there will also be more that have experience with DOs.
Current salary and current growth for PCPs will not last with reckless school openings and massive amount of supplies of PCPs down the road. The current admin people are literally selling your future and mine right now in order to make a quick buck in order to compare themselves to their ortho buddies next door.
If you want to see the future of PCPs in 5-7 years, feel free to stop by the dental forum. Here's the reality for general dentists right now:
90-120K/yr
As a dentist, if you work really hard, business savy, own your practice, and see 30-35+ pts/day, you will crack 225-250 K as your limit. Have fun paying that 300-400K debt while making 100-120 K/yr. If you want to call bs on these thoughts, feel free to become a PCP.
Yeah, that doesn't really hold up given that the number of residencies limits actual practicing physicians. In other words, school expansion has done next to nothing to change supply. There were and still are far more applicants to residency programs than there are seats.
Also, primary care salaries have actually only gone up in recent years, but feel free to spread the doom and gloom. PCPs aren't having any issues breaking $200k with 3 yrs of residency and outpatient only work.
I would bet that a lot of those residents have a working spouse with income at the same time or moonlight for extra income.
A lot of residents I know with families don't have spouses with independent incomes.
As for moonlighting, sure its more common among those with families, but most residents aren't allowed to moonlight until late 2nd or 3rd year of residency, so plenty of people are getting by without moonlighting.
Its really not as bad as you're making it out to be.
20 years down the line this will be a positive for DO schools. For one, it may precipitate the destruction of COCA and the DO degree for a unified MD degree. Second, over time students will be matching at better places making the stigma of DO lower. Third, AOA will no longer be able to force fees for us to keep our license if we do AOA training. The problem of the match is for those of us that have to live it presently.
The first point will be really far down the line, if it happens.
The second will eventually happen.
As for the third, the AOA has already announced plans to discontinue that requirement. I'm pretty sure that was a year ago or something.
This post is simply a joke. Try having kids.
Yeah, its harder, but plenty of people with kids are getting by fine.
Let me know when there's an actual shortage of physician as evident by skyrocketing increase in physician wages across all specialties. Otherwise, this impending physician shortage is fake news.
Medicine isn't a straight supply and demand profession (few things actually are). Reimbursements are pretty much predetermined. There is slight wiggle room in hugely high demand areas for certain fields, because hospitals rely on offering "services" to stay open, but for the most part your salary doesn't change much because reimbursements for your work doesn't.
Living paycheck by paycheck isn't doing fine. Here's my monthly spending per month with 2 kids:
$1,500 rent
$1,000 grocery shopping
$400-500 on restaurants and recreational activities
$300-400 on phone bill, electric bill, heating/water bill, and internet bill
$200 on gas
$50-60 on car insurance
You're spending too much. $1500 on groceries, restaurants and recreation/mo is a lot even with 2 kids. Most (almost all?) residents with children, myself included, aren't spending that much. It honestly should be half that. Either you're exaggerating to make a point or you should recognize you're living more than the average "resident with a family" lifestyle.
Also, let's assume you continue to live like that in residency (you honestly won't be able to because you're not going to spend $100 on restaurants/recreation during your 1 day off a week every week), you wouldn't be that far off from the salary of many residents (high $50s, low $60s salary with loans taken into account). That's still way less than $100k POST-tax.
