Why are DO schools promulgating the idea that the residency merger is of benefit to DO students?

[DrfluffyMD]

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Your ignorance lately is downright astounding. It’s like you don’t even research before you post horse manure. “DO fellowships”? It’s all ACGME now, and there are exceptionally few “DO” fellowships. If you were actually trying to advocate the same you would propose that any program that isn’t giving actual consideration to DOs punished heavily.

The point of the merger was to get all programs on the same accreditation level and up to the same standards. The spirit of the merger was never “to make DO programs consider MDs.” Never. They have no obligation to even look at a single MD application. Not one bit. It’s the exact same concept that you all defend that we say is dumb when programs simply screen out all DO applications. Our ortho program will never match an MD because the PD says that he knows that even the most stellar DOs don’t get honest consideration at a lot of MD programs and they are going to continue to make it possible for those students to get into the field they deserve.

Opportunities - AOA-Approved Internships and Residencies

Here’s an AOA fellowship right here.

 

[Ho0v-man]

I feel like SDN makes MDs anti-DO. DrFluffyMD is probably the most fair and straightforward MD who regularly posts on DO forums. If an MD and a DO have the exact same CV, the PD should pick the MD almost every time. They went to a better school. How much better is always up for debate, but on average, it was better. If I were a PD at a really competitive program that essentially never goes unfilled, I wouldn’t take DO applicants. Why would I waste my time reading an application that may or may not have a STEP 1 for Pete’s sake?

 

[jrlob91]

Before you point fingers, I am not ok with the existing system as indicated by my post history. I argued for a single, unified medical school system just earlier in this thread.

I am more than happy to advocate the same, as in banning MD resident grads from partaking in DO fellowships if the MD residency do not take DOs. It’s only fair.

Opportunities - AOA-Approved Internships and Residencies

Here’s an AOA fellowship right here.

Wow

 

[AnatomyGrey12]

Opportunities - AOA-Approved Internships and Residencies

Here’s an AOA fellowship right here.

*facepalm

No one ever said they didn’t exist.... there are very few. And from now on they still have to be accredited by the ACGME so I’m still not sure what your point is seeing as everything will be considered an ACGME fellowship.

I feel like SDN makes MDs anti-DO. DrFluffyMD is probably the most fair and straightforward MD who regularly posts on DO forums. If an MD and a DO have the exact same CV, the PD should pick the MD almost every time. They went to a better school. How much better is always up for debate, but on average, it was better. If I were a PD at a really competitive program that essentially never goes unfilled, I wouldn’t take DO applicants. Why would I waste my time reading an application that may or may not have a STEP 1 for Pete’s sake?

Then screen for Step scores, or screen for some other measure. There is no reason a grad from PCOM shouldn’t be looked at yet a grad from Morehouse or the PR gets full consideration.

 

[Scrubs101]

When you know fully well that the merger wasn’t done to equal the residency application playing fields for MDs or DOs and claim that it’s perfectly acceptable for “MD” residencies to say “DO’s do not apply”, yet have the audacity to also say that “DO” residencies should be shut down for requiring 200hrs of OMM in attempt to protect their own grads...you kinda come off as hypocritical and FOS.

I fully respect and value @DrfluffyMD ’s contributions to sdn, and think he has a lot of valuable wisdom to share. However this is sdn, and sdn wouldnt be sdn if we didn’t call out BS when we saw it

 

[deleted831695]

If an MD and a DO have the exact same CV, the PD should pick the MD almost every time. They went to a better school. How much better is always up for debate, but on average, it was better. If I were a PD at a really competitive program that essentially never goes unfilled, I wouldn’t take DO applicants. Why would I waste my time reading an application that may or may not have a STEP 1 for Pete’s sake?

Then screen for STEP 1....If the program is taking grads from 'low-tier MDs' (a handful of which have lower matriculant stats than some of the DOs), then there's no reason why grads from MSU, PCOM, etc. shouldn't considered. Unless you want to tell me that the grad from CMU is so much better than the grad from Oklahoma State?

 

[NurWollen]

I feel like SDN makes MDs anti-DO. DrFluffyMD is probably the most fair and straightforward MD who regularly posts on DO forums. If an MD and a DO have the exact same CV, the PD should pick the MD almost every time. They went to a better school. How much better is always up for debate, but on average, it was better. If I were a PD at a really competitive program that essentially never goes unfilled, I wouldn’t take DO applicants. Why would I waste my time reading an application that may or may not have a STEP 1 for Pete’s sake?

You're a DO student, telling us you wouldn't take DO applicants if you were a PD of a competitive program?

I'm curious how you'll feel about that when you're going through the match.

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[Ho0v-man]

You're a DO student, telling us you wouldn't take DO applicants if you were a PD of a competitive program?

I'm curious how you'll feel about that when you're going through the match.

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It sucks. I don’t like it. But I get it. They’ve got plenty of apps with the metric they care about on it. They don’t need to look through even more CV’s just to sift through a bunch of apps that might only offer a test score they don’t even understand.

I’m not blaming students here, I’m blaming aoa for not getting on board with showing the MD side what we can do. I’m very proud of the degree I’m working toward and it’s a shame our leadership isn’t doing more to show the medical community what we’re capable of.

Edit: for the record, I also agree the program directors at former DO programs should take whoever they want and shouldn’t face any consequences for throwing MD apps in the trash. I don’t see why they would get flak for doing what plenty of other residencies do to DOs. They should screen on whatever basis they want.

 

[SLC]

Before you point fingers, I am not ok with the existing system as indicated by my post history. I argued for a single, unified medical school system just earlier in this thread.

We know that you don’t like the existing system. The existing system has a reliable path to careers in the surgical subspecialties for DO’s.

We know that what you’re really arguing for is an MD quota at formerly AOA residency programs; while at the same time, implying that it’s A-OK that certain ACGME programs maintain a no-DO policy.

Seems perfectly logical to me 🙄

 

[DrfluffyMD]

Interesting, because it seems to me that what you’re really arguing for is an MD quota at formerly AOA residency programs; while at the same time, implying that it’s A-OK that certain ACGME programs maintain a no-DO policy.

Seems perfectly logical to me 🙄

Your assumptions about my posts are incorrect. I do not support exclusion of DOs from top residencies. However, there is a de facto exclusion due to some residencies able to recruit exclusivey based on their criteria and being a DO is used by them to close doors.

I understand why that is happening, and honestly, it is very difficult to change that.

What I take issue with, is that some posters here sound like they honestly have never worked with some of the best and the brightest USMD graduates and assume that on the average, the AOA education pathway is exactly as rigorous as the LCME / ACGME pathway.

It is not.

 

[SLC]

Your assumptions about my posts are incorrect. I do not support exclusion of DOs from top residencies. However, there is a de facto exclusion due to some residencies able to recruit exclusivey based on their criteria and being a DO is used by them to close doors.

You seem just fine with it based on reading your posts. Maybe it’s just me, and my intermittent participation in this forum; but I don’t think I’ve ever seen you write that you thought DO’s shouldn’t be excluded from top residencies before. In-fact, I’ve seen you imply that DO’s aren’t as good or as qualified for a myriad of reasons: pre-med grades, school rank, school rigor, geographic location of schools, etc etc. pretty much whatever you can get to stick it seems.

I understand why that is happening, and honestly, it is very difficult to change that.

But based on what you wrote above, you’ll absolutely argue forcefully for it to end when you “wind up in residency education business as expected” right?

What I take issue with, is that some posters here sound like they honestly have never worked with some of the best and the brightest USMD graduates and assume that on the average, the AOA education pathway is exactly as rigorous as the LCME / ACGME pathway.

It is not.

I see, so it’s like this?:

But seriously

What has someone holding that view got to do with your posts this morning? No wait…what has that got to do with anything at all? Let it go man.

 

[SurgDoc95]

What has that got to do with your posts this morning? No wait…what has that got to do with anything at all?

To him, the majority of MDs>>>>>the majority of DOs. He tries to toe the line between coming across as neutral and his real opinion that most DOs and DO students are inferior to MDs and MD students. I’m sure he’ll fire back at me but everyone on here can see that. At least when it comes to this thread alone.


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[DrfluffyMD]

To him, the majority of MDs>>>>>the majority of DOs. He tries to toe the line between coming across as neutral and his real opinion that most DOs and DO students are inferior to MDs and MD students. I’m sure he’ll fire back at me but everyone on here can see that. At least when it comes to this thread alone.


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Nope. The degree behind your name have absolutely no impact about how you are as a physician.

The degree behind people’s name just happened to impact the training pathway. Starting from questionable clinical training in medical school to questionable AOA residencies.

Some people absolutely rise above that and I respectthem the most.

The merger is an excellent way to address this disparity of training.

So yes, when I work with my ACGME trained DO colleague I treat them just like everyone else. I have worked with several AOA trained residents and I have notice a difference, and not in a good way.

And yes, if I am working as an APD, and I have too many apps on my hand to review, I will probably use filter like radiologyPD on the forum does, including using LCME status as a filter if it comes to that point because
1. I won’t be working at WashU or Harvard (personal choice), and a midtier program may be more hesistant to recruit FMG/DO due to the fear of being viewed as a place unable to recruit USMDs (see radiologyPD’s post for the exact reasoning)
2 If I have 2 spots, need 20 names on rank list to match, and have 200USMD applicants, it’s hard to take time to review everything without the filters.

 

[SurgDoc95]

Nope. The degree behind your name have absolutely no impact about how you are as a physician.

The degree behind people’s name just happened to impact the training pathway. Starting from questionable clinical training in medical school to questionable AOA residencies.

Some people absolutely rise above that and I respectthem the most.

The merger is an excellent way to address this disparity of training.

So yes, when I work with my ACGME trained DO colleague I treat them just like everyone else. I have worked with several AOA trained residents and I have notice a difference, and not in a good way.

And yes, if I am working as an APD, and I have too many apps on my hand to review, I will probably use filter like radiologyPD on the forum does, including using LCME status as a filter if it comes to that point because
1. I won’t be working at WashU or Harvard (personal choice), and a midtier program may be more hesistant to recruit FMG/DO due to the fear of being viewed as a place unable to recruit USMDs (see radiologyPD’s post for the exact reasoning)
2 If I have 2 spots, need 20 names on rank list to match, and have 200USMD applicants, it’s hard to take time to review everything without the filters.

Do you not see the snowball effect your views on filtering DOs out could have if it’s shared across the residency world? If residencies are simply going to filter out DOs why should we bother building up a comparable app? I realize not all residencies will do this, but that’s one way the merger could potentially screw those of us wanting non PCP.


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[Instatewaiter]

This entire thread gave me a good chuckle

 

[Neopolymath]

It sucks. I don’t like it. But I get it. They’ve got plenty of apps with the metric they care about on it. They don’t need to look through even more CV’s just to sift through a bunch of apps that might only offer a test score they don’t even understand.

I’m not blaming students here, I’m blaming aoa for not getting on board with showing the MD side what we can do. I’m very proud of the degree I’m working toward and it’s a shame our leadership isn’t doing more to show the medical community what we’re capable of.

Edit: for the record, I also agree the program directors at former DO programs should take whoever they want and shouldn’t face any consequences for throwing MD apps in the trash. I don’t see why they would get flak for doing what plenty of other residencies do to DOs. They should screen on whatever basis they want.

I see where you are coming from here, and have to agree, the AOA has done us a net negative with their **** publicity and ad campaign. None of the publicity of the DO profession does anything but make people compare us to chiropractors... It never elicits any indication that we are physicians. It is just so ****ty. They should be ashamed and we are feeling the affects of this.

 

[Ho0v-man]

Do you not see the snowball effect your views on filtering DOs out could have if it’s shared across the residency world? If residencies are simply going to filter out DOs why should we bother building up a comparable app? I realize not all residencies will do this, but that’s one way the merger could potentially screw those of us wanting non PCP.


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Look at it this way. If your the PD of a derm program that for the past 10 years has filled every slot w USMDs from top 20 schools all of which have step scores >255, would you bother sifting through apps from lower tier schools? If you were that PD would you look through apps from a low tier school you’ve never heard of on the off chance you get a 270?


The logic is that you look through apps from lower tier schools\ unfamiliar if you can’t get the apps you want. If you’ve got plenty of apps w the stats you want from a place you trust then there’s no point in making more work for yourself.

But hey, that PD of an ortho program in the Midwest who’s a grad of kcu might not care about the app of an U of south Alabama student if he knows he can fill with super star DOs from the Midwest. The pendulum can swing both ways.

 

[Chibucks15]

Look at it this way. If your the PD of a derm program that for the past 10 years has filled every slot w USMDs from top 20 schools all of which have step scores >255, would you bother sifting through apps from lower tier schools? If you were that PD would you look through apps from a low tier school you’ve never heard of on the off chance you get a 270?


The logic is that you look through apps from lower tier schools\ unfamiliar if you can’t get the apps you want. If you’ve got plenty of apps w the stats you want from a place you trust then there’s no point in making more work for yourself.

But hey, that PD of an ortho program in the Midwest who’s a grad of kcu might not care about the app of an U of south Alabama student if he knows he can fill with super star DOs and MDs from the Midwest who will likely want to match there. Always s the possibility he’ll rank the DOs higher too. The pendulum can swing both ways.

That's what my mindset is. Especially with some of the bigger DOs with a good track record. If you apply in the general geographic area to where you go to school you'll have better luck because they may know the quality of past grads. Which really sucks for the people who travel cross country to go to a certain school and want to go back to Cali or whatever but its the nature of the beast

 

[Ho0v-man]

I see where you are coming from here, and have to agree, the AOA has done us a net negative with their **** publicity and ad campaign. None of the publicity of the DO profession does anything but make people compare us to chiropractors... It never elicits any indication that we are physicians. It is just so ****ty. They should be ashamed and we are feeling the affects of this.

Although I am pleased they updated the 3rd year requirements. If they’d kill the comlex it’d be sweet.

 

[Neopolymath]

Although I am pleased they updated the 3rd year requirements. If they’d kill the comlex it’d be sweet.

Any progress is good progress at this point. Maybe next time they will decide that more than 1 single rotation with 5 minutes of resident exposure isn't enough lol.

 

[AnatomyGrey12]

And yes, if I am working as an APD, and I have too many apps on my hand to review, I will probably use filter like radiologyPD on the forum does, including using LCME status as a filter if it comes to that point because
1. I won’t be working at WashU or Harvard (personal choice), and a midtier program may be more hesistant to recruit FMG/DO due to the fear of being viewed as a place unable to recruit USMDs (see radiologyPD’s post for the exact reasoning)
2 If I have 2 spots, need 20 names on rank list to match, and have 200USMD applicants, it’s hard to take time to review everything without the filters.

But if a former DO program does the exact same thing then you want to prevent their grads from fellowships.... do you see the hipocrisy?

I have worked with several AOA trained residents and I have notice a difference, and not in a good way.

You are in rads, a field where the majority of DOs who go into it do so through the ACGME side. The rads AOA programs have long been consider inferior and this is nothing new. On the other hand I’ve literally had MD orthopods tell me to my face they thought that the AOA ortho grads were better coming out of residency and in the OR because they operate a lot more than many MD ortho residents.


I honestly hold the opinion that if all residency programs are accredited by the same body and that DOs have to apply through the NRMP match then the LCME filter should be removed. Make it a LCME/COCA filter. Create a new filter for people with USMLE scores or something like that.

Any progress is good progress at this point. Maybe next time they will decide that more than 1 single rotation with 5 minutes of resident exposure isn't enough lol.

What’s interesting is that the requirement is the exact same as the one by the LCME now.

 

[Ho0v-man]

What’s interesting is that the requirement is the exact same as the one by the LCME now.

Yes but some of our schools are having to make adjustments to barely meet this minimum requirement. On the MD side they easily exceed the minimum. Plenty of our schools do, but a lot don’t.

 

[AnatomyGrey12]

Yes but some of our schools are having to make adjustments to barely meet this minimum requirement. On the MD side they easily exceed the minimum. Plenty of our schools do, but a lot don’t.

Oh I know, but I find it I just find it interesting that people like to prop up LCME accreditation as if it is so much different from COCA and, clinically at least, it’s the exact same verbiage.

 

[Lawpy]

Here's a solution to keep everyone happy: just reintegrate DO schools into MD schools and make ACGME/LCME a standard accrediting regulatory body. This way, many good DO schools will be like UC Irvine and produce awesome graduates who won't be hamstrung in their career choices. Many of the problems are due to DO schools being separate from MD schools despite both leading to the same outcome (a board-certified and licensed physician). As long as AOA/COCA continue to oppose this reintegration due to historical and political reasons, the problems will persist.

 

[Lexdiamondz]

Here's a solution to keep everyone happy: just reintegrate DO schools into MD schools and make ACGME/LCME a standard accrediting regulatory body. This way, many good DO schools will be like UC Irvine and produce awesome graduates who won't be hamstrung in their career choices. Many of the problems are due to DO schools being separate from MD schools despite both leading to the same outcome (a board-certified and licensed physician). As long as AOA/COCA continue to oppose this reintegration due to historical and political reasons, the problems will persist.

I agree.

You can’t simultaneously argue there’s no difference between MDs and DOs and honestly say the two degrees should remain distinct - if we’re gonna have one standard for postgraduate training then why maintain this supposedly insignificant difference in degrees?

 

[AnatomyGrey12]

Here's a solution to keep everyone happy: just reintegrate DO schools into MD schools and make ACGME/LCME a standard accrediting regulatory body. This way, many good DO schools will be like UC Irvine and produce awesome graduates who won't be hamstrung in their career choices. Many of the problems are due to DO schools being separate from MD schools despite both leading to the same outcome (a board-certified and licensed physician). As long as AOA/COCA continue to oppose this reintegration due to historical and political reasons, the problems will persist.

I agree.

You can’t simultaneously argue there’s no difference between MDs and DOs and honestly say the two degrees should remain distinct - if we’re gonna have one standard for postgraduate training then why maintain this supposedly insignificant difference in degrees?

I don’t disagree with either of you, but that isn’t the situation we currently have, and it isn’t going to be happening anytime soon.

 

[Lawpy]

I don’t disagree with either of you, but that isn’t the situation we currently have, and it isn’t going to be happening anytime soon.

It can actually happen in the future and the residency merger is the first step. The reason why the degrees remain separate is due to historical and political reasons on AOA/COCA part. As long as AOA/COCA oppose full reintegration, the problems and systemic biases will continue to persist.

 

[Neopolymath]

It can actually happen in the future and the residency merger is the first step. The reason why the degrees remain separate is due to historical and political reasons on AOA/COCA part. As long as AOA/COCA oppose full reintegration, the problems and systemic biases will continue to persist.

The AOA president came to my school recently (talk about a walking figurative vestigial structure) and said people would be fine with comlex only. AnatomyGrey is right. This **** isn't changing any time soon. Those old dudes are quite comfy on their thrones.

 

[Lawpy]

The AOA president came to my school recently (talk about a walking figurative vestigial structure) and said people would be fine with comlex only. AnatomyGrey is right. This **** isn't changing any time soon. Those old dudes are quite comfy on their thrones.

And that’s the main issue I have. It’s just politics and history that keep the two degrees distinct and allow for problems to continue even though they both achieve the goal of producing physicians.

 

[AnatomyGrey12]

It can actually happen in the future and the residency merger is the first step. The reason why the degrees remain separate is due to historical and political reasons on AOA/COCA part. As long as AOA/COCA oppose full reintegration, the problems and systemic biases will continue to persist.

Yes but not in the near future. What you fail to realize is that this could happen tomorrow and DO schools could be fully accredited by LCME and there would still be programs and directors who would throw out any app that had the letters DO on it. The current bias really doesn’t actually have much to do with clinical rotations, or board exams, or entrance stats. That’s just the line that people like to throw out, and I’m sure some actually do have these reservations, but a lot of the bias really has nothing to do with those. It has to do with a long held bias that DOs are still the quack job chiros that trained in AT Still’s basement. It has to do with, “if I take a DO my program isn’t as good.” This is the bias I argue against, and is what I am arguing now.

And that’s the main issue I have. It’s just politics and history that keep the two degrees distinct and allow for problems to continue even though they both achieve the goal of producing physicians.

I don’t argue that it shouldn’t happen, because it eventually will, but that to the discussion that is currently going on in this thread it actually doesn’t mean anything.

 

[Lawpy]

Yes but not in the near future. What you fail to realize is that this could happen tomorrow and DO schools could be fully accredited by LCME and there would still be programs and directors who would throw out any app that had the letters DO on it. The current bias really doesn’t actually have much to do with clinical rotations, or board exams, or entrance stats. That’s just the line that people like to throw out, and I’m sure some actually do have these reservations, but a lot of the bias really has nothing to do with those. It has to do with a long held bias that DOs are still the quack job chiros that trained in AT Still’s basement. It has to do with, “if I take a DO my program isn’t as good.” This is the bias I argue against, and is what I am arguing now.



I don’t argue that it shouldn’t happen, because it eventually will, but that to the discussion that is currently going on in this thread it actually doesn’t mean anything.

If the DO schools became accredited by LCME, they would be MD schools. The DO label would no longer exist. And I’m not so sure whether the anti-DO bias would persist against graduates from former DO schools, since they no longer have the DO label attached to them. I don’t think UC Irvine grads suffered from this problem when the school converted from DO to MD. Perhaps some odd programs may have a short term bias but i think this would disappear completely in 5 years after the conversion.

Even if the bias persists, it’s key to note that it is just a type of prestige bias. There are always those elitist program directors and prestige prostitutes who will look down on anyone who didn’t go to a top 20 med school. Someone coming from a former DO program will suffer from this bias as someone coming from a low tier or state schools. And by all means, we should blame program directors for this gross behavior, but as long as they are in power, the power differential persists and the applicants are sadly screwed over to no fault of their own. But this is just a tragedy of human-driven admissions process.

 

[Neopolymath]

Yes but not in the near future. What you fail to realize is that this could happen tomorrow and DO schools could be fully accredited by LCME and there would still be programs and directors who would throw out any app that had the letters DO on it. The current bias really doesn’t actually have much to do with clinical rotations, or board exams, or entrance stats. That’s just the line that people like to throw out, and I’m sure some actually do have these reservations, but a lot of the bias really has nothing to do with those. It has to do with a long held bias that DOs are still the quack job chiros that trained in AT Still’s basement. It has to do with, “if I take a DO my program isn’t as good.” This is the bias I argue against, and is what I am arguing now.

And while everyone on this forum was more or less laughing about how **** the DO PR campaigns are, we all should have been pissed about the latest PR campaign and how it takes us even further toward this line of thinking. During our typical inter-disciplinary workshops, the pharmacy students in our own school don't even know what a DO is. In fact, while giving tours to potential students the other day, I heard a pharmacy student essentially say that the DO students " are like doctors but also even better chiropractors." Do I think there was a negative connotation to their phrasing? Not at all! I think they were being nice. What does that say about our branding though if the people studying next to us in the library and at these workshops don't even know that we are physicians first and foremost???

It always comes back to "so you are like chiropractors who can write prescriptions???" Obviously the AOA wants this to be the message for some reason.

 

[AnatomyGrey12]

It always comes back to "so you are like chiropractors who can write prescriptions???" Obviously the AOA wants this to be the message for some reason.

Yeah I already have no love for the AOA or any of its branches. They are a joke and are the ones honestly holding everyone back.

The funny thing is that they could really have some serious credibility. They have been trying for a century to get DOs recognized and we are finally at a time where the quality of students is the best it has ever been, we have tons of legal recognition, and many of the schools are actually really good and produce great physicians. If they wanted to they could hold onto that and really turn the “DO brand” into something really great by continuing to better clinical training, open solid residencies, start doing some decent research, and just build off this foundation to show how we are just as competent as MDs. Instead they *****ically green light almost every school that applies in the most random of places, continue to water down clinical education by over saturating resources, and push the stupid idea that somehow we are so much better than MDs because of who knows what “Doctors that DO” and all that nonsense. It’s their funeral, but what really makes me mad is they are determined to bring down everyone else down with them.

/endrant *quietly steps off soapbox

 

[Goro]

It can actually happen in the future and the residency merger is the first step. The reason why the degrees remain separate is due to historical and political reasons on AOA/COCA part. As long as AOA/COCA oppose full reintegration, the problems and systemic biases will continue to persist.

Well, if this generation of DO students will join AOA and rise up the decision making ranks, then it's doable. I hope that you guys will indeed do this.

But until then, we're stuck with waiting for the current generation of decision makers to literally die off.

 

[hallowmann]

Here’s the thing though, not to disparage how awesome you are (I am sure you are), but for a USMD grad to end up in a program with DOs and FMGs, there are often red flags (myself being an example) and their level of performence doesn’t really speak to the USMD student bodies as a whole.

Likewise, people who ended up in programs that had to scramble are probably aren’t the average USMD applicants (because the average USMDs dont end up in programs IMG heavy or needing to scramble)

Just food for thought. No meant to disrespect anyone’s hardwork.

Yeah, except in certain fields, even the best and most competitive programs have DOs in them. I will also say that there are plenty of mid-tier programs that take DOs as well as average MDs without redflags. Do you honestly believe every MD at a program that takes DOs is below average? Or are you one of the people that believes the MD average applicant has 15 publications, a 250 Step 1, an NIH grant, and went to a top 20 school?

Your generalizations are at best woefully misinformed.

That isn't his point. The fact is, what DOs consider competitive is very different from what MDs would consider competitive. For example, in my field (IM), I think most DOs would agree programs such as University of Iowa and Albert Einstein (Montefiore) are strong, and they are. These programs are probably higher quality than the program with many DOs and IMGs the other poster was referring to. However, they are not particularly competitive for us. Applicants from my (MD) school get interviews at these places with below average step scores (210-220s) and no significant research/m3 honors. I can imagine the criteria for DOs is not anywhere the same. Sure, not everyone ranks their list based on the most competitive program they can get, and some strong MDs may end up at "lower" programs, but on average, the DO student will have far superior credentials in the same residency. My school is one that takes DOs and the ones I knew had step scores ranging 240-260s, while the MDs had 200-220s. I do think the DO residents here were superior in knowledge to the MDs, but you can see how this isn't a fair comparison of MD vs DO students as a whole (comparing the top DOs to the bottom MDs). Nor is it fair for the differences in admission criteria to be this drastic, but as of now, this is the reality for many residencies.

Yeah, what's competitive for DOs is obviously different than what's competitive for MDs. With all due respect, that's not what he said at all. He said that we'd primarily find subpar MDs with redflags at programs that take DOs.

Sure, on average the DO has to be a much better applicant than the MD at those programs, but to imply that those MDs have redflags or bellow average MD stats is ridiculous.

...The next logical step will be eliminating COCA and AOA and bring everything under ACGME and LCME with osteopathic medicine becoming its own ACGME subspecialty.

Yeah, literally the only thing in that quote that either hasn't happened or isn't in the process of happening is COCA being replaced by the LCME. The ACGME is already taking over accreditation of AOA residencies and the ACGME has already created an RRC for an ONMM specialty as well as another RRC for reviewing osteopathic focus at residency programs.

COCA has already changed some of its requirements to match the LCME. I honestly don't think you'll get much pushback from students if the LCME wanted to take over DO school accreditation.

Were this to happen in the distant future, what areas of medicine could osteopathic physicians practice in in your ideal world? Family medicine? PM&R? I am curious where you think that should go.

...both of you.

It already exists. Osteopathic Neuromusculoskeletal Medicine. It's a standalone specialty under the ACGME. It was part of the merger.

Osteopathic Neuromusculoskeletal Medicine

A standalone osteopathic specialty is possible but I have no idea how it would work. I think the principles work well with already existing specialties.

Again, it already exists. See above.

There already is a stand-alone OMM specialty.

Thank you

So these guys are going to force DOs to continue to do OMM in this program even if they don't want the future cert, but not the MD students that might end up there??? I'm guessing I'm misunderstanding.

This is purely program dependent. In all honesty this was already happening at programs that had dual-accreditation. A number of programs in my area did this even if you matched to them through the NRMP match. I know people that were caught off guard and felt screwed over.

 

[Instatewaiter]

If the DO schools became accredited by LCME, they would be MD schools. The DO label would no longer exist.

That is not how degree confirmation occurs. A school can decide to confer any degree they wish. So if VCOM wanted to suddenly give an MD degree (without LCME accredidation) they could. I'm sure the AOA/ COCA would have a fit. Similarly, were the LCME to accredit VCOM, VCOM wouldn't suddenly become an MD confering institution (unless this is a requirement by the LCME). If allowed by the LCME, they could still confer a DO degree.

Even if the bias persists, it’s key to note that it is just a type of prestige bias. There are always those elitist program directors and prestige prostitutes who will look down on anyone who didn’t go to a top 20 med school. Someone coming from a former DO program will suffer from this bias as someone coming from a low tier or state schools. And by all means, we should blame program directors for this gross behavior, but as long as they are in power, the power differential persists and the applicants are sadly screwed over to no fault of their own. But this is just a tragedy of human-driven admissions process.

A common idea that gets thrown around on SDN is that these elitist PDs are discriminating against low tier MDs and DOs unfairly. They are only after prestige and these students at top programs are the same caliber and get the same education as other students.

Having come from a "low tier" medical school and then trained at one of those elitist ivory tower institution I have a unique perspective. I can tell you that the students at that elite program were vastly stronger than where I went to medical school. Furthermore, their education was more indepth than mine. My co-residents from these elite schooles came in more prepared.

The argument that board scores demonstrate equivalence, is also false. Through your training you will meet people with monster board scores who just don't get it and are terrible clinicians. On average, those with better board scores have a better fund of knowledge but this is not always converted into clinical acumen. Your clinical training is important.

 

[Dwan]

Yeah, what's competitive for DOs is obviously different than what's competitive for MDs. With all due respect, that's not what he said at all. He said that we'd primarily find subpar MDs with redflags at programs that take DOs.

Sure, on average the DO has to be a much better applicant than the MD at those programs, but to imply that those MDs have redflags or bellow average MD stats is ridiculous.

Red flags may be true at a program with many DOs and FMGs, the one he was referring to. The programs I cited are strong and rarely (but occasionally) take either, and while red flag MD applicants may be a stretch at those, they definitely take many below average students. Above average students (>230) get places typically closed off to DOs such as BU, Baylor, UVA, UCSD etc (referring to IM, a moderately competitive field). Additionally, below average students can match very competitive fields such as radiation oncology at high rates (per charting outcomes, 220-230, 13/14 matched, 210-220, 3/3 matched), as long as you are not picky about where you go, but they will be among stellar DO applicants. I agree that true red flag students are rare in general, but many MD students score below average on the step, yet their match results remain strong. In less competitive fields than the ones I mentioned, you can get top places with below average scores, see below for the anesthesia match list for Drexel, one of the lowest tier MD schools. This wasn't a special year where their stars went anesth, they matched plenty programs that are much more competitive than these. You don't have to be a star to do well unless you are going for the most competitive places in the nation, which generally don't take DO. Keep in mind the data here I kept very conservative, using only outcomes from low-mid tier MD schools. You will see much greater disparity when we include the top 20 MD schools.

Anesthesiology Drexel Univ COM/Hahnemann Univ Hosp-PA
Anesthesiology George Washington Univ-DC
Anesthesiology Hershey Med Ctr/Penn State-PA
Anesthesiology Icahn SOM at Mount Sinai-NY
Anesthesiology Johns Hopkins Hosp-MD
Anesthesiology Johns Hopkins Hosp-MD
Anesthesiology Johns Hopkins Hosp-MD
Anesthesiology Massachusetts Gen Hosp
Anesthesiology Northwestern McGaw/NMH/VA-IL
Anesthesiology NYP Hosp-Columbia Univ Med Ctr-NY
Anesthesiology NYP Hosp-Weill Cornell Med Ctr-NY
Anesthesiology Stanford Univ Progs-CA
Anesthesiology U Maryland Med Ctr
Anesthesiology U Massachusetts Med School
Anesthesiology U North Carolina Hospitals
Anesthesiology U Texas Med Branch-Galveston
Anesthesiology UC Davis Med Ctr-CA
Anesthesiology UC Irvine Med Ctr-CA
Anesthesiology UC San Diego Med Ctr-CA
Anesthesiology UPMC Medical Education-PA

 

[Lawpy]

That is not how degree confirmation occurs. A school can decide to confer any degree they wish. So if VCOM wanted to suddenly give an MD degree (without LCME accredidation) they could. I'm sure the AOA/ COCA would have a fit. Similarly, were the LCME to accredit VCOM, VCOM wouldn't suddenly become an MD confering institution (unless this is a requirement by the LCME). If allowed by the LCME, they could still confer a DO degree.

Well I'm surprised because any new school accredited by LCME becomes an MD school, and the former DO schools that became accredited by LCME offered MD degrees (UC Irvine being an example). I don't see how a DO school being accredited by LCME can retain the DO title, because the DO reflects that of their accrediting body, so AOA/COCA which would clearly not approve.

So if DO schools became reabsorbed by MD and AOA/COCA no longer exist, the DO label becomes outdated and has no value. So it would naturally be that these former DO schools would grant MD degrees.

Also I thought that for any school in the US to grant the MD degree, they need LCME approval. That's why Caribbean schools are necessarily off-shore. They can't exist in the US because the LCME will shut them down.

A common idea that gets thrown around on SDN is that these elitist PDs are discriminating against low tier MDs and DOs unfairly. They are only after prestige and these students at top programs are the same caliber and get the same education as other students.

Having come from a "low tier" medical school and then trained at one of those elitist ivory tower institution I have a unique perspective. I can tell you that the students at that elite program were vastly stronger than where I went to medical school. Furthermore, their education was more indepth than mine. My co-residents from these elite schooles came in more prepared.

I could see how the average student from top tier school is stronger than average student from a low tier, because the top tier school has higher admissions standards (so higher matriculant GPA/MCAT scores) than the low tier school. And those who did well on the MCAT will naturally do well on the boards/shelves. And I suppose since top schools have more money, they can afford more resources, hire better faculty and offer more research/clinical opportunities to make students more skilled.

But, when I say PD's are elitist, I'm referring to cases where students from low tier schools who despite being very strong (they destroyed Step exams, excelled in clinical years, have very strong/productive research etc.) end up being shafted simply because they attended a low tier school. An applicant with a 3.9/39 (or 523) can decide to attend their state school or low tier for personal reasons (say their SO has an inflexible job or their parents are sick and need help/comfort). Clearly they have strong academic record before attending school but their situation forces them to attend a low tier. Why should they get shafted by elitist PD's on mere grounds of where they went to school even when they have very strong credentials?

The argument that board scores demonstrate equivalence, is also false. Through your training you will meet people with monster board scores who just don't get it and are terrible clinicians. On average, those with better board scores have a better fund of knowledge but this is not always converted into clinical acumen. Your clinical training is important.

I agree.

 

[DrfluffyMD]

Well I'm surprised because any new school accredited by LCME becomes an MD school, and the former DO schools that became accredited by LCME offered MD degrees (UC Irvine being an example). I don't see how a DO school being accredited by LCME can retain the DO title, because the DO reflects that of their accrediting body, so AOA/COCA which would clearly not approve.

So if DO schools became reabsorbed by MD and AOA/COCA no longer exist, the DO label becomes outdated and has no value. So it would naturally be that these former DO schools would grant MD degrees.

Also I thought that for any school in the US to grant the MD degree, they need LCME approval. That's why Caribbean schools are necessarily off-shore. They can't exist in the US because the LCME will shut them down.



I could see how the average student from top tier school is stronger than average student from a low tier, because the top tier school has higher admissions standards (so higher matriculant GPA/MCAT scores) than the low tier school. And those who did well on the MCAT will naturally do well on the boards/shelves. And I suppose since top schools have more money, they can afford more resources, hire better faculty and offer more research/clinical opportunities to make students more skilled.

But, when I say PD's are elitist, I'm referring to cases where students from low tier schools who despite being very strong (they destroyed Step exams, excelled in clinical years, have very strong/productive research etc.) end up being shafted simply because they attended a low tier school. An applicant with a 3.9/39 (or 523) can decide to attend their state school or low tier for personal reasons (say their SO has an inflexible job or their parents are sick and need help/comfort). Clearly they have strong academic record before attending school but their situation forces them to attend a low tier. Why should they get shafted by elitist PD's on mere grounds of where they went to school even when they have very strong credentials?



I agree.

Excelling in clinical rotations have a vastly different meaning depends on your clinical education.

Students are graded in comparison with their cohort. A student who had pass on all his third year cores at Columbia maybe average in all subjects compared to his cohort but may possibly honor everything if he goes to PCOM.

 

[Lawpy]

Excelling in clinical rotations have a vastly different meaning depends on your clinical education.

Students are graded in comparison with their cohort. A student who had pass on all his third year cores at Columbia maybe average in all subjects compared to his cohort but may possibly honor everything if he goes to PCOM.

I thought this also depends on grade inflation/deflation and the type of attending with whom the students are paired? Maybe PCOM has more students paired with crappy attendings and they get crushed clinically, but Columbia students are more often paired with good attendings and they do well. So we can't really say with confidence that the average Columbia student will somehow excel clinically at PCOM just because the cohort is weaker.

 

[AnatomyGrey12]

Excelling in clinical rotations have a vastly different meaning depends on your clinical education.

Students are graded in comparison with their cohort. A student who had pass on all his third year cores at Columbia maybe average in all subjects compared to his cohort but may possibly honor everything if he goes to PCOM.

Maybe, but maybe not. The same way that student may or may not honor everything if they went to Drexel, or Penn State, or some other lower tier MD school. There are far too many variables to make this comparison between any schools honestly.

I thought this also depends on grade inflation/deflation and the type of attending with whom the students are paired? Maybe PCOM has more students paired with crappy attendings and they get crushed clinically, but Columbia students are more often paired with good attendings and they do well. So we can't really say with confidence that the average Columbia student will somehow excel clinically at PCOM just because the cohort is weaker.

This, you can’t even make his kind of comparison between MD students.

Edit: not to mention that grading is completely different between schools. Some schools have clinical honors where only the top 15% can get honors in any given rotation, regardless of how well someone does if they aren’t in that top 15% they can’t get honors. Other schools just have a cutoff where if you hit that mark you get honors so it is much easier, and other schools may only be P/F in the clinical years. Far too many variables.

 

[Instatewaiter]

But, when I say PD's are elitist, I'm referring to cases where students from low tier schools who despite being very strong (they destroyed Step exams, excelled in clinical years, have very strong/productive research etc.) end up being shafted simply because they attended a low tier school. An applicant with a 3.9/39 (or 523) can decide to attend their state school or low tier for personal reasons (say their SO has an inflexible job or their parents are sick and need help/comfort). Clearly they have strong academic record before attending school but their situation forces them to attend a low tier. Why should they get shafted by elitist PD's on mere grounds of where they went to school even when they have very strong credentials?

But this doens't really happen with any realistic frequency. Those students who are on par with these elite students do match very well from low tier schools. As an example, my medical school class alone there were 4 matches to Hopkins in various specialties, 2 to Duke, MGH for urology, ENT at Wash U, CCF for ortho (#3 program in the country), a handful each to ortho, ENT, ophtho, and more that I can't remember off of the top of my head.

 

[Lawpy]

But this doens't really happen with any realistic frequency. Those students who are on par with these elite students do match very well from low tier schools. As an example, my medical school class alone there were 4 matches to Hopkins in various specialties, 2 to Duke, MGH for urology, ENT at Wash U, CCF for ortho (#3 program in the country), a handful each to ortho, ENT, ophtho, and more that I can't remember off of the top of my head.

I guess that's good news if these programs are still accessible to strong students from low tier and state schools (which was my main concern).

But even in these cases, prestige bias still plays a role since students from top schools can get into top programs despite having average applications (say average Step 1, no honors, average research etc.). Name probably does matter, but my bigger concern is accessibility.

 

[Instatewaiter]

I guess that's good news if these programs are still accessible to strong students from low tier and state schools (which was my main concern).

But even in these cases, prestige bias still plays a role since students from top schools can get into top programs despite having average applications (say average Step 1, no honors, average research etc.). Name probably does matter, but my bigger concern is accessibility.

The assumption is that the student from Harvard with a 225 and all passes is a worse student and would be a worse resident than a guy from State School U with a 245 and all honors. While you and I can never know if this is the truth, a PD with experience with "average" Harvard students and great state school students does. And they keep matching the "average" student from Harvard... perhaps that should tell us something.

 

[Lawpy]

The assumption is that the student from Harvard with a 225 and all passes is a worse student and would be a worse resident than a guy from State School U with a 245 and all honors. While you and I can never know if this is the truth, a PD with experience with "average" Harvard students and great state school students does. And they keep matching the "average" student from Harvard... perhaps that should tell us something.

Which doesn't make sense to me, and all it tells me is these PD's are selecting for prestige. Because to me, it looks like the state school guy with 245/all honors shows the necessary clinical acumen to function as a good resident. I thought all honors > all passes? Apparently even in these cases, it depends on the med school and PD's care heavily about the name. Which is frustrating.

 

[Instatewaiter]

Which doesn't make sense to me, and all it tells me is these PD's are selecting for prestige. Because to me, it looks like the state school guy with 245/all honors shows the necessary clinical acumen to function as a good resident. I thought all honors > all passes? Apparently even in these cases, it depends on the med school and PD's care heavily about the name. Which is frustrating.

I can't tell if you are being difficult or are just completely missing the point. The point was that a PD can create a class with whomever they want. If the students from low-tier U with great stats were better residents, they would choose them time after time. They don't which likely means these "average" students from Harvard become excellent residents and aren't average at all. In this circumstance, perhaps board scores aren't representative and a pass at Harvard isn't the same as a pass at state U.

 

[Neopolymath]

This is purely program dependent. In all honesty this was already happening at programs that had dual-accreditation. A number of programs in my area did this even if you matched to them through the NRMP match. I know people that were caught off guard and felt screwed over.

I would be really pissed off if I went into this program to do ACGME FM program with the intention of never doing OMM again. Like livid lol. Not even giving an option to opt out if you didn't want the cert implies to me that the program wants the revenue stream that comes with performing the OMM more than anything.

 

[Lawpy]

I can't tell if you are being difficult or are just completely missing the point. The point was that a PD can create a class with whomever they want. If the students from low-tier U with great stats were better residents, they would choose them time after time. They don't which likely means these "average" students from Harvard become excellent residents and aren't average at all. In this circumstance, perhaps board scores aren't representative and a pass at Harvard isn't the same as a pass at state U.

I understood your point and I know that applying for residency can act as a seller's market with PD's choosing whoever they want, which means they are free to select for prestige and justify that by saying these students would become "excellent residents" (even though excellence is subjective). That doesn't mean PD's aren't elitist when making such decisions, because by selecting regularly for average students at top schools, they are also acting on the idea that good students at average schools don't meet the cut.

Then again, no one said human-driven admissions is a fair process especially with cognitive biases and personal preferences playing a major role in deciding who gets interviewed and matched.

 

[deleted831695]

It sucks. I don’t like it. But I get it. They’ve got plenty of apps with the metric they care about on it. They don’t need to look through even more CV’s just to sift through a bunch of apps that might only offer a test score they don’t even understand.

Sure, but then just screen for apps with Step scores. I would agree that applying with only COMLEX is fair grounds to filter out.

Nope. The degree behind your name have absolutely no impact about how you are as a physician.

The degree behind people’s name just happened to impact the training pathway. Starting from questionable clinical training in medical school to questionable AOA residencies.

Aren't you just contradicting yourself? If you think one degree provides "questionable clinical training" starting from medical school (and lol if you believe this is true for all schools), then it does have an impact on how that individual turns out as a physician.

and a midtier program may be more hesistant to recruit FMG/DO due to the fear of being viewed as a place unable to recruit USMDs (see radiologyPD’s post for the exact reasoning)

If a program like Ohio State took in several DO grads, it would still get USMDs lol.

 

[AnatomyGrey12]

I can't tell if you are being difficult or are just completely missing the point. The point was that a PD can create a class with whomever they want. If the students from low-tier U with great stats were better residents, they would choose them time after time. They don't which likely means these "average" students from Harvard become excellent residents and aren't average at all. In this circumstance, perhaps board scores aren't representative and a pass at Harvard isn't the same as a pass at state U.

I think that’s a little assuming. PDs are on record as saying, “I don’t match DOs because it will make my program look bad.” When it comes the tip top of medicine the same thing happens in reverse, “If I take the Harvard guy over the U of Iowa guy, my program looks better.” I’m sure that those students with a 225, all passes from HMS will be great physicians, but to claim that the reason they are always taken at these top programs because “they make better residents” than the great student from State U is kind of dumb. I’ve personally had discussions with too many physicians who trained at the tip top to believe that. They absolutely will choose prestige simply for prestige sake. The reality is that both students will most likely turn out the exact same so the programs choose the one with the bigger name attached because it makes them look better.