Window of opportunity closing for incoming D.O. students?

Nov 21, 2013
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Given the increasing allopathic and osteopathic medical school enrollment combined with the lack of ACGME residency position increases, do you think that incoming osteopathic medical students (class of 2018 and beyond) are going to be faced with similar challenges in attaining ACGME residency positions as international medical graduates of today (class of 2013-2014)?

I just watched this video by the AAMC (shown below) and I am worried about my future prospects as an incoming osteopathic medical student. Namely, taking out 250k in loans and not matching scares me sh!tless.

Please comment on your predictions on how difficult it will be for incoming osteopathic medical students to match in comparison to today's difficulty in matching. Btw, I am primarily interested in matching into a mid- to top-tier ACGME FM residency program (cannot do AOA residency for Canada) but I do not want to exclude other specialties outside of surgery, derm and rad-onc.
 

user3

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20,432 MD matriculants and 6,800 or so DO matriculants are projected for 2014. For 2012-2013 year, there were 27,000 ACGME pipeline residency positions and 2,000 AOA positions (these include military and non-NRMP matches but do NOT include 1 yr programs).

In 2018 about 26,000 US students will graduate if you predict 5% attrition. So in terms of students/residency spot, we should still be in the green. However, no one can predict what specialties will become more or less competitive, so we cannot predict how easily a DO will match into X specialty in 5 years.
 
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DrHitchcraft
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20,432 MD matriculants and 6,800 or so DO matriculants are projected for 2014. For 2012-2013 year, there were 27,000 ACGME pipeline residency positions and 2,000 AOA positions (these include military and non-NRMP matches but do NOT include 1 yr programs).

In 2018 about 26,000 US students will graduate if you predict 5% attrition. So in terms of students/residency spot, we should still be in the green. However, no one can predict what specialties will become more or less competitive, so we cannot predict how easily a DO will match into X specialty in 5 years.
Assuming there are no increases in the number of ACGME residency positions, if approximately all USMDs match (26,000 USMDs into 26,000 of the total 27,000 spots) I am assuming that only the least competitive specialties of 2018 (whatever specialties they may be) would be left for USDOs and IMGs to compete for. Of course, unlike IMGs, USDOs have an alternate path to residency (AOA match)...but for DOs who need an ACGME residency (Canadians), the future prospects seems like something to consider...
 

ChineseKid

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We (Canadians) can always do AOA too. As long as you are ok with staying in the USA.

Besides, it will only get more and more 'competitive.' So do your best and hold no regrets!
 

user3

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Assuming there are no increases in the number of ACGME residency positions, if approximately all USMDs match (26,000 USMDs into 26,000 of the total 27,000 spots) I am assuming that only the least competitive specialties of 2018 (whatever specialties they may be) would be left for USDOs and IMGs to compete for. Of course, unlike IMGs, USDOs have an alternate path to residency (AOA match)...but for DOs who need an ACGME residency (Canadians), the future prospects seems like something to consider...
26,000 will be MD + DO. I am projecting just under 20K MD and 6K DO grads in 2018. In 2013 there were around 18K MD grads
 

macbookpro45

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Medicine was a great, stable field to go into. Is it still? Right now, yes. By the time 2020 rolls around? Who knows, and this video is preccisely why the future is uncertain.

I've been saying this for the past few years to colleagues and friends that we NEED more residency positions to solve physician shortage AND to keep brilliant people entering medicine. Think about it, if you are smart why would you go to med school for 4 years, sink in 250k in loans, only to have a 66% chance of actually being employed as a physician? You wouldn't. You wouldn't take that gamble, and neither would II
 
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26,000 will be MD + DO. I am projecting just under 20K MD and 6K DO grads in 2018. In 2013 there were around 18K MD grads
Totally missed that. Thanks for the correction.

Are you using any sources for these projections?
 

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One thing that is sorta startling to me, why does the AOA have only 2000 spots but admits 6,000 students and steady adding more schools? Second, this topic is posted here every couple of days. US DOs will most likely be okay in the match but you can't predict the future. What needs to happen, is the creating of more high quality residency spots by the AOA, and less discrimination by ACGME against DOs. If there really is a "physician shortage" there has to be somebody to let the idiots in congress know that you can't have more doctors without more GME slots.
 

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verynice

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If it is such an obvious problem and one that seems reasonably fixable (per the video,) then why on earth are we left sitting here being completely worried about our futures? Why don't policy makers just remove/raise the cap and cut funding elsewhere?
 

TheWeeIceMan

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If it is such an obvious problem and one that seems reasonably fixable (per the video,) then why on earth are we left sitting here being completely worried about our futures? Why don't policy makers just remove/raise the cap and cut funding elsewhere?
If only it were that easy...
 
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BestDoctorEver

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If it is such an obvious problem and one that seems reasonably fixable (per the video,) then why on earth are we left sitting here being completely worried about our futures? Why don't policy makers just remove/raise the cap and cut funding elsewhere?
Do we have anyone or any organization lobbying for us? Probably none... If you can not put money into these lawmakers' pocket, your problem will simply be ignored. Period.
 
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Don't internationals have a hard time cause of visa's? I thought Canadian med schools were just as good as the US, are there DO's there too?
 

cabinbuilder

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Given the increasing allopathic and osteopathic medical school enrollment combined with the lack of ACGME residency position increases, do you think that incoming osteopathic medical students (class of 2018 and beyond) are going to be faced with similar challenges in attaining ACGME residency positions as international medical graduates of today (class of 2013-2014)?

I just watched this video by the AAMC (shown below) and I am worried about my future prospects as an incoming osteopathic medical student. Namely, taking out 250k in loans and not matching scares me sh!tless.

Please comment on your predictions on how difficult it will be for incoming osteopathic medical students to match in comparison to today's difficulty in matching. Btw, I am primarily interested in matching into a mid- to top-tier ACGME FM residency program (cannot do AOA residency for Canada) but I do not want to exclude other specialties outside of surgery, derm and rad-onc.
What I don't understand is WHY would you purposely go into DO school thinking you will do and MD residency? There are DO residencies, everyone acts like all DO students want and go into MD residencies, which is not the case. So if you are SO WORRIED about matching ACGME as a DO, then don't go to DO school. Plain and simple.
 
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cabinbuilder

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I haven't found any info, but how do AOA residencies look in terms of post-graduate jobs?
What kind of question is this? Like the quality of your AOA residency is going to affect your future salary? I don't think so. What matter is being board certified, plain and simple. No employer goes into what you did/did not do in residency.
 

Dr. Zombie

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What kind of question is this? Like the quality of your AOA residency is going to affect your future salary? I don't think so. What matter is being board certified, plain and simple. No employer goes into what you did/did not do in residency.
Yep. You're in a bad mood tonight. I PMed you.
 

cabinbuilder

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DrHitchcraft
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What I don't understand is WHY would you purposely go into DO school thinking you will do and MD residency? There are DO residencies, everyone acts like all DO students want and go into MD residencies, which is not the case. So if you are SO WORRIED about matching ACGME as a DO, then don't go to DO school. Plain and simple.
I have nothing against DO residencies or DO schools. I am a Canadian however and Canada does not recognize AOA residency training. I do intend to go back to Canada to practice medicine so I need to get into an ACGME residency.
 

cabinbuilder

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I have nothing against DO residencies or DO schools. I am a Canadian however and Canada does not recognize AOA residency training. I do intend to go back to Canada to practice medicine so I need to get into an ACGME residency.
Well, that does change the thread, doesn't it? I wish you would have stated that in the original post.
 

scoKraz4

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Medicine, like many other industries, will eventually become saturated. So is the window closing? Definitely. Who knows the timeframe though.
When you see statistics on people not matching lately, usually it is people applying to residencies they aren't competitive enough for. So just be realistic about what specialty you are choosing. If you are DO applying for ACGME residency, be prepared to score 20 points or more on USMLE than the MD's applying to those.
 

notbobtrustme

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What I don't understand is WHY would you purposely go into DO school thinking you will do and MD residency? There are DO residencies, everyone acts like all DO students want and go into MD residencies, which is not the case. So if you are SO WORRIED about matching ACGME as a DO, then don't go to DO school. Plain and simple.
There's issues of specialization and localization. If you do an AOA residency, you may not be able to transfer directly into an ACGME fellowship. Also, where you do residency does matter for job placement. High powered residencies have high powered recruiters that let graduates get jobs in better locations with better conditions. Do you really think the person coming out of a Johns Hopkins Osler internal medicine residency will in the same boat as Podunk AOA residency?

That's not to say you can't get a good education at an AOA residency, but people should be aware of what they are getting into. They aren't equivalent in any sense of the word. Finally, there aren't enough AOA residencies anyways, so DO students HAVE to be able to match in ACGME residencies and with increasing MD class sizes, most DOs might end up in poor, malignant programs that were reserved for IMGs.
 
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koan

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What I don't understand is WHY would you purposely go into DO school thinking you will do and MD residency? There are DO residencies, everyone acts like all DO students want and go into MD residencies, which is not the case. So if you are SO WORRIED about matching ACGME as a DO, then don't go to DO school. Plain and simple.
Given that there aren't enough AOA residency slots to meet even half of the graduating DO cohort each year, it makes perfect sense that roughly half of us should assume we will need to be competitive for ACGME positions. Of course it's a source of worry. We are coming in to medical school as a group with presumably lower stats, and an expectation to to compete with MD students for those slots, we need to score better than them on the Steps. And with the GME crunch, anxiety and competition will only increase.

Not every DO student needs to think that way. There are many quality AOA positions out there. But just because a large subset of us are planning to apply to both matches or the ACGME match only, does not mean we shouldn't have gone to DO school. It bugs me when people call ACGME programs "MD residency" or "allopathic residency".
 

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Each new year has been better for DOs than the previous year. However, last year, the acgme gave a presentation at my school describing a GME crisis that will impact the class of 2020. Additional, who knows how the affordable care act will influence GME. My hospital is expecting huge revenue losses due to the ACA, so the hospital administrations have been cutting funds to everything, including graduate medical education. I think, in general, it's a bad time to a doctor in training, MD or DO.
 

Mad Jack

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There's issues of specialization and localization. If you do an AOA residency, you may not be able to transfer directly into an ACGME fellowship. Also, where you do residency does matter for job placement. High powered residencies have high powered recruiters that let graduates get jobs in better locations with better conditions. Do you really think the person coming out of a Johns Hopkins Osler internal medicine residency will in the same boat as Podunk AOA residency?

That's not to say you can't get a good education at an AOA residency, but people should be aware of what they are getting into. They aren't equivalent in any sense of the word. Finally, there aren't enough AOA residencies anyways, so DO students HAVE to be able to match in ACGME residencies and with increasing MD class sizes, most DOs might end up in poor, malignant programs that were reserved for IMGs.
This is really field dependent. If you are in IM, Peds, gen surg, or are looking for an academic position, the name and reputation of your school can matter a lot. But there are many fields where anyone with a pulse and board certification can get a job in a decent hospital, such as EM, optho, any surgical subspecialty, most of the medical subspecialties, etc. You might not end up working at Johns Hopkins, but you can get a job at a decent hospital in a decent city. Having worked at a big Ivy League med center, let me just say that they aren't as great as you would imagine anyway. It was good, but not "OMFG my mind is blown I can never leave this place" sort of good. I was just as happy at the state university medical center. And even at the big med center, our small population of DOs were mostly educated at community ACGME programs, not big ACGME ones, so I wouldn't say a smaller program limits where you end up.

The only AOA residencies I've heard you can somewhat limit yourself with are anesthesia and IM, the former because of some allo group hiring bias, the latter because you are limiting your specialty choices. Oh, and oto/FPS, because the board certification isn't all that widely recognized.
 

guylewis

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Each new year has been better for DOs than the previous year. However, last year, the acgme gave a presentation at my school describing a GME crisis that will impact the class of 2020. Additional, who knows how the affordable care act will influence GME. My hospital is expecting huge revenue losses due to the ACA, so the hospital administrations have been cutting funds to everything, including graduate medical education. I think, in general, it's a bad time to a doctor in training, MD or DO.
Actually, the ACA hasn't fully taken effect yet, and won't until 2014 so this isn't necessarily true. also, having more patients who can pay for their visits ((rather than having them go to the emergency room and foot the bill onto taxpayers) is a good thing for doctors, Primary Care Physician pay has been going up since the bill's passage, and as part of the bill there will be more funding for adding primary care GME slots. it's a great time to become a DO, especially if you're deciding to go the primary care route (which a large percentage DOs decide to do).
 

TheWeeIceMan

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Actually, the ACA hasn't fully taken effect yet, and won't until 2014 so this isn't necessarily true. also, having more patients who can pay for their visits ((rather than having them go to the emergency room and foot the bill onto taxpayers) is a good thing for doctors, Primary Care Physician pay has been going up since the bill's passage, and as part of the bill there will be more funding for adding primary care GME slots. it's a great time to become a DO, especially if you're deciding to go the primary care route (which a large percentage DOs decide to do).
Doesn't matter if the ACA has taken full effect or not. Hospitals are projecting shortfalls and need to take steps early to stay ahead of the curve. As to your second statement, I'm not sure how it is relavent to what cliquesh said, but either way, it is an incredibly simplistic view of how the ACA will effect hospitals.

Lastly, I can't agree with it being a great time to be a DO. Like cliquesh said, it's not that great of a time to be either an MD or DO.
 

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Doesn't matter if the ACA has taken full effect or not. Hospitals are projecting shortfalls and need to take steps early to stay ahead of the curve. As to your second statement, I'm not sure how it is relavent to what cliquesh said, but either way, it is an incredibly simplistic view of how the ACA will effect hospitals.

Lastly, I can't agree with it being a great time to be a DO. Like cliquesh said, it's not that great of a time to be either an MD or DO.
Primary GME spots will be getting more funding as part of the ACA = good news for MDs and DOs who go into primary care. If the House will allow the Schock-Schwartz Training Tomorrow's Doctors Today Act (which was introduced to the House back in March with bipartisan support) to finally be allowed up for a vote, then there will be additional federal funding for 15,000 GME spots over the next five years. but alas, this House refuses to get any legislation through unless it's voting on naming another building after Ronald Reagan

so everyone, lobby for your congressman to allow this critical piece of legislation to finally get voted on in the House.

http://beta.congress.gov/bill/113th/house-bill/1201
 

Fedxup

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I would be happy if only 5000 spots were added...
 
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EMDO2018

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15,000???????



Hello IMG influx, medicine saturation, increased competition for jobs and lower salaries.
 
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EMDO2018

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I didn't actually watch the video until now, so the DOs participating in the ACGME match will go from 2600 to 6000 by 2016 ? Will no one match AOA in 2016 and every single DO goes into the ACGME match? These videos are notorious for leaving out info to make it look as if doomsday is coming.
 
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guylewis

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Would be very true if there wasn't an enormous drought of physicians. 15,000 won't be close to oversaturating
15,000???????



Hello IMG influx, medicine saturation, increased competition for jobs and lower salaries.
 

EMDO2018

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That's 150000 extra residency graduates per Year
 

Instatewaiter

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20,432 MD matriculants and 6,800 or so DO matriculants are projected for 2014. For 2012-2013 year, there were 27,000 ACGME pipeline residency positions and 2,000 AOA positions (these include military and non-NRMP matches but do NOT include 1 yr programs).

In 2018 about 26,000 US students will graduate if you predict 5% attrition. So in terms of students/residency spot, we should still be in the green. However, no one can predict what specialties will become more or less competitive, so we cannot predict how easily a DO will match into X specialty in 5 years.
This assumes the people who want each specialty will match with the availability of specialties. Realistically it will not. So, there will be a larger unmatched rate. How high would just be a guess.
 

user3

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This assumes the people who want each specialty will match with the availability of specialties. Realistically it will not. So, there will be a larger unmatched rate. How high would just be a guess.
Well true, demand across the different specialties will not be even. I looked at charting outcomes in the match and compared 2007 and 2011. Over those 4 years, there were 8% more USMD seniors. However, USMDs applying to Psych, rads, path, peds, gas, dermatology, pm&r, and I think ob/gyn stayed similar or dropped. Applications to FM, IM, EM, GS, ortho, plastics, and a few more rose 10-20% or more. If such trend continues (hypothetical) it looks as if only EM will no longer be as do friendly, as there would still be enough spots in fm and IM while the surgery specialties were never very DO friendly to begin with.

My point, even with more USMD in the match, I imagine there should still be plenty of options for do's due to uneven demand across the specialties.
 

DrBowtie

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Would be very true if there wasn't an enormous drought of physicians. 15,000 won't be close to oversaturating
...not really. There isn't a huge shortage just a maldistribution in location and specialty.
 
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DrBowtie

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Primary GME spots will be getting more funding as part of the ACA = good news for MDs and DOs who go into primary care. If the House will allow the Schock-Schwartz Training Tomorrow's Doctors Today Act (which was introduced to the House back in March with bipartisan support) to finally be allowed up for a vote, then there will be additional federal funding for 15,000 GME spots over the next five years. but alas, this House refuses to get any legislation through unless it's voting on naming another building after Ronald Reagan

so everyone, lobby for your congressman to allow this critical piece of legislation to finally get voted on in the House.

http://beta.congress.gov/bill/113th/house-bill/1201
Is that 15000 funded years total over 5 years meaning ~3k spots?
 

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guylewis

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...not really. There isn't a huge shortage just a maldistribution in location and specialty.
there is actually a shortage of doctors that will be drastically exacerbated over the coming years due to three factors: first, the increased number of senior citizens from the baby boom generation that will be needing doctors. second, an increase in the number of potential patients due to everyone having health insurance. third, a large loss of doctors due to the baby boomer doctors retiring.

so medical schools have been working overtime, accepting 18% more students and opening a whole bunch of medical schools the last couple of years in order to keep up with this shortage

added from the Washington Post: "Nearly 40 percent of doctors are 55 or older, according to the Center for Workforce Studies of the Association of American Medical Colleges. Included in that group are doctors whose specialties will be the pillars of providing care in 2014, when the overhaul kicks in; family medicine and general practitioners (37 percent); general surgeons (42 percent); pediatrics (33 percent), and internal medicine and pediatrics (35 percent)"
 

notbobtrustme

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we need another 1.5 trillion dollar airplane project that utterly fails instead of actually investing in this country's infrastructure.
 
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InGen

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we need another 1.5 trillion dollar airplane project that utterly fails instead of actually investing in this country's infrastructure.
You have to admit though, some of those airplanes are pretty cool :p
 
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One thing that is sorta startling to me, why does the AOA have only 2000 spots but admits 6,000 students and steady adding more schools?.
Because they are entirely out of touch with reality.

Brb 60% of DOs train acgme
Brb we can't merge because we must retain our identity
Brb let's open 4 new schools to expand our brand
Brb brb
 
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darklabel

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there is actually a shortage of doctors that will be drastically exacerbated over the coming years due to three factors: first, the increased number of senior citizens from the baby boom generation that will be needing doctors. second, an increase in the number of potential patients due to everyone having health insurance. third, a large loss of doctors due to the baby boomer doctors retiring.

so medical schools have been working overtime, accepting 18% more students and opening a whole bunch of medical schools the last couple of years in order to keep up with this shortage

added from the Washington Post: "Nearly 40 percent of doctors are 55 or older, according to the Center for Workforce Studies of the Association of American Medical Colleges. Included in that group are doctors whose specialties will be the pillars of providing care in 2014, when the overhaul kicks in; family medicine and general practitioners (37 percent); general surgeons (42 percent); pediatrics (33 percent), and internal medicine and pediatrics (35 percent)"
Yup, we thankfully shouldn't see saturation any time soon, besides in programs like pathology and rads. The problem with any other professional program is that they don't need residency and can practice/work right after school (such as nursing, pharmacy, PA etc). Also, physicians are one of the few groups that can afford to retire so we won't run into the problem nursing has where older nurses are staying longer than anticipated due to economic hardship.
 
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DrBowtie

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Yup, we thankfully shouldn't see saturation any time soon, besides in programs like pathology and rads. The problem with any other professional program is that they don't need residency and can practice/work right after school (such as nursing, pharmacy, PA etc). Also, physicians are one of the few groups that can afford to retire so we won't run into the problem nursing has where older nurses are staying longer than anticipated due to economic hardship.
Check out the Cards/Gas forums. Not saturated, but not a robust job market.
 

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We (Canadians) can always do AOA too. As long as you are ok with staying in the USA.

Besides, it will only get more and more 'competitive.' So do your best and hold no regrets!
Hey, I thought Canadians couldn't do AOA because the AOA residencies didn't sponsor visa. Is that true?
 
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Accepted Canadian at NSU, Nova told me very few AOA residencies sponsor Visa's and even if you get one that does, do you really want to never ever go back to Canada? Canada's healthcare system is much safer than the US system. You don't want to restrict yourself.

ACGME is a must.

Also, if you did somehow do an AOA residency, if you're on a J1, you have to go back to Canada for 2 years. What would you plan on doing for 2 years without recognized training, sitting on 350k Debt? Good luck getting an H1B visa with an AOA residency!
 
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