Why DO graduates are being discriminated by top ACGME programs?

[DrBumblebee]

http://forums.studentdoctor.net/showthread.php?t=984756

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[MedPR]

In

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[113]

IN

An MD attending I worked with at a prominent Boston IM program said it would make his program look "weak."

I'm sure DOs practice medicine just as well as MDs. But in the upper echelons of academic medicine, there are some people who are very concerned with prestige and pedigree. This isn't something that's unique to medicine. For example, investment banking, big law, and consulting shops mostly hire people with prestigious pedigrees.

Sorry bro. Life isn't fair. Just do your best, and hope the chips fall in your favor.

 

[abolt18]

Seriously not seeing the point/objective of the post at the other end of the link...

 

[MedPR]

Seriously not seeing the point/objective of the post at the other end of the link...

Hating on DOs is unethical and illegal.

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[pre med 2014]

Hating on DOs is unethical and illegal.

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And unconstitutional

 

[113]

Hating on DOs is unethical and illegal.

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Lewd. Lascivious. Salacious. Outrageous!

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[Dmr6186]

Why do people make these threads? Can't you watch TV or talk to your friends?

 

[Ost3oclast]

Why do people make these threads? Can't you watch TV or talk to your friends?

Hahahaha this.

 

[Mr Kenobi]

Now cool down.

 

[IslandStyle808]

Now cool down.

For a second there I thought you were going to say the s*** hit the fan.

 

[docmayer]

Because they have DO after their name and not MD. It's that simple.

 

[SLC]

Because up until 2015, the ACGME exists to provide post graduate training to graduates of LCME accredited medical schools and the AOA programs exist to provide GME for COCA institutions.

The fact that ACGME takes DO's is a nice bonus for those of us who are becoming DO's, but it's not their purpose at all. And that makes their preference for MD grads understandable and for that matter...appropriate.

Come 2015 however...things may have to change.

 

[kjamess]

Come 2015 however...things may have to change.

Unless the members of the selection committees of these institutions change, I wouldnt hold my breath.

 

[Dharma]

Brush your shoulders off!

These programs also discriminate against certain MD schools. Not worth the time or the dime to sweat over.

 

[HalfListic]

And otherwise...stop caring

 

[DrBumblebee]

Brush your shoulders off!

These programs also discriminate against certain MD schools. Not worth the time or the dime to sweat over.

Yes, I don't care "top" ACGME programs, at all. I'm just curious why this discrimination exists. Contrary to some monkeys posting "because MD >>> DO" without evidence, I'm finding evidence for this unethical discrimination: it's all about the POLITICS to be able to use the huge amount of money among a group of elitists, which has been under serious investigation. Things will definitely change...

I think all problems related with discrimination of DO graduates at top ACGME programs, and with the same for MD graduates at AOA programs just boil down to politics... politics of some who'd like to play with huge amounts of money that is used to finance the GME, which needs a careful and deep investigation.

In recent years, Congress has revealed its uncertainty over how to change federal workforce policy. (The uncertain future of Medicare and graduate medical education. N Engl J Med 2011;365:1340-1345)

In the Affordable Care Act (ACA), Congress emphasized the importance of expanding the primary care workforce. But legislators rejected the AAMC's call to expand the number of Medicare-funded GME positions by 15% in response to reported physician shortages in some specialties. And the National Commission on Fiscal Responsibility and Reform, which included 14 senior congressional leaders, recommended substantial reductions in Medicare's GME support but failed to muster the votes necessary to send its package to the House and Senate floor for consideration.

On December 21, seven senators — Democrats Michael Bennet (CO), Jeff Bingaman (NM), Mark Udall (CO), and Tom Udall (NM) and Republicans Mike Crapo (ID), Chuck Grassley (IA), and Jon Kyl (AZ) — sent a letter to the Institute of Medicine (IOM) encouraging it to “conduct an independent review of the governance and financing of our system of [GME].” They urged the IOM to explore subjects including accreditation; reimbursement policy; the use of GME to better predict and ensure adequate workforce supply in terms of type of provider, specialty, and demographic mix; GME's role in care of the underserved; and use of GME to ensure the creation of a workforce with the skills necessary for addressing future health care needs.

The senators emphasized their interest “in IOM's observations about the uneven distribution of GME funding across states based on need and capacity, and how to address this inequity.”

In an interview, Bingaman said he initiated the letter for the same reasons he had championed creation of a National Health Care Workforce Commission as part of the ACA: to strengthen the government's resolve to do “a more credible job of assessing workforce shortages” and because he believes Medicare's GME policies are “outmoded ” Republicans have opposed appropriating the $3 million requested for launching the workforce commission because its authority derives from the ACA.

The priorities cited in the IOM letter parallel some of the recommendations of a group of academic medical leaders who gathered at two conferences underwritten by the Josiah Macy Jr. Foundation. At the first conference, in October 2010, the top recommendation was that “an independent external review of the goals, governance, and financing of the GME system should be undertaken by the Institute of Medicine, or a similar body. (Ensuring an effective physician workforce for America: recommendations for an accountable graduate medical education system — conference summary, October 2010, Atlanta. New York: Josiah Macy Jr. Foundation, 2010.)

Similarly, a recent Carnegie Foundation report asserted that “GME redesign demands . . . a more broad-based, less politicized flow of funds. (Cooke M, Irby DM, O'Brien BC. Educating physicians: a call for reform of medical school and residency. San Francisco: Jossey-Bass, 2010.)

Source:
Financing Graduate Medical Education — Mounting Pressure for Reform - http://www.nejm.org/doi/full/10.1056/NEJMp1114236#t=article

 

[SLC]

Unless the members of the selection committees of these institutions change, I wouldnt hold my breath.

I won't either, but if the ACGME becomes the official GME institution for both MD's and DO's at that point (as is the plan), then I could see someone with a legal complaint of discrimination potentially having somewhat of a case.

 

[DrBowtie]

I won't either, but if the ACGME becomes the official GME institution for both MD's and DO's at that point (as is the plan), then I could see someone with a legal complaint of discrimination potentially having somewhat of a case.

On what grounds? Your school attended part of your credentials that you are judged on, and not a protected class.

 

[SLC]

On what grounds? Your school attended part of your credentials that you are judged on, and not a protected class.

I disagree completely. The accrediting standards make sure that everyone gets a more or less standardized education. We're all highly trained and had to learn the same material to pass the boards.

Your board scores, clinical grades and recommendations, and your Pre-clinical grades should be what determines what residency you can get, not what school you were able to talk into accepting you.

 

[kjamess]

I won't either, but if the ACGME becomes the official GME institution for both MD's and DO's at that point (as is the plan), then I could see someone with a legal complaint of discrimination potentially having somewhat of a case.

...this is a joke, right?

 

[DrBowtie]

I disagree completely. The accrediting standards make sure that everyone gets a more or less standardized education. We're all highly trained and had to learn the same material to pass the boards.

Your board scores, clinical grades and recommendations, and your Pre-clinical grades should be what determines what residency you can get, not what school you were able to talk into accepting you.

Actually, the GME standards will be the same, not the medical education part. COCA vs. LCME.

Secondly, academic pedigree always will matter.

 

[DrBumblebee]

I disagree completely. The accrediting standards make sure that everyone gets a more or less standardized education. We're all highly trained and had to learn the same material to pass the boards.

Your board scores, clinical grades and recommendations, and your Pre-clinical grades should be what determines what residency you can get, not what school you were able to talk into accepting you.

This. +1

This is what could be named as standardization. Anything less is unethical, let alone illegal, if GME has been using public money.

Besides, no single PD in question is funding GME but the public, and tax payers in large. So, federal government should be able to have control and investigation rights about what's going on using this fund. Current system doesn't allow federal government to control or question where and how this fund's being spent, which gives way to some elitist groups (which have prejudiced PDs) to favor "their" groups. This must be changed...

 

[Skeeks]

Actually, the GME standards will be the same, not the medical education part. COCA vs. LCME.

Secondly, academic pedigree always will matter.

This is true. Academic pedigree is the only way academia keeps its self justification for existing, its not going anywhere.

Dont worry about it. Work hard as a DO, go to whatever residency you want (AOA or ACGME) regardless of supposed "prestige" and if you want to be a kick 'A' doctor then do it by your own hard work. Be a good student, work your 'A' off, be humble and learn from other's mistakes and strengths and leave all the prestige to those who need someone else's opinion to feel good about themselves.

 

[DrBumblebee]

Actually, the GME standards will be the same, not the medical education part. COCA vs. LCME.

Secondly, academic pedigree always will matter.

Sure, unless a federal authority pounds on this illegal structure and shatters it for the public's own good, which is on its way.

People and innovations follow the money. If, let's say, GME money would be adequately funding "less favorable" residency programs, these programs would be attracting much better physicians and academicians, which in turn would cause this "less favorable" program to become a stronger one. This should be happening if we need more than one strong research hospitals by par with Johns Hopkins or Columbia.

I'm expecting the new changes in Graduate Meducal Education (GME) would give much better chances to build new yet reputable research centers. Single payer, single controlled system is the way to go for GME for our times to provide transparent and fair education rights for all US medical school graduates. Power without control is extremely dangerous...

 

[kjamess]

Sure, unless a federal authority pounds on this illegal structure and shatters it for the public's own good, which is on its way.

People and innovations follow the money. If, let's say, GME money would be adequately funding "less favorable" residency programs, these programs would be attracting much better physicians and academicians, which in turn would cause this "less favorable" program to become a stronger one. This should be happening if we need more than one strong research hospitals by par with Johns Hopkins or Columbia.

I'm expecting the new changes in Graduate Meducal Education (GME) would give much better chances to build new yet reputable research centers. Single payer, single controlled system is the way to go for GME for our times to provide transparent and fair education rights for all US medical school graduates. Power without control is extremely dangerous...

fight the good fight, bro.

 

[SLC]

...this is a joke, right?

No, not a joke.

In 2015 I fully expect there to be a move toward taking the best qualified applicant, based solely on stats, not the letters on the degree. There will always be programs that only take grads from Hopkins, Harvard, Penn etc. but by-and-large I think the notion of discrimination against DO's will have to go away if the ACGME is going to be our GME organization. It's common sense isn't it?

I'm not saying it will happen over-night, but I think that's the way it will have to start going.

 

[SLC]

Actually, the GME standards will be the same, not the medical education part. COCA vs. LCME.

Secondly, academic pedigree always will matter.

I understand this, but if the ACGME is going to be the DO GME organization, they won't get far condoning the practice of holding DO's to a different standard, or discriminating against them completely.

I think Dr. BB takes things a little too far most of the time, but I think there's at least something to the idea he's tryig to get across.

 

[MedPR]

Why do people make these threads? Can't you watch TV or talk to your friends?

Cool down

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[HalfListic]

No, not a joke.

In 2015 I fully expect there to be a move toward taking the best qualified applicant, based solely on stats, not the letters on the degree. There will always be programs that only take grads from Hopkins, Harvard, Penn etc. but by-and-large I think the notion of discrimination against DO's will have to go away if the ACGME is going to be our GME organization. It's common sense isn't it?

I'm not saying it will happen over-night, but I think that's the way it will have to start going.

+1

Agree for sure

 

[MedPR]

I disagree completely. The accrediting standards make sure that everyone gets a more or less standardized education. We're all highly trained and had to learn the same material to pass the boards.

Your board scores, clinical grades and recommendations, and your Pre-clinical grades should be what determines what residency you can get, not what school you were able to talk into accepting you.

I understand this, but if the ACGME is going to be the DO GME organization, they won't get far condoning the practice of holding DO's to a different standard, or discriminating against them completely.

I think Dr. BB takes things a little too far most of the time, but I think there's at least something to the idea he's tryig to get across.

Discrimination of this sort already occurs in the MD world when you consider top school grads vs lower tier grads. Just putting that out there.

Pedigree matters at some programs and that's not going to change just because of the merger.

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[DrBowtie]

Sure, unless a federal authority pounds on this illegal structure and shatters it for the public's own good, which is on its way.

Again on what grounds? The opportunity is already accessible, but in a competitive market, small things such as school attended can send you to the circular file. No different than applying for a federal job with a degree from Harvard vs. UofPhoenix.

People and innovations follow the money. If, let's say, GME money would be adequately funding "less favorable" residency programs, these programs would be attracting much better physicians and academicians, which in turn would cause this "less favorable" program to become a stronger one. This should be happening if we need more than one strong research hospitals by par with Johns Hopkins or Columbia.

New GME funding already goes to less favorable residency programs. The quotas at the top notch places have been set for years and any new additions must be funded from their own budgets or outside revenue. It's new hospitals applying for spots that are in the most advantageous position.

I'm expecting the new changes in Graduate Meducal Education (GME) would give much better chances to build new yet reputable research centers. Single payer, single controlled system is the way to go for GME for our times to provide transparent and fair education rights for all US medical school graduates. Power without control is extremely dangerous...

What changes are you expecting? Reputable research centers are built by reputable researchers bringing in competitive research grants with the help of outside private donors. That has nothing to do with GME.

The hospital becomes great/well known before GME there becomes popular/competitive not vice versa.

 

[Dissected]

I understand this, but if the ACGME is going to be the DO GME organization, they won't get far condoning the practice of holding DO's to a different standard, or discriminating against them completely.

I think Dr. BB takes things a little too far most of the time, but I think there's at least something to the idea he's tryig to get across.

A little too far??

There is not a conspiracy..theres no one person or board of people in the ACGME plotting against DO's. It boils down to individual perceptions of Osteopathic training which is profoundly varied among PD's and educators. Like others have said there is an academic pedigree which is in no way illegal..it just exists and it always will.

Haters will continue to hate. DO's will still have to suck it up and bust their butts. The old guard will retire and things will get better as they slowly have for the past decade or so.

 

[DrBowtie]

I understand this, but if the ACGME is going to be the DO GME organization, they won't get far condoning the practice of holding DO's to a different standard, or discriminating against them completely.

I think Dr. BB takes things a little too far most of the time, but I think there's at least something to the idea he's tryig to get across.

I again think this is wishful thinking for it to be degree blind, but I do think there will be more DOs in the mid tier places since they won't have to gamble on forgoing the AOA match, not because of increased "acceptance".

 

[MedPR]

A little too far??

There is not a conspiracy..theres no one person or board of people in the ACGME plotting against DO's. It boils down to individual perceptions of Osteopathic training which is profoundly varied among PD's and educators. Like others have said there is an academic pedigree which is in no way illegal..it just exists and it always will.

Haters will continue to hate. DO's will still have to suck it up and bust their butts. The old guard will retire and things will get better as they slowly have for the past decade or so.

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[DrBumblebee]

This is true. Academic pedigree is the only way academia keeps its self justification for existing, its not going anywhere.

Dont worry about it. Work hard as a DO, go to whatever residency you want (AOA or ACGME) regardless of supposed "prestige" and if you want to be a kick 'A' doctor then do it by your own hard work. Be a good student, work your 'A' off, be humble and learn from other's mistakes and strengths and leave all the prestige to those who need someone else's opinion to feel good about themselves.

This is true, and is the way many students, at US-DO and US-MD schools, follow.

However, there's a known issue that's called the "American greed" for money and power. If some people in America intentionally starts building a select group of people or institutions (a pedigree is the name of it???) by playing with the public money and/or resources, then the federal government, sooner or later, should intervene and shatter this monopoly for public's good.

It's an unbelievable amount of money that's been spent on GME, which is definitely attracting some people's attentions. Then, to cover their bases, they name it like "we tend to prefer a pedigree in medical education, so we don't prefer those MD schools' and all DO schools' graduates." But why? The answer is that they are helping the monopoly undercover, while benefiting from that pie. Whose pie is it? Who's the owner of all of this money spent to GME? It's public money and resources in large without a doubt...

We all went through many science courses, and we all learned that things are useful, applicable, understandable, and transparent when are standardized.

GME and it's funding must be standardized and investigated frequently, too.

 

[SLC]

Discrimination of this sort already occurs in the MD world when you consider top school grads vs lower tier grads. Just putting that out there.

Pedigree matters at some programs and that's not going to change just because of the merger.

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You're right, and I'm not denying it. I'm just saying that I fully expect to see DO's and MD's having equal opportunities. Meaning that you with an MD from a run-of-the-mill institution and a fellow DO student from a run-of-the-mill will compete head to head on an equal playing field. If the DO has a higher board score, better recs etc then he/she gets the position (and vice-versa). I know there's more to it than that (the program has to like the applicant or scores aren't going to mean much), but the idea of an MD getting in over a DO with a 10-15 point higher 3-digit USMLE score (all else being equal) is going to have to go by the wayside. That or I think you'll see legal complaints, and I think they'd have a chance of getting somewhere.

 

[MedPR]

You're right, and I'm not denying it. I'm just saying that I fully expect to see DO's and MD's having equal opportunities. Meaning that you with an MD from a run-of-the-mill institution and a fellow DO student from a run-of-the-mill will compete head to head on an equal playing field. If the DO has a higher board score, better recs etc then he/she gets the position (and vice-versa). I know there's more to it than that (the program has to like the applicant or scores aren't going to mean much), but the idea of an MD getting in over a DO with a 10-15 point higher 3-digit USMLE score (all else being equal) is going to have to go by the wayside. That or I think you'll see legal complaints, and I think they'd have a chance of getting somewhere.

How would anyone know that's happening though? I know the NRMP publishes some stats but it's not that detailed is it?

In the end I do agree that there shouldn't be discrimination because of all the points you make about standardized medical education. I just don't see it happening, and I again refer to the analogy I once made about the civil rights movement. Yes there are safeguards in place, but there is still widespread discrimination for no other reason than skin color.

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[kjamess]

You're right, and I'm not denying it. I'm just saying that I fully expect to see DO's and MD's having equal opportunities. Meaning that you with an MD from a run-of-the-mill institution and a fellow DO student from a run-of-the-mill will compete head to head on an equal playing field. If the DO has a higher board score, better recs etc then he/she gets the position (and vice-versa). I know there's more to it than that (the program has to like the applicant or scores aren't going to mean much), but the idea of an MD getting in over a DO with a 10-15 point higher 3-digit USMLE score (all else being equal) is going to have to go by the wayside. That or I think you'll see legal complaints, and I think they'd have a chance of getting somewhere.

and when does it stop? will md applicants from low tier schools start suing for getting passed over for an md applicant from a prestigious place? I honestly dont see how this merger will influence members of the selection committee, because whatever reservation they had against DOs before will still remain even after the merger.

 

[DrBowtie]

You're right, and I'm not denying it. I'm just saying that I fully expect to see DO's and MD's having equal opportunities. Meaning that you with an MD from a run-of-the-mill institution and a fellow DO student from a run-of-the-mill will compete head to head on an equal playing field. If the DO has a higher board score, better recs etc then he/she gets the position (and vice-versa). I know there's more to it than that (the program has to like the applicant or scores aren't going to mean much), but the idea of an MD getting in over a DO with a 10-15 point higher 3-digit USMLE score (all else being equal) is going to have to go by the wayside. That or I think you'll see legal complaints, and I think they'd have a chance of getting somewhere.

Sure if you assume that run of the mill DO school = run of the mill MD school then yes you'd be correct, however there are clearly plenty of people including program directors who don't view them as equal hence the need for higher USMLE scores to compensate.

 

[SLC]

How would anyone know that's happening though? I know the NRMP publishes some stats but it's not that derailed is it?

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Like I said, if a DO goes out on the interview trail and interviews with a bunch of MD's with significantly lower scores and still doesn't match, that might be a good indication and worth investigating.

How do civil rights cases get investigated? I'd imagine it wouldn't be all that different. (No I'm not equating this to a civil rights issue, but there are comparisons to be drawn).

 

[Dissected]

Sure if you assume that run of the mill DO school = run of the mill MD school then yes you'd be correct, however there are clearly plenty of people including program directors who don't view them as equal hence the need for higher USMLE scores to compensate.

I think a lot of what is getting lost here is that each program interviews and selects candidates individually. There is no master, over-arching panel that dictates why programs select who they do. Things will change in 2015, but like Dr. Bowtie is trying to get across none of these programs are simply going to change gears and look at all applicants differently just because some previously AOA accredited programs are now ACGME accredited. They will still use the same selection criteria, interview the same type of applicants, and rank whoever they darn well please.

And Dr. Bowtie was exactly right when he said that there will be more DO's in mid-tier programs.. and it will be because they don't have to gamble and skip a guaranteed spot in the AOA match anymore..it won't be beause of an inherent change in how candidates are chosen. Remember people, for every rockstar DO applicant, there are going to be MD applicants with higher scores, more research, and more connections. So all of this talk about a hypothetical "more qualified DO applicant being discriminated against" certainly exists, but it makes up the minority. Trust me. In general, the DO applicants that are qualified enough for their specialty of choice usually do very well.

 

[SLC]

Sure if you assume that run of the mill DO school = run of the mill MD school then yes you'd be correct, however there are clearly plenty of people including program directors who don't view them as equal hence the need for higher USMLE scores to compensate.

This is exactly the issue though. Can anyone put out a coherent description of the difference in quality between your average DO and average MD 4th year? Our best are as good clinically as the best MD's and our worst are just as bad.

I will concede research experience, but in programs that focus on patient care and not research, what's the difference exactly?

There was a story a week or so posted on SDN of a DO student who was told by a top IM program director that taking DO's would "make his program look weak", now if there are DO's who are just as gifted as the residents he takes, why would his program "look weak"?

That's a pretty lame excuse IMO, and noone here has had any response except "that's how it is, deal with it". I'm saying that come 2015, we shouldn't have to "deal with it". Especially not when these programs are largely funded by tax dollars.

 

[DrBumblebee]

and when does it stop? will md applicants from low tier schools start suing for getting passed over for an md applicant from a prestigious place? I honestly dont see how this merger will influence members of the selection committee, because whatever reservation they had against DOs before will still remain even after the merger.

All osteopathic and allopathic committees are private institutions. Those committees are only responsible to oversee the GME funding and accreditation.

GME funding comes, in large, from the federal government's resources. Thus, if the federal government intervenes, and dictates what it'd like to see to be accomplished by its money, I don't see any of those private institutions would argue with the federal government without losing their credibility and then their seats around the table for the new, unified GME controlling body.

There's a strong support to build a new organization to control the GME and its funding to make things standardized for all US medical school graduates.

In October 2010, the top recommendation was that "an independent external review of the goals, governance, and financing of the GME system should be undertaken by the Institute of Medicine, or a similar body. (Ensuring an effective physician workforce for America: recommendations for an accountable graduate medical education system — conference summary, October 2010, Atlanta. New York: Josiah Macy Jr. Foundation, 2010.)

 

[Dissected]

This is exactly the issue though. Can anyone put out a coherent description of the difference in quality between your average DO and average MD 4th year? Our best are as good clinically as the best MD's and our worst are just as bad.

Well then be a hero and go confront these PD's. See how many minds you can change!

Nothing is compelling their minds to change and honestly the only thing that might is if they are impressed by a DO student who rotates, a DO resident that works hard, or a DO physician that is a respected colleague.

Short of this, it sucks, but that is the predicament we are faced with. It's tough out there, but work harder and read more than those around you and you can succeed.

 

[racerwad]

Like I said, if a DO goes out on the interview trail and interviews with a bunch of MD's with significantly lower scores and still doesn't match, that might be a good indication and worth investigating.

How do civil rights cases get investigated? I'd imagine it wouldn't be all that different. (No I'm not equating this to a civil rights issue, but there are comparisons to be drawn).

But there is more to residency application evaluation than just board scores. That's just one metric. What about the fact that when a PD looks at two applicants they will consider who needs the most work getting up to speed? If one applicant has a lot of experience (through their core rotations) working with sick patients while another applicant did a lot of outpatient rotations (through their core rotations) who do you think that PD is going to choose?

There isn't anything wrong with being a DO but if you think that the average DO school is the same as an average MD school, that is a mistake. I think that this has more to do with the "bias" than any quantifiable board score. I think most PDs (esp of more competitive programs) know that DO students tend to rotate through smaller, lower acuity facilities. This doesn't make them dumber, but it does give the program more work on the front end getting the DO student up to scratch. Again, this counts more for specialties that deal in higher acuity patients than FM. I think this, along with pedigree, is also what PDs take into account when evaluating MD students from lower-tier institutions.

 

[DrBumblebee]

Well then be a hero and go confront these PD's. See how many minds you can change!

Nothing is compelling their minds to change and honestly the only thing that might is if they are impressed by a DO student who rotates, a DO resident that works hard, or a DO physician that is a respected colleague.

Short of this, it sucks, but that is the predicament we are faced with. It's tough out there, but work harder and read more than those around you and you can succeed.

I admit what you're talking about. However, things should and will change if the regulations to select the candidates for GME change. The tipping point for this change was the federal government's strong efforts to unify those private institutions around a single table, and dictate them what it wants its public's money be spent on and how.

If those PDs that used to be prejudice against some MDs and all DOs are really that smart, then they'll definitely feel the wind behind the change and assume their positions.

No single MD or DO can confront any PD, who has a prejudice. But, there's the government to iron out any of those conflicts, if there's a benefit for the public.

 

[MedPR]

Like I said, if a DO goes out on the interview trail and interviews with a bunch of MD's with significantly lower scores and still doesn't match, that might be a good indication and worth investigating.

How do civil rights cases get investigated? I'd imagine it wouldn't be all that different. (No I'm not equating this to a civil rights issue, but there are comparisons to be drawn).

That's assuming people share their stats on interviews though.. Unless there's something I'm missing?

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[kjamess]

This is exactly the issue though. Can anyone put out a coherent description of the difference in quality between your average DO and average MD 4th year? Our best are as good clinically as the best MD's and our worst are just as bad.

I will concede research experience, but in programs that focus on patient care and not research, what's the difference exactly?

There was a story a week or so posted on SDN of a DO student who was told by a top IM program director that taking DO's would "make his program look weak", now if there are DO's who are just as gifted as the residents he takes, why would his program "look weak"?

That's a pretty lame excuse IMO, and noone here has had any response except "that's how it is, deal with it". I'm saying that come 2015, we shouldn't have to "deal with it". Especially not when these programs are largely funded by tax dollars.

Because the more DOs and US IMGs there are in a program, the more "uncompetitive" a program is viewed as. There is a general bias against DOs and US IMGs at the competitive programs, so when a program is filled by DOs and IMGs, its considered uncompetitive.

 

[DrBumblebee]

But there is more to residency application evaluation than just board scores. That's just one metric. What about the fact that when a PD looks at two applicants they will consider who needs the most work getting up to speed? If one applicant has a lot of experience (through their core rotations) working with sick patients while another applicant did a lot of outpatient rotations (through their core rotations) who do you think that PD is going to choose?

There isn't anything wrong with being a DO but if you think that the average DO school is the same as an average MD school, that is a mistake. I think that this has more to do with the "bias" than any quantifiable board score. I think most PDs (esp of more competitive programs) know that DO students tend to rotate through smaller, lower acuity facilities. This doesn't make them dumber, but it does give the program more work on the front end getting the DO student up to scratch. Again, this counts more for specialties that deal in higher acuity patients than FM. I think this, along with pedigree, is also what PDs take into account when evaluating MD students from lower-tier institutions.

No single medical school can give its students an exceptionally better clinical experience than other schools do. It's just the 1.5 years (including the holidays and off time) between the end of the pre-clinical training and the residency match we're talking about. However, it's the GME that the US-DO and US-MD graduates learn to be a real physician. Even some need to go for a fellowship to further extend their experience before they start working as an attending physician. So, your logic behind the comparison between US-DO and US-MD graduates is invalid or doesn't apply at all conditions.

We need a standardized application process for the GME, regardless of the school the applicant comes from. Better grades, better board scores, better LORs and reviews, etc. should equate a better chance.