DO vs. Caribbean MD?

[Shinken]

a 5% diff between DO vs Carib step 1 and a 3% diff between DO vs Carib Step 2....you're really making a huge deal out of those numbers?

You don't think that's a big deal? Let's see, what percentage of DO students take the USMLE? Perhaps 70% or so? There are about 2,000 or 3,000 DO graduates every year. There are more than 18,000 foreign grads taking the USMLE every year. You tell me if that's something to think about or not.

Would you rather be in a group of 1,500 that passes the USMLE at 77% or a group of 18,000 that passes the USMLE at 71%?

I think that's very significant, particularly when you consider the fact that DOs do not have to pass the USMLE to become licensed, whereas an FMG that doesn't pass the USMLE is in a real bind.

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[Shinken]

Would you rather be in a group of 1,500 that passes the USMLE at 77% or a group of 18,000 that passes the USMLE at 71%?

Actually, I made a mistake. I looked at the ECFMG numbers for FMGs that go through the match, which means that more than 18,000 actually passed Step 1 (at least) to participate in the match. Those are the 71% that passed Step 1.

In other words, more than 25,000 FMGs in 2006 sat for the USMLE 1, and only 71% (or about 18,000) passed. Significant? For the 7,000 FMGs left behind I'm sure that's pretty darn significant (that's more than 3 times the number of DOs that graduate in a single year).

 

[Instatewaiter]

Do well in rotations, smoke the boards and have good interviews and you'll be fine.

Everytime I see someone post something like this I think of John Madden on Monday night football saying, "Well Tom, the team that scores the most points by the end of this game is going to win"

IF YOU GO TO THE CARIB SCHOOLS FOR THE GLORIOUS MD, YOU WILL NOT BE ABLE TO MATCH UNTIL AFTER ALL OF THE MDs AND DOs HAVE CHOSEN

YOU GET TO PICK FROM THE SCRAPS AND GET WHATEVER CRAP RESIDENCIES ARE LEFT OVER.
BE PRO AND GO DO.

MAYBE IF I CAPITALIZE EVERYTHING I WRITE PEOPLE WILL LISTEN TO ME!
Pretty sure everyone enters the same match.

What is relevant is that certain residencies accept DO's and either don't accept FMG's or just hold them to a higher standard. There are other residencies where this is the opposite.

If any residency is going to make these kinds of distinctions you better believe that both FMGs and DOs are not going to have much luck.

Pass rates are irrelevant.
If you have 100 people in a class, and 99 score very high and 1 fails, this is much better than 100 people marginally passing.

The pass rate does not tell you how well someone did on the exam.

Sure this is a possibility but you dont think that there is a significant correlation between pass rates and average scores?

Since most DO students try to match into ACGME residencies you would assume that they take the USMLE seriously.

You don't think that's a big deal? Let's see, what percentage of DO students take the USMLE? Perhaps 70% or so? There are about 2,000 or 3,000 DO graduates every year. There are more than 18,000 foreign grads taking the USMLE every year. You tell me if that's something to think about or not.

Would you rather be in a group of 1,500 that passes the USMLE at 77% or a group of 18,000 that passes the USMLE at 71%?

I think that's very significant, particularly when you consider the fact that DOs do not have to pass the USMLE to become licensed, whereas an FMG that doesn't pass the USMLE is in a real bind.

You would also assume selection bias for the DOs that take the USMLE. Those that take the USMLE are probably those who are shooting for better residencies and it stands to reason that those would be the better students. So is that 6% significant? In the end, who cares?

 

[lacesoutdan]

no one cares if you are MD/DO but the ERAS applicant online system labels you as a FMG/IMG so you are screwed if you go CARIB

So American MDs have no advantage over DOs in getting competative allopathic residencies, but DOs have a signifigant advantage over FMGs? What a lucky coincidence for you as a DO student!

 

[MedicineMan168]

Here are the numbers so you all can stop fighting and go study something. It doesn't matter MD or DO as long as your are in the country. What matters is your USMLE board scores and grades in med school. Just like it doesn't matter where you went for undergraduate, but rather your grades and MCAT. Now, if your stats are identical they will take the MD student over the DO, other than that it is fair.



*note D.O.s make up roughly 6% of all physicians, and many choose to go into primary care

From the Journal of the American Medical Association(JAMA) Vol 294, No. 9 (Sept 7, 2005)
Total DO in ACGME: 5675
Total Number of Residents/Fellows: 101,291
Percent DO: 5.6%

General Internal Medicine
Total # of Programs: 387
Total # of Residents: 21332
Total # of USMD: 11271
Total # of DO: 1097
Percent DO: 5.1%

Hematology/Oncology
Total # of Programs: 123
Total # of Fellows: 1020
Total # of USMD: 595
Total # of DO: 46
Percent DO: 4.5%

Oncology
Total # of Programs: 20
Total # of Fellows: 208
Total # of USMD: 140
Total # of DO: 6
Percent DO: 2.9%

Pediatrics
Total # of Programs: 204
Total # of Residents: 7811
Total # of USMD: 5415
Total # of DO: 442
Percent DO: 5.7%

Pediatric Heme/Onc
Total # of Programs: 60
Total # of Fellows: 312
Total # of USMD: 230
Total # of DO: 5
Percent DO: 1.6%

Radiation/Oncology
Total # of Programs: 79
Total # of Residents: 526
Total # of USMD: 493
Total # of DO: 8
Percent DO: 1.5%

 

[Shinken]

So is that 6% significant? In the end, who cares?

All FMGs/IMGs should care. The OP should care (he's the one trying to decide which path to take).

Basically it roughly boils down to this: Of all the foreign-trained MDs, only about 3/4 will be able to participate in the match, the rest won't because they haven't passed the USMLE. Of the 3/4 that survived, only 1/2 of them will match. It's not a 6% difference, it's HUGE.

Example: 20,000 foreign grads take the USMLE, only 15,000 pass. Of those 15,000 only 7,500 match. 20,000 start the journey and 7,500 finish it. 12,500 are either still trying to pass the USMLE or trying to match. That's pretty significant.

Yes, it's a simplification, but roughly those are the numbers you're looking at when you go outside the US for your medical education and try to come back. Don't get fixated on the "6% difference" because it's a much, much bigger issue than that. I can pretty much guarantee you that one way or another, 99%+ of graduating US DOs and US MDs will end up in a residency program. Cannot say the same for IMGs.

Remember, I'm not saying anything about the quality of education or abilities of IMGs. I'm just commenting on the USMLE & match success.

 

[Vizsla]

Now, if your stats are identical they will take the MD student over the DO, other than that it is fair.

 

[Instatewaiter]

All FMGs/IMGs should care. The OP should care (he's the one trying to decide which path to take).

It's not a 6% difference, it's HUGE.

I cant tell if you're kidding or not because in all reality, 6% is not big, especially since only a select few DOs will take USMLE while all FMGs coming to the US have to (selection bias anyone?). Were all DOs to take USMLE I am sure the pass rate would approach that of the FMGs. It is not as if DOs have such a greater success matching to ACGME residencies either. The numbers arent all that different.

I'm not saying he should choose Carribean over DO at all.

You make it seem as if he's going to match derm just because he chose DO.

 

[Shinken]

I cant tell if you're kidding or not because in all reality, 6% is not big, especially since only a select few DOs will take USMLE while all FMGs coming to the US have to (selection bias anyone?). Were all DOs to take USMLE I am sure the pass rate would approach that of the FMGs. It is not as if DOs have such a greater success matching to ACGME residencies either. The numbers arent all that different.

I'm not saying he should choose Carribean over DO at all.

You make it seem as if he's going to match derm just because he chose DO.

I guess I'm going to stop here. You're obviously not understanding one bit what I'm trying to say, and that's OK. Life goes on.

 

[J1515]

Now, if your stats are identical they will take the MD student over the DO

This is rapidly becoming my new favorite line. In fact I'm thinking of making it my new sig.

By the way, I put this offer out to a pre-med in another thread: if anyone can show me two candidates for a residency position that have the same board scores, same grades, same amount of research, same previous work experience, same personality, and same interview for a given position, I will fork over my next loan check to you.

 

[drugdealer3000]

All FMGs/IMGs should care. The OP should care (he's the one trying to decide which path to take).


Basically it roughly boils down to this: Of all the foreign-trained MDs, only about 3/4 will be able to participate in the match, the rest won't because they haven't passed the USMLE. Of the 3/4 that survived, only 1/2 of them will match. It's not a 6% difference, it's HUGE.

Example: 20,000 foreign grads take the USMLE, only 15,000 pass. Of those 15,000 only 7,500 match. 20,000 start the journey and 7,500 finish it. 12,500 are either still trying to pass the USMLE or trying to match. That's pretty significant.

Yes, it's a simplification, but roughly those are the numbers you're looking at when you go outside the US for your medical education and try to come back. Don't get fixated on the "6% difference" because it's a much, much bigger issue than that. I can pretty much guarantee you that one way or another, 99%+ of graduating US DOs and US MDs will end up in a residency program. Cannot say the same for IMGs.

Remember, I'm not saying anything about the quality of education or abilities of IMGs. I'm just commenting on the USMLE & match success.

Shinken,

You've REALLY oversimplified the FMG situation. First of all the USMLE is administered all over the world to people that have NEVER taken a SAT/MCAT style exam. Secondly there are literally thousands of FMG USMLE test takers that speak English as a second language. THIRDLY there are a ton of FMGs that take the exams after they have already completed their residencies in their respective countries just so they can pop over to the US to do a fellowship and then go back home. They don't care about scoring high. They just need a pass. Some of them take the exam in medical school just as an afterthought just in case they ever want to train in the US. They are not spoon fed USMLE material for 4yrs. You would be eaten alive if you had to take their exams without prep/knowledge of the language.

The idea that every single FMG is a US citizen diligently studying SAT/MCAT/USMLE style MCQs all through medical school like a US MD student and then flunks the USMLE is absurd. Please go to La Sorbonne and take their final medical exam then come back and throw around statistics.

Where did you guys take your USMLE Step 2 CS? It was like the UN when I took mine.

In regards to the match keep in mind that thousands of FMGs require visas to work. There are numerous programs that either don't offer any visas or only offer certain kinds. This is a restriction that a US citizen FMG won't have to deal with... unless he/she plans on renouncing their citizenship while in medical school.

By the way a significant number of FMGs sign offers outside the match. They drop out of the match because they have JOBS. I don't know about you but all things being equal I would rather have a job in November than waste time, money, and sleep flying around just so I could be in the precious match!

I can't believe you guys are going to be doctors... how myopic and provincial.

This thread has been going on for days and NO ONE has pointed out these ridiculous generalizations! Sheesh. No wonder we are invading countries we have no idea about and getting stuck in quagmires. Do some homework before pontificating about people and places you have no idea about.

I shudder to think what sort of rigorous analysis you guys do of the statistics in research journals if these simple facts escaped your notice. Journal club at your school must be a b-tch!

 

[tms2]

a 5% diff between DO vs Carib step 1 and a 3% diff between DO vs Carib Step 2....you're really making a huge deal out of those numbers? if you wanted to point out a glaring discrepancy, how about the 17% diff between MD and DO pass rates on Step 1 even when both schools apparently teach the same material except for OMM

you are comparing two different things. D.O. students are prepared for the COMLEX exam, those who take USMLE take it on their own and prepare for it independently. If M.D. students took the COMLEX, i think they'd do worse than the D.O. students

 

[polycythemia]

tms2, it is pretty generally accepted that the comlex is easier than the USMLE. Nothing wrong with that, hardness doesnt equate to a better test, but I can almost gaurantee MD students wouldnt do worse on the comlex than Do students ( granted Md students dont learn OMM) so OMM aside I highly doubt they would perform lower than DO students...anyone else think the same?

 

[PeeWee137]

tms2, it is pretty generally accepted that the comlex is easier than the USMLE. Nothing wrong with that, hardness doesnt equate to a better test, but I can almost gaurantee MD students wouldnt do worse on the comlex than Do students ( granted Md students dont learn OMM) so OMM aside I highly doubt they would perform lower than DO students...anyone else think the same?

no because half the questions on the comlex are ones that NO ONE can answer. i had a q about a pt going to mexico, and then i had to pick what bacterial infection they had. no symptoms or labs or anything. and i had to choose between 6 bacteria i never heard of in my entire life. and i honored micro. i highly doubt anyone could've answered that correctly unless it was pure luck. the comlex isnt an easier test, its a bad one. the usmle is hard but at least they give you the info you need to answer it, whether you know it or not is another story.
this thread is getting ridiculous, as usual. i like being a DO. i dont feel superior or inferior to anyone.

 

[polycythemia]

i agree this thread is getting ridiculous, with the author of the thread not even participating...we should add a twist to this thread ..or make it into an NCAA bracket and people can fight..ex US MD vs US DO vs England DO vs IMG MD vs FMG MD vs chinese ninja vs pirate vs clown vs ice cream man vs porn star vs etccccc

 

[Shinken]

Shinken,

You've REALLY oversimplified the FMG situation.

What part of "roughly" and "simplification" was hard to understand in my post?

By the way, I'd appreciate a discussion on the issue, not a personal attack.

I provided evidence from the ECFMG and the USMLE websites to support my argument. I'd appreciate it if you did the same to support your arguments as well, otherwise I'm the one with more "facts" and you're the one with "opinions."

Provide links that explain what "significant numbers" or "a ton of FMGs" mean. 2%? 10%? 50%? Just telling me "a ton of FMGs that take the exams after they have already completed their residencies in their respective countries" or "a significant number of FMGs sign offers outside the match" means nothing to me other than your unsubstantiated and potentially uninformed opinion.

 

[anthroguy]

With DO students, you have a segment which chose DO over MD, a segment that only applied DO and a segment that ended up there after all American MD rejections were in. Only one group of these students is comparable to the carib students and even then in the American system, the schools will do all in their power to produce competent physicians and will try everything in their powers to not let you fail whereas across the pond, of the two people sitting next to you in first year lecture, one is not going to make it all the way through. And with 10 or so DO state schools and the schools that have there own hospital networks, how is the caribbean a valid choice. I go to UMDNJ and the "stigma" spoken of does not exist. Most doctors in south jersey seem to be DOs and with PCOM across the river, we're represented in philly too. DOs head departments at the other two UMDNJs and DOs are present in nyc as well.

The stigma begins and ends with premeds, in my shadowing, patients dont ask and most in areas 20-30 miles out from a DO school, will know for themselves.

 

[Shinken]

i agree this thread is getting ridiculous, with the author of the thread not even participating...

Was there any doubt whatsoever that this wouldn't happen?

Yes, this is SDN, otherwise known as electronic crack cocaine. You know it's bad for you, you know you shouldn't, you know there are healthier things to do with your time...yet here we are.

 

[drugdealer3000]

If you could do it all again (assuming you have already done it), would you go the DO route, or would you go to the Caribbean for an MD? I'm up in the air right now as to which path to pursue. Reading some of the posts on this osteopathic forum has me thinking twice about the DO route. Any thoughts?

Having debunked some rather outrageous statistics allow me to try and answer the original question...

I don't think a DO or US MD can really comment on going the Caribbean route. I think the Caribbean route has so many different challenges that really it would take someone that has gone through it to make an overall judgment.

You do take some kind of hit in the specialty sweepstakes if you do the DO or Caribbean route. Question is how much of a hit. We can all argue about that all day long. The fact there is an argument tells you there's a hit. And regardless of which Kool Aide you drink you are still going to have to explain what da' ph-ck at every cocktail party where your credentials come up... not a cool feeling . Bottom line whatever you do you better be one motivated, self studying, confident SOB!

If you have $h-tty MCAT scores you will probably have $h-tty USMLE scores if nothing drastic changes in your study habits/cognition/etc. $h-tty USMLE = FP, IM, PEDS, etc. There are lots of DOs in FP/IM because they "like it". I dunno about that. I think its within the realm of possibility that there are other forces at play here ... could be wrong.

However, I would caution you about living in another country. Even if its only for two years. The US of A is numero uno. Everywhere else is just a different level of suck... everywhere.

Totally shooting from the hip I would GUESS that DO makes your life easier when it comes to the match.

This is an interesting topic. Most DOs and Caribbean grads are fine docs. I don't think that's being questioned at all. I PERSONALLY can't imagine having a DO behind my name and neither can I imagine telling people I went to medical school in the Caribbean! Having said that if I had to have bypass surgery I wouldn't even think twice about letting a Caribbean grad or DO crack open my chest. DO and Caribbean sheep's skin ain't fashionable but as far as my health care it doesn't make a bit of difference. Anyone feel different?

 

[drugdealer3000]

What part of "roughly" and "simplification" was hard to understand in my post?

By the way, I'd appreciate a discussion on the issue, not a personal attack.

I provided evidence from the ECFMG and the USMLE websites to support my argument. I'd appreciate it if you did the same to support your arguments as well, otherwise I'm the one with more "facts" and you're the one with "opinions."

Provide links that explain what "significant numbers" or "a ton of FMGs" mean. 2%? 10%? 50%? Just telling me "a ton of FMGs that take the exams after they have already completed their residencies in their respective countries" means nothing to me other than your unsubstantiated and potentially uninformed opinion.

Shinken,


MOST FMGs IN THE MATCH ARE NOT US CITIZENS. That is not an opinion. Its a fact. Please read the NRMP site. Now who were you saying is uniformed?

Just because I presented first person anecdotal evidence doesn't mean its not factual... unless of course you are calling me a liar.

 

[group_theory]

Ok, this thread definately took a turn for the worst and will be closed.