Conditional acceptance to top choice vs other acceptance

[dracosta]

So I was accepted early this cycle by an IS DO school (PNWU) and then this week I got an email for a conditional acceptance at my top choice school (MSUCHM). I was thinking that the choice of where I would go would be really easy after hearing from MSU, either I would be accepted or rejected, but now I'm feeling really conflicted. The conditional acceptance is that I would have to complete a 1 year post-bac at MSU and would then be guaranteed acceptance the next year. I'm a reapplicant so I've already waited one year and I'm not sure that I want to wait another year, PLUS do another year in school. Basically I'm 50/50 in either direction so I need something to sway my decision. I'm not starting an MD vs DO debate, I'm trying to think out all other pros and cons and hoping to hear something I haven't thought of before.

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[cabinbuilder]

Take the acceptance you have and just be a doctor. I personally am leary about "conditional acceptances". Worse case scenario you go to the post bacc, have issues (it happens) and don't do well. They can choose not to give that promised slot in next year's class and then you would be left with nothing. I personally would not risk it. Take the acceptance and move on.

 

[dracosta]

Take the acceptance you have and just be a doctor. I personally am leary about "conditional acceptances". Worse case scenario you go to the post bacc, have issues (it happens) and don't do well. They can choose not to give that promised slot in next year's class and then you would be left with nothing. I personally would not risk it. Take the acceptance and move on.

That's a really good point, one I hadn't thought of. Thanks.

 

[Goro]

Bird in the hand is worth??????

So I was accepted early this cycle by an IS DO school (PNWU) and then this week I got an email for a conditional acceptance at my top choice school (MSUCHM). I was thinking that the choice of where I would go would be really easy after hearing from MSU, either I would be accepted or rejected, but now I'm feeling really conflicted. The conditional acceptance is that I would have to complete a 1 year post-bac at MSU and would then be guaranteed acceptance the next year. I'm a reapplicant so I've already waited one year and I'm not sure that I want to wait another year, PLUS do another year in school. Basically I'm 50/50 in either direction so I need something to sway my decision. I'm not starting an MD vs DO debate, I'm trying to think out all other pros and cons and hoping to hear something I haven't thought of before.

 

[pietachok]

Are you guaranteed the acceptance regardless of your grades in the post-baccalaureate year? From what you wrote, that's what it sounded like.

 

[QofQuimica]

Did MSU explain why they want you to do the year of postbac? Because if they expressed some reservations about your academic preparedness for med school that they feel would be resolved by the extra postbac year, it would be wise to take their concerns seriously. On the other hand, if they can't really point to a specific deficiency or deficiencies that they feel you have, and especially if they can't explain how your participation in their postbac would remedy the perceived problems, then I agree with CB and Goro that you should just go with the sure thing. I'm guessing you're probably fine. Adcoms are pretty good at weeding out people who can't hack the academics, and PNWU doesn't seem to share MSU's concerns, whatever they may be. But I've never heard of a "conditional acceptance" like this, and it might be helpful for your own self-awareness of any academic weaknesses if you understood the logic behind them doing this.

 

[FormerPhysicist]

Just wanted to mention, PNWU runs at $46k/year in tuition, while MSU costs $61.5k/year. That's a very large difference in debt level between the two, without even considering the one year post-bac at MSU.

 

[dracosta]

Are you guaranteed the acceptance regardless of your grades in the post-baccalaureate year? From what you wrote, that's what it sounded like.

I've emailed the school for more info on the program because I know there are minimum requirements for gpa etc but I dont know what they are. I got referred to the program because I got some less than great grades in biochem and ochem. I would be retaking some upper level bio classes and some M1 classes in the year of the postbac and assuming I met the requirements I would be guaranteed a spot in the next years class. I don't know how successful the program is but I've heard good things from several people.

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[dracosta]

Just wanted to mention, PNWU runs at $46k/year in tuition, while MSU costs $61.5k/year. That's a very large difference in debt level between the two, without even considering the one year post-bac at MSU.

I had thought about that and I think I could qualify for in state after one year because my husband would have a full time job there, in which case it would be considerably cheaper.

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[cabinbuilder]

I've emailed the school for more info on the program because I know there are minimum requirements for gpa etc but I dont know what they are. I got referred to the program because I got some less than great grades in biochem and ochem. I would be retaking some upper level bio classes and some M1 classes in the year of the postbac and assuming I met the requirements I would be guaranteed a spot in the next years class. I don't know how successful the program is but I've heard good things from several people.

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Forget that. How much biochem and organic do you get in med school? Not much. There is a biochem section but in the overall scheme, their reasoning just sounds dumb to me. Take the acceptance, move on.

 

[pietachok]

Forget that. How much biochem and organic do you get in med school? Not much. There is a biochem section but in the overall scheme, their reasoning just sounds dumb to me. Take the acceptance, move on.

I disagree. I do not think it is that straightforward of a decision. And I felt there was a significant biochem component in the first semester of med school -- having come from a postbacc where the bio course somehow fulfilled biochem requirements in spite of not actually covering the material, I really struggled with a bunch of stuff that was new to me. While orgo probably universally is not a big deal, the utility of biochem is probably different school to school.

If essentially all of the students with the conditional acceptance end up matriculating, there is little risk to doing it. Regardless of one's opinions on DO vs MD or whether it is fair, it's simply fact that while no residency will be biased against you simply for holding an MD, some will be biased against DO applicants. I am not even going into a competitive field and many of the good let alone great programs will just not even consider DO candidates even though there are only enough MD applicants to fill about half of the spots nationally. I nearly attended a DO program, and now that I'm at the point of applying to residency, osteopathic colleagues from my postbacc who are going into the same field and actually performed as well or better than I did are getting less interviews and really struggling to get prelim interviews.

And it sounds like they will be allowing the OP to take some MS1 courses in her postbacc -- OP, do they make you retake those once you technically matriculate? If they don't, that actually frees up time to kick butt on the courses she does take, which may be useful to someone who has academically struggled in the past. Alternatively, it might allow for more research or similar ECs that can strengthen a residency application.

 

[FormerPhysicist]

I had thought about that and I think I could qualify for in state after one year because my husband would have a full time job there, in which case it would be considerably cheaper.

Edit: Nevermind, I'm bad at reading fine print. MSUCHM is considerably cheaper for in-state residents, so that is a definite advantage to attending.

 

[dracosta]

I disagree. I do not think it is that straightforward of a decision. And I felt there was a significant biochem component in the first semester of med school -- having come from a postbacc where the bio course somehow fulfilled biochem requirements in spite of not actually covering the material, I really struggled with a bunch of stuff that was new to me. While orgo probably universally is not a big deal, the utility of biochem is probably different school to school.

If essentially all of the students with the conditional acceptance end up matriculating, there is little risk to doing it. Regardless of one's opinions on DO vs MD or whether it is fair, it's simply fact that while no residency will be biased against you simply for holding an MD, some will be biased against DO applicants. I am not even going into a competitive field and many of the good let alone great programs will just not even consider DO candidates even though there are only enough MD applicants to fill about half of the spots nationally. I nearly attended a DO program, and now that I'm at the point of applying to residency, osteopathic colleagues from my postbacc who are going into the same field and actually performed as well or better than I did are getting less interviews and really struggling to get prelim interviews.

And it sounds like they will be allowing the OP to take some MS1 courses in her postbacc -- OP, do they make you retake those once you technically matriculate? If they don't, that actually frees up time to kick butt on the courses she does take, which may be useful to someone who has academically struggled in the past. Alternatively, it might allow for more research or similar ECs that can strengthen a residency application.

Assuming I succeeded in the postbac I would not have to retake the M1 classes and so yes, would be able to focus even more on the other classes and potentially participate in more time consuming/valuable EC's. This is a plus for me, though as of yet I still have not heard back from the school as to what is actually required to succeed in the program.

I've heard similar arguments from others regarding what you said about the bias against DO applicants, especially in the residency application department. In your experience, is it possible that many of the DO applicants could have avoided these problems if they had given more effort and attention to the process? Or is it a matter of the DO school not offering enough/appropriate support to the student for them to successfully enter into their desired residency? I'm sorry if my questions sound ignorant, I'm trying to figure out what my real problems are going to be and if they can be solved by me putting more effort into what I want or if I'm just going to be out of luck if I choose to pursue DO. Thanks for the input everyone.

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[pietachok]

Assuming I succeeded in the postbac I would not have to retake the M1 classes and so yes, would be able to focus even more on the other classes and potentially participate in more time consuming/valuable EC's. This is a plus for me, though as of yet I still have not heard back from the school as to what is actually required to succeed in the program.

I've heard similar arguments from others regarding what you said about the bias against DO applicants, especially in the residency application department. In your experience, is it possible that many of the DO applicants could have avoided these problems if they had given more effort and attention to the process? Or is it a matter of the DO school not offering enough/appropriate support to the student for them to successfully enter into their desired residency? I'm sorry if my questions sound ignorant, I'm trying to figure out what my real problems are going to be and if they can be solved by me putting more effort into what I want or if I'm just going to be out of luck if I choose to pursue DO. Thanks for the input everyone.

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Some residency programs just outright will not consider DO applicants regardless of their level of accomplishment, and that has nothing to do with anything the student can fix with effort and attention to the process.

I can only speak anecdotally from my experience with about a dozen friends who have attended DO programs. None have received equivalent or adequate advising with regards to residency applications and all are very upset with their programs because of this. That said, there are surely some MD programs that give piss poor advising.

 

[QofQuimica]

OP, why did you do poorly in o chem and biochem? If you did your best and still struggled with those classes, then I'd advise you to seriously consider doing the post bac (and essentially stretch out your first two years of med school into three). Never mind improving your ECs and debating DO vs MD; you should use that time and mentoring to develop the strong study habits necessary to get you through med school. Because the most important things you need for a successful residency app are good med school grades and a good step 1 score, preferably with the test being passed on your first attempt. Those are the things that matter most to residency PDs. The rest of it is all window dressing.

But if you didn't do well in those classes because you didn't put the time and effort needed into them, then that is a different story. In that case, you need to make a conscious decision to buckle down and get serious. Getting through med school requires four years of consistent, nearly daily hard work. Be honest with yourself and make up your mind now as to whether you're willing to put in the kind of time and effort necessary to succeed. If you're not, best to avoid wasting your time and money on a med school boondoggle.

 

[dracosta]

OP, why did you do poorly in o chem and biochem? If you did your best and still struggled with those classes, then I'd advise you to seriously consider doing the post bac (and essentially stretch out your first two years of med school into three). Never mind improving your ECs and debating DO vs MD; you should use that time and mentoring to develop the strong study habits necessary to get you through med school. Because the most important things you need for a successful residency app are good med school grades and a good step 1 score, preferably with the test being passed on your first attempt. Those are the things that matter most to residency PDs. The rest of it is all window dressing.

But if you didn't do well in those classes because you didn't put the time and effort needed into them, then that is a different story. In that case, you need to make a conscious decision to buckle down and get serious. Getting through med school requires four years of consistent, nearly daily hard work. Be honest with yourself and make up your mind now as to whether you're willing to put in the kind of time and effort necessary to succeed. If you're not, best to avoid wasting your time and money on a med school boondoggle.

There were many factors that went into my grades in those classes, some avoidable and some not. I worked a mid-time job through undergrad (arguably an avoidable time suck) and I was also hurt by a steep curve in both those classes. Idk what msu does in terms of curving their grades or if they do, but that was a pretty large part of it. I also felt like forty question multiple choice exams did not accurately test my knowledge of the subjects. Being honest, I should have done better and probably could have had I applied myself more, but those are some of the reasons I struggled.

In your experience, what is considered a "good" med school grade? I was under the impression that med school classes are generally P/F. Not that I am just shooting for a pass, I would like to clear that by a good margin, I am just wondering. Also, is it common for students to have to retake step 1 because they failed it or is it more of an MCAT situation where you might just retake it to improve your score? Thanks for your input!

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[pietachok]

In your experience, what is considered a "good" med school grade? I was under the impression that med school classes are generally P/F. Not that I am just shooting for a pass, I would like to clear that by a good margin, I am just wondering. Also, is it common for students to have to retake step 1 because they failed it or is it more of an MCAT situation where you might just retake it to improve your score? Thanks for your input!

Grading systems will be school specific. You need to ask the school(s) you are considering and the students there for details about the grading process and how harsh it is. Many schools only have multiple choice exams, so if that in particular is a problem for you, you might want to think about how that will affect your med school performance.

You cannot retake Step 1 after you pass, so there is strong pressure to do as well as you can the first time.

 

[QofQuimica]

There were many factors that went into my grades in those classes, some avoidable and some not. I worked a mid-time job through undergrad (arguably an avoidable time suck) and I was also hurt by a steep curve in both those classes. Idk what msu does in terms of curving their grades or if they do, but that was a pretty large part of it. I also felt like forty question multiple choice exams did not accurately test my knowledge of the subjects. Being honest, I should have done better and probably could have had I applied myself more, but those are some of the reasons I struggled.

Well, you won't have a job to interfere with your work in med school, so that's one plus. But the rest of those factors you mentioned (curves, multiple choice tests) are a part of medical training life. I'm getting ready to take my specialty boards this fall, and guess what? It's a multiple choice test. So are all three parts of the USMLE, all of the NBME exams, the shelf exams, and probably every other exam you will take once you start med school. If you're not good at multiple choice tests, this is a weakness you absolutely need to improve on.

In your experience, what is considered a "good" med school grade? I was under the impression that med school classes are generally P/F. Not that I am just shooting for a pass, I would like to clear that by a good margin, I am just wondering. Also, is it common for students to have to retake step 1 because they failed it or is it more of an MCAT situation where you might just retake it to improve your score? Thanks for your input!

As pietachok said, it's school-dependent. Each med school makes its own exams, its own test grading policies, and its own course grade system. Some schools are P/F for the first year, or for the first two years, and others give grades during all four years. But regardless of where you go, you will almost certainly have grades for at least part of your time in med school; there are almost no schools that are P/F for the last two years. In addition, nearly every medical school ranks its classes, and the top 10% of each class are eligible for the medical honor society AOA. Getting AOA is definitely a boon to your app. Some med schools include grades from the first two years when deciding on AOA, while others do not. I don't know what MSU does; you'd have to find out from them.

Also, as pietachok said, there is no do-over on the USMLE. If you barely pass with a 185 (or whatever passing is these days), then you will be applying for residency with a barely passing score. If you fail, you can retake, but then you apply with a fail plus retake on your record, which is also bad. So if you're going to succeed in your medical training (residency as well as med school), you need to get good at multiple choice tests. Because you keep taking them throughout your training, and they keep getting harder as you go along. I've been told the post-fellowship boards for my future subspecialty make the general specialty boards look like a walk in the park....

 

[dracosta]

Well, you won't have a job to interfere with your work in med school, so that's one plus. But the rest of those factors you mentioned (curves, multiple choice tests) are a part of medical training life. I'm getting ready to take my specialty boards this fall, and guess what? It's a multiple choice test. So are all three parts of the USMLE, all of the NBME exams, the shelf exams, and probably every other exam you will take once you start med school. If you're not good at multiple choice tests, this is a weakness you absolutely need to improve on.


As pietachok said, it's school-dependent. Each med school makes its own exams, its own test grading policies, and its own course grade system. Some schools are P/F for the first year, or for the first two years, and others give grades during all four years. But regardless of where you go, you will almost certainly have grades for at least part of your time in med school; there are almost no schools that are P/F for the last two years. In addition, nearly every medical school ranks its classes, and the top 10% of each class are eligible for the medical honor society AOA. Getting AOA is definitely a boon to your app. Some med schools include grades from the first two years when deciding on AOA, while others do not. I don't know what MSU does; you'd have to find out from them.

Also, as pietachok said, there is no do-over on the USMLE. If you barely pass with a 185 (or whatever passing is these days), then you will be applying for residency with a barely passing score. If you fail, you can retake, but then you apply with a fail plus retake on your record, which is also bad. So if you're going to succeed in your medical training (residency as well as med school), you need to get good at multiple choice tests. Because you keep taking them throughout your training, and they keep getting harder as you go along. I've been told the post-fellowship boards for my future subspecialty make the general specialty boards look like a walk in the park....

Hm, well it looks like I will be working on my testing abilities... all of that is really good to know. What kinds of things are you graded on in your 3rd and 4th years? I understand you take tests at different intervals throughout those years, are the tests covering whatever clinical rotation you've just been on or what? For the board exams you talked about are there minimum (above failing) scores for different specialties/programs?

I worked for a year in a rural clinic system (neurology, peds, and gen surg) and 2 more in an ED and am currently most interested in going into either gen surg or EM. If you don't mind me asking, what are you specializing in? And how often do you find yourself taking exams after med school (between grad and being an attending)?

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[cabinbuilder]

Hm, well it looks like I will be working on my testing abilities... all of that is really good to know.
What kinds of things are you graded on in your 3rd and 4th years? This is school specific. Things have changed. I think most school have a SHELF exam at the end of each rotation (they didn't exist when I was in school). This grade is added to your subjective evaluation you get from your preceptor on that rotation.


I understand you take tests at different intervals throughout those years, are the tests covering whatever clinical rotation you've just been on or what? Yes, generally. You do a 4 week rotation and you take the exam at the end.


For the board exams you talked about are there minimum (above failing) scores for different specialties/programs? Not sure, they didn't really give us a minimum pass score in medical school or residency.

I worked for a year in a rural clinic system (neurology, peds, and gen surg) and 2 more in an ED and am currently most interested in going into either gen surg or EM. If you don't mind me asking, what are you specializing in? And how often do you find yourself taking exams after med school (between grad and being an attending)?
You take step I, step II, and step II PE of the board exams during medical school. You take step III after intern year. You take the specialty board exam towards the end of residency to be board certified. Then you take the recert 8-10 yrs after that.

 

[cabinbuilder]

Not all medical school are pass fail. LECOM is by percent. You have to have a 70% or higher to pass the class. We had exams weekly.

 

[pietachok]

For the board exams you talked about are there minimum (above failing) scores for different specialties/programs?

There aren't hard cutoffs for whole specialties, but individual programs often have a published minimum score (albeit often pretty low although I saw some as high as 220) and I'm sure some have unpublished minimums. Quite a few programs require that you passed the exams on first attempt.

Page 9 of this booklet has the avg step 1 scores for different specialties.
http://b83c73bcf0e7ca356c80-e8560f4...tent/uploads/2013/08/chartingoutcomes2011.pdf

 

[QofQuimica]

As the others have said, the range of board scores that is considered competitive is program and specialty dependent. Even in relatively noncompetitive specialties, the more competitive programs will have higher board score expectations. I'm not in a super competitive specialty, but my PD is definitely a numbers kind of guy. But I'd guess that most of the other big academic name programs we compete with are similar.

At any rate, it's a bit premature for you to be all wound up about Step 1 before you've even set foot in a med school classroom. Find out the post bac details from MSU, then make what you think is the best decision for you, based on your own needs and goals.

 

[pietachok]

At any rate, it's a bit premature for you to be all wound up about Step 1 before you've even set foot in a med school classroom. Find out the post bac details from MSU, then make what you think is the best decision for you, based on your own needs and goals.

I agree with Q.

I also can't help but wonder if your concern about test taking and failing (which I may be misconstruing due to the limited means of a forum) is an indicator that this postbaccalaureate coursework would actually be a good idea for you. How is the curriculum laid out for you during those first 3 yeas? Consider whether the courses would be a good place to get your feet wet with regards to *this school's* grading procedures and exams and become more comfortable with them while doing coursework that is more familiar.

 

[stlrams22]

Go with the DO school, no wait year plus significantly lower tuition.

 

[dracosta]

I agree with Q.

I also can't help but wonder if your concern about test taking and failing (which I may be misconstruing due to the limited means of a forum) is an indicator that this postbaccalaureate coursework would actually be a good idea for you. How is the curriculum laid out for you during those first 3 yeas? Consider whether the courses would be a good place to get your feet wet with regards to *this school's* grading procedures and exams and become more comfortable with them while doing coursework that is more familiar.

I also agree with Q that I don't need to be worrying about Step 1 yet...sidetrack. I don't feel like I have an irrational concern about failing. My concern is that I don't want to fail, and that motivates me to pass. I don't have any serious concerns about my ability to succeed in the postbac program; I did well in undergrad aside from a those classes and I feel confident in my study skills and abilities to perform at a med school level (from what I hear from friends and others). The stakes in the MSU program are pretty high and so I see myself doing whatever it takes to do well (aside from crazy circumstances that I can't foresee). According to their website they push their free one on one tutoring pretty hard and I would absolutely take advantage of that if I were to go there. I have no doubt that adding a year to med school and spreading out some of those classes would make it easier on me and that's part of my struggle - why wouldn't I do something that will give me a better chance to perform at a higher level? The other side of that is...it's another year = more tuition, more time. The vibe I'm getting from most of you that are pro-postbac is that
1. A refresher in those classes will be good for me/I could use the extra time to make sure I do well, and
2. The bias against DO's exists and I will make things easier for myself if I go MD.

I feel like I'm leaning towards just taking the acceptance, so how much am I going to care about #2 after I graduate from med school? Supposing I choose emergency medicine, am I significantly limiting my residency options?

I don't even know. Sorry for rambling, it helps me figure out what I'm even thinking. I need future me to make this decision.

 

[pietachok]

Can't you hold on to both acceptances until May anyhow. Use that time to gather more information and possible get another interview invite.

 

[cabinbuilder]

1. A refresher in those classes will be good for me/I could use the extra time to make sure I do well, and
2. The bias against DO's exists and I will make things easier for myself if I go MD.

I feel like I'm leaning towards just taking the acceptance, so how much am I going to care about #2 after I graduate from med school? Supposing I choose emergency medicine, am I significantly limiting my residency options?

I don't even know. Sorry for rambling, it helps me figure out what I'm even thinking. I need future me to make this decision.

With the exception of some highly competitive fields, there is no bias against DO's except in the minds of pre-med students. Your are NOT limiting yourself doing ER as a DO, tons of DO ER docs - its a non-issue.

 

[Plecopotamus]

With the exception of some highly competitive fields, there is no bias against DO's except in the minds of pre-med students. Your are NOT limiting yourself doing ER as a DO, tons of DO ER docs - its a non-issue.

And what if she is one of the many individuals who enters med school believing they want to be an ER doctor but who graduates into a completely different field?

I'm going into Neurology. It is not a competitive field and many good programs are biased against DO applicants. If you go over to the threads about residency applications, you will find DOs with good grade/scores getting far fewer interview invitations while every MD applicant to Neuro who I know is essentially getting interview offers from the majority of programs. There is a clear bias -- whether it is fair is an entirely different issue that I am not trying to argue. Unfortunately in a field that is otherwise not competitive, given that there are no official rankings for quality of residency programs, the number of DOs and FMGs in a program ends up being used by many as a proxy for program quality and pressures many programs to fill classes with US MDs so that they will continue to seem desirable to strong applicants. (There are notable exceptions such as Cleveland Clinic, but they are few and far between).

I think it is wonderful that you don't feel the bias in your career, but to say that there is no bias except in competitive fields and in the minds of pre-med students is disingenuous or ill informed. I will acknowledge that there are confounding factors here, not just whether or not you stick "osteopathic" on someone's residency application -- many DO schools do not have a strong affiliation with a hospital in which all specialties are represented, and this poses a unique obstacle when it comes to getting letters of recommendation from certain physicians. If you're sent to a community site for your Neuro rotation, your letter will not be interpreted the same as one from an instructor at a well-regarded academic site, and since this is not really a field with community-based residencies, that's a disadvantage. If you have no Neuro department, you are disadvantaged for programs that require a Chair letter from a department that does not exist at your school. I suspect these problems are not limited to the field of Neurology. There is clearly also a regional difference in willingness to accept DOs, likely due to the density of programs in certain regions -- programs in the Midwest seem much more inclined to take DOs, but who knows how much that will help someone applying from the PNW rather than the more local programs or how it will be affected by the worsening ratio of US MD seniors to residency positions.

When I was applying to medical school, I almost went to an osteopathic program. I have many friends from my post-baccalaureate program who went to DO schools and have recently been on away rotations with several who were impressive students and who I'm sure will be wonderful doctors. I, myself, do not care whether there is a DO or an MD after a physician's name as long as he/she is good at being a doctor. There may be minimal/negligible bias once in practice, but that does not mean it was absent along the whole path -- you may regard a DO and MD from the same "ok" residency equally, but that doesn't tell you that the DO may have had opportunities denied along his path that might have sent him to a place of stronger training and set him up to be happier with his career opportunities (not for the letters behind his name but for the difference in site of training). Now that I am knee deep in residency applications and hearing the difficulties/bias many of my DO friends are facing in this process, I feel deceived by every single DO who sat there and told me that this was only among pre-meds and competitive specialties.

 

[cabinbuilder]

So tired of this argument. I choose not to argue.

 

[Plecopotamus]

So tired of this argument. I choose not to argue.

I'm so tired of people being dishonest.

Going to osteopathic school is an amazing life opportunity just as going to allopathic school is. That doesn't mean that both paths are the same, and it does nobody any good to distort the truth when they are trying to collect information to make a huge life decision. She's trusting people here to help her get info to make a decision. In some fields it's more and in some it's less, but telling her that there is no bias in the residency admission process except in competitive specialties is bunk -- it's the same information I was fed all throughout the osteopathic admissions process, but very much not true for a non-trivial number of residency applicants.

 

[cabinbuilder]

Well, I'm sorry that you think I would be so callous as to perpetuate fallacy. I didn't talk about bias in residency admission (because I agree that does exist). I was talking about bias in the work force (which there isn't) , nothing more. Do not misconstrue.

 

[mymembernames]

OP,

Did you make a decision yet?

 

[dracosta]

OP,

Did you make a decision yet?

I'm leaning pretty hard in the PNWU direction. I still haven't heard from MSU and I won't know if I'm for sure in the program until June. Plus already paid the hefty deposit there.

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[wades]

OP, if it means anything, I think both are great opportunities and congratulations! I know several people who have matriculated into MSUCHM after completing the ABLE program. From what I understand it is a very nice opportunity to come by, in past years the requirement has been to maintain a B average (not sure if this has changed, I doubt it). The postbacc class size is very small and is setup to support successful matriculation, not to weed out. It is a hard decision, a friend of mine was actually faced with the same dilemma last year and decided to turn down his acceptance (about a week before orientation) to enroll in a similar "conditional acceptance" program. His family thought he was crazy but he thought hard about it, and ultimately decided based upon what he felt was best for him.

Best of luck in whichever you choose!

 

[moto_za]

OP,

Just a thought: Can you defer your DO acceptance and take your chances on the able program? Just saying since I think MSU is your top choice.

 

[Elisabeth Kate]

With the exception of some highly competitive fields, there is no bias against DO's except in the minds of pre-med students. Your are NOT limiting yourself doing ER as a DO, tons of DO ER docs - its a non-issue.

This might have been true when you went through training, but I'm not sure it's true anymore regarding ER. I know several DOs going for ER and most are only getting a couple of interviews. If you look at SDN threads, you'll see that the competition for ER has gone up considerably in recent years and it appears DOs are feeling it more. I'm not going into ER, so I haven't been on that interview trail, but from what I hear, it isn't exactly a non-issue.

Regarding neurology, I have two good friends who are in DO school at the same school and applied to neurology. Neither took the USMLE. One only got 3 neurology interviews and applied to family med as a back up because he freaked out. The other got over 15 interviews, some at places that many would like to go, including Cleveland Clinic and UC Davis. I don't know what to make of that since I don't know their board scores or class ranks or if they applied to the same places. All I know is one is doing considerably better than the other for some reason.

 

[pietachok]

This might have been true when you went through training, but I'm not sure it's true anymore regarding ER. I know several DOs going for ER and most are only getting a couple of interviews. If you look at SDN threads, you'll see that the competition for ER has gone up considerably in recent years and it appears DOs are feeling it more. I'm not going into ER, so I haven't been on that interview trail, but from what I hear, it isn't exactly a non-issue.

Regarding neurology, I have two good friends who are in DO school at the same school and applied to neurology. Neither took the USMLE. One only got 3 neurology interviews and applied to family med as a back up because he freaked out. The other got over 15 interviews, some at places that many would like to go, including Cleveland Clinic and UC Davis. I don't know what to make of that since I don't know their board scores or class ranks or if they applied to the same places. All I know is one is doing considerably better than the other for some reason.

I believe that cabinbuilder did a family medicine residency, not emergency medicine. I am not going into EM, but I believe that it is going to become increasingly difficult to practice after a different residency -- someone else will need to confirm that.

With regards to neurology, one's choice of programs is going to make a big difference. You could at random apply with great scores & evals to all DO-unfriendly programs and shoot yourself in the foot.

Before using anecdotes to gauge anything, you have to know that outside of the tippy top programs, many of the really strong ones are not in the places you'd expect (i.e. Rochester is amazing, Iowa, & Wisconsin among others in the Midwest/north have really good programs). On the other hand, UC Davis is not very well regarded for neuro these days & in fact has recently been plagued by a lot of conflict in the department. While CC has a huge name in Neuro and is still a well-regarded place to train, a lot of MD applicants are shying away -- likely based largely on location and unnecessary worry about "what's wrong with it?" b/c it has so many DOs and IMGs, but some legit concerns that there are so many fellows that resident training might be compromised and that the amazingness of the attendings and fellowships doesn't really extend to the residency training (I chose not to interview, so I'm not saying any of this is valid). So, you have to interpret interview/match lists with a lot of caution. Those are both fine places to train, but for many MD applicants with decent board scores and clinical evaluations, they'd be at the bottom of their list rather than the top. Because there is so little basis for objectively judging programs before interviewing, some programs closely control their %DO and %IMG stats, because they're aware that's what others will judge them by (again, not saying it's fair). The Midwest in general is more DO friendly and has some very good Neuro programs. Neuro is completely attainable as a DO, and some definitely get into *great* programs. However, you would start facing a significant amount of bias as you go to major metropolitan areas on either coast and/or the strongest programs, and some outright will not consider DO applicants.

 

[Elisabeth Kate]

I believe that cabinbuilder did a family medicine residency, not emergency medicine. I am not going into EM, but I believe that it is going to become increasingly difficult to practice after a different residency -- someone else will need to confirm that.

With regards to neurology, one's choice of programs is going to make a big difference. You could at random apply with great scores & evals to all DO-unfriendly programs and shoot yourself in the foot.

Before using anecdotes to gauge anything, you have to know that outside of the tippy top programs, many of the really strong ones are not in the places you'd expect (i.e. Rochester is amazing, Iowa, & Wisconsin among others in the Midwest/north have really good programs). On the other hand, UC Davis is not very well regarded for neuro these days & in fact has recently been plagued by a lot of conflict in the department. While CC has a huge name in Neuro and is still a well-regarded place to train, a lot of MD applicants are shying away -- likely based largely on location and unnecessary worry about "what's wrong with it?" b/c it has so many DOs and IMGs, but some legit concerns that there are so many fellows that resident training might be compromised and that the amazingness of the attendings and fellowships doesn't really extend to the residency training (I chose not to interview, so I'm not saying any of this is valid). So, you have to interpret interview/match lists with a lot of caution. Those are both fine places to train, but for many MD applicants with decent board scores and clinical evaluations, they'd be at the bottom of their list rather than the top. Because there is so little basis for objectively judging programs before interviewing, some programs closely control their %DO and %IMG stats, because they're aware that's what others will judge them by (again, not saying it's fair). The Midwest in general is more DO friendly and has some very good Neuro programs. Neuro is completely attainable as a DO, and some definitely get into *great* programs. However, you would start facing a significant amount of bias as you go to major metropolitan areas on either coast and/or the strongest programs, and some outright will not consider DO applicants.

I don't know much about the neurology match. Do you mind me asking which programs will outright not consider DO applicants?

 

[cabinbuilder]

This might have been true when you went through training, but I'm not sure it's true anymore regarding ER. I know several DOs going for ER and most are only getting a couple of interviews. If you look at SDN threads, you'll see that the competition for ER has gone up considerably in recent years and it appears DOs are feeling it more. I'm not going into ER, so I haven't been on that interview trail, but from what I hear, it isn't exactly a non-issue.

Regarding neurology, I have two good friends who are in DO school at the same school and applied to neurology. Neither took the USMLE. One only got 3 neurology interviews and applied to family med as a back up because he freaked out. The other got over 15 interviews, some at places that many would like to go, including Cleveland Clinic and UC Davis. I don't know what to make of that since I don't know their board scores or class ranks or if they applied to the same places. All I know is one is doing considerably better than the other for some reason.

This is where your friends made their mistake. You cannot expect to go into an ACGME residency without doing their exam. The scoring scale is totally different and you need to do what you have to for the best possible package. ER is currently a saturated market, it's all shift work. no one wants to work 80 hours a week anymore. I think the avg ER doc works 11 shifts a month. You are also limiting yourself doing ER as there has to be a large enough hospital to warrant the staff.

 

[cabinbuilder]

I believe that cabinbuilder did a family medicine residency, not emergency medicine. I am not going into EM, but I believe that it is going to become increasingly difficult to practice after a different residency -- someone else will need to confirm that.

.

Yes I did FP but I also work rural ER.

 

[pietachok]

I don't know much about the neurology match. Do you mind me asking which programs will outright not consider DO applicants?

You have to look at each school's requirements and their current list of residents to figure it out, and hopefully get some anecdotal evidence from other DOs as to whether or not they were interviewed there. There are some schools that are open about it, many that are not, and some that will interview a few but rarely rank any high enough to match them.

This is where your friends made their mistake. You cannot expect to go into an ACGME residency without doing their exam.

I totally missed that these friends did not take the USMLE. Yeah, you cannot just decide to not take the USMLE and expect to be well received by ACGME residencies. Honestly, that was absurdly poor decision making and/or advising. There are many programs that do not accept COMLEX, and over on the Neuro forums it has become clear to me that some osteo applicants didn't realize that before sending off apps like that -- if you apply to 20 programs that state on their app req's that they don't take COMLEX, you can't compare your interviews to the applicant who actually check requirements before submitting.

Yes I did FP but I also work rural ER.

I've heard that there is a push to have only EM-residency trained docs allowed to practice EM. True? If so, is that going to apply to rural areas at all (I don't see how it could . . . FM training seems more appropriate for the person who is functioning as the IM/FM/EM/OB physician at once) or change the need to do a EM fellowship after FM/IM for someone like you to practice? And is the door already closed to FM-trained docs when you're talking about major metropolitan EDs & level one trauma centers? . . . very different ED work, I assume, so I think that if a prospective DO applicant has their heart set on being the ER doc in one of those places, I'd guess they need to look more rigorously at the changing competitiveness of EM rather than FM, which is obviously going to remain readily available to DOs. Possible I'm totally off base or misinformed, however, since I'm not going into this field.

 

[Elisabeth Kate]

This is where your friends made their mistake. You cannot expect to go into an ACGME residency without doing their exam. The scoring scale is totally different and you need to do what you have to for the best possible package. ER is currently a saturated market, it's all shift work. no one wants to work 80 hours a week anymore. I think the avg ER doc works 11 shifts a month. You are also limiting yourself doing ER as there has to be a large enough hospital to warrant the staff.

I never said the friends aiming for ER didn't take the USMLE. At least two of them did. I don't know about the third.

 

[Elisabeth Kate]

You have to look at each school's requirements and their current list of residents to figure it out, and hopefully get some anecdotal evidence from other DOs as to whether or not they were interviewed there.

I disagree that this is the way you can tell in any specialty. I thought perhaps you had some information straight from the horse's mouth, but if you're going by websites and anecdotal evidence about who interviewed there, I don't think you can make blanket statements about whether or not they consider DOs.

I totally missed that these friends did not take the USMLE. Yeah, you cannot just decide to not take the USMLE and expect to be well received by ACGME residencies

You missed it because I never said it in regards to ER. What I said was that my two friends going into neuro didn't take the USMLE. Yet, one got 15 interviews and the other only got 3. So, in my opinion, one was well received by the ACGME residencies.

There are many DOs who don't take the USMLE in a fair number of residencies and many do fine. I would never advise going for a competitive specialty without it, but many do well in the ACGME match in the less competitive specialties without it.

 

[pietachok]

I disagree that this is the way you can tell in any specialty. I thought perhaps you had some information straight from the horse's mouth, but if you're going by websites and anecdotal evidence about who interviewed there, I don't think you can make blanket statements about whether or not they consider DOs.

Ok. If one wants to throw out money on a program that hasn't interviewed a DO applicant in 10 years, then go ahead. That's one's prerogative. When picking programs to apply to, I'd think of those programs like the lottery or as "far reaches" rather than realistic shots, b/c one just don't know.

I'm not going by anecdotal evidence regarding whether or not certain programs do not consider DOs -- that's info I do have "from the horses mouth" from several programs (I have the privilege of having grown up with a disproportionate # of friends with neurologists as parents, and have specifically asked around for a friend of mine who is a DO going through the process simultaneously). I suggested getting anecdotal evidence or looking at current residents to guide applications b/c places don't tend to outright say that they have such a policy, thus for people who don't have any contacts at a program, it can be the only/best way to gauge whether or not they are throwing out their money vs have a realistic chance of interview/match. I do think programs should be upfront about their policies regarding any such limitations (Step 1 cutoffs, research req's, IMG status, DO status, etc.) because regardless of what type of applicant one is, it doesn't feel good to know one's app wasn't even considered. Conversely, some programs write "we encourage qualified graduates of osteopathic medical schools to apply," and many have a substantial DO representation in their program -- if you're applying without insider knowledge, then that's probably the best reassurance you can get that they will be un-/less biased. Overall it is a very DO friendly field, and I do not mean to insinuate otherwise, but that doesn't mean certain programs aren't fiercely maintaining a bias.

You missed it because I never said it in regards to ER. What I said was that my two friends going into neuro didn't take the USMLE. Yet, one got 15 interviews and the other only got 3. So, in my opinion, one was well received by the ACGME residencies.

There are many DOs who don't take the USMLE in a fair number of residencies and many do fine. I would never advise going for a competitive specialty without it, but many do well in the ACGME match in the less competitive specialties without it.

I didn't comment about ER residency success. I commented on what you said about your friends applying to Neuro. With competitive specialties, it's a no-brainer. In less competitive specialties, my statement that it is ill-advised is really under the assumption that one is trying to maximize one's chances at matching to the strongest residency where he/she feels a good fit. If your only goal is to match at all, you're probably fine in Neuro. If you want more clout in your own fate, then I think choosing not to take Step 1 is an unnecessary and imprudent risk, (1) b/c you really have no idea what kind of crotchety nay-sayer is going to be considering your application and whining that they don't have apples to compare to apples when ranking you, and (2) you otherwise have to go to every program website to make sure they accept COMLEX (and then count on the website being up to date). As I mentioned above, you may otherwise totally unintentionally and randomly apply to 15 lovely programs that don't accept it. Even in non-competitive specialties, the great and very good programs are competitive. And b/c it's totally a mysterious grey area where the transition to the lower tiers is located, I think it is wise to prepare for the harshest situation possible. As one PD said to me when I asked whether it was OK that my Step 2 scores would be coming in later than expected -- "we'll rank you without it, but more information is almost always better in making sure you get the rank you deserve." I suppose the caveat there is that the rank you "deserve" may be lower if that extra piece of data is negative (a low USMLE score).

I have a very close friend who is DO and currently applying to Neuro residencies with otherwise very similar CVs and coming from the same region. She actually has one point higher on Step 1 than I do (both above average), and we both applied to similar programs (in number, ~35, and quality). While I've been offered interviews by 90% of the programs I applied to & only got 2 rejections (a few with dead silence still), she's gotten interviews at about half of the programs she applied to and already rejected by nearly all of the others. It's a crummy, awful, unfair, ridiculous process, even when it's . . . just Neuro. That said, I don't think either of us has a fear of not matching, and that's wonderful.

 

[Elisabeth Kate]

Ok. If you want to throw out money on a program that hasn't interviewed a DO applicant in 10 years, then go ahead. That's your prerogative. When picking programs to apply to, I'd think of those programs like the lottery or as "far reaches" rather than realistic shots, b/c you just don't know.

I'm a 4th year and I didn't apply to neurology, so none of that applies to me.

I'm not going by anecdotal evidence regarding whether or not certain programs do not consider DOs -- that's info I do have "from the horses mouth" from several programs (I have the privilege of having grown up with a disproportionate # of friends with neurologists as parents, and have specifically asked around for a friend of mine who is a DO going through the process simultaneously).

What I meant by the horse's mouth was the program itself, residents, faculty, etc. I think that's the only way to know which programs will outright not accept DO applicants. Without that, we can assume they probably aren't DO friendly based on what we hear from other neurologists and so forth, but we really can't know definitively.

I didn't comment about ER residency success. I commented on what you said about your friends applying to Neuro

Right, but the first part of my post was to Cabinbuilder about ER and I never said my friends applying to ER didn't take the USMLE. CB replied to me about ER, but said my friends should have taken the USMLE. I was simply saying that my friends applying to ER DID take the USMLE.

With competitive specialties, it's a no-brainer. In less competitive specialties, my statement that it is ill-advised is really under the assumption that one is trying to maximize one's chances at matching to the strongest residency where he/she feels a good fit. If your only goal is to match at all, you're probably fine in Neuro. If you want more clout in your own fate, then I think choosing not to take Step 1 is an unnecessary and imprudent risk, (1) b/c you really have no idea what kind of crotchety nay-sayer is going to be considering your application and whining that they don't have apples to compare to apples when ranking you, and (2) you otherwise have to go to every program website to make sure they accept COMLEX (and then count on the website being up to date).

I don't disagree with this. I'm just not familiar with the neuro side of things since I didn't apply to neuro. I just know that my two friends didn't take the USMLE.

 

[pietachok]

I'm a 4th year and I didn't apply to neurology, so none of that applies to me . . . What I meant by the horse's mouth was the program itself, residents, faculty, etc. I think that's the only way to know which programs will outright not accept DO applicants.

I was referring to the general "you" not you, personally. I have changed it to "one" for you.

And that is also what I meant by "from the horses mouth". I'm speaking about people who have been heavily involved with resident selection, not random physicians I'm asking for opinions about programs with which they are not affiliated.

As we're tangential to the thread, if you have more questions or want to talk more about it, you can message me. Good luck with your residency interviews/apps.

 

[cabinbuilder]

I've heard that there is a push to have only EM-residency trained docs allowed to practice EM. True? If so, is that going to apply to rural areas at all (I don't see how it could . . . FM training seems more appropriate for the person who is functioning as the IM/FM/EM/OB physician at once) or change the need to do a EM fellowship after FM/IM for someone like you to practice? And is the door already closed to FM-trained docs when you're talking about major metropolitan EDs & level one trauma centers? . . . very different ED work, I assume, so I think that if a prospective DO applicant has their heart set on being the ER doc in one of those places, I'd guess they need to look more rigorously at the changing competitiveness of EM rather than FM, which is obviously going to remain readily available to DOs. Possible I'm totally off base or misinformed, however, since I'm not going into this field.

Don't see how a rural ER that sees 2-4 patients a day is going to hire strictly EM trained doc - doubt that will ever happen. The places I work (frontier medicine vs "rural") I cover FP clinic all day, do the 15 bed inpatient service, cover the little nursing home wing, and cover the ER. Don't see an ER guy covering clinic, do you? I cannot comment on metropolitan ER since I have never worked in a major city and would never want to. That's a whole different ball game. I don't do trauma as a rule and all places I work it's stabilize and ship, not be the hero and keep. Now my next job is going to be in a larger area in west Texas that has a shortage but it is fast track ER, not the "real" ER as I am not comfortable with lines, chest tubes, trauma, etc but I can do walk-in/urgent care all day every day. The ONLY reason I got this fast track job (they are paying me ER wages) is that I have lots of rural experience and kept patient logs of EVERY PATIENT I have seen for the past 4 years and was able to prove that I had the volume to be competent.

If you are a DO who want to be an ER doc, then do an ER residency. If you want to be jack of all trades and work in a smaller place then do FM.

 

[cabinbuilder]

I never said the friends aiming for ER didn't take the USMLE. At least two of them did. I don't know about the third.

OK, well my reply was a general blanket statement whether ER or neuro or surgery, etc. Doesn't really matter. I read your post quickly in an airport today. My point was there should be no complaining about being a DO and not matching ACGME if you don't take the USMLE. I learned that the hard way and didn't get into the residency I wanted. You have to put yourself on the same playing field as the MD students if you expect to be applying to those residencies.

 

[Elisabeth Kate]

My point was there should be no complaining about being a DO and not matching ACGME if you don't take the USMLE.

Agreed and no one complained. No one I know anyway.