REALITY of the merger: PD: "We went from 170 applications to 450 applications our first cycle"

[SurgDoc95]

We can discuss again this once you are through with residency and fellowship application season. Best of luck to you.

I mean, if you enjoy primary care and if your family / desired location isn't on the coasts or Colorado you should be just fine.

Again, making generalizations that someone will only be fine going DO if they want to be a PCP is a little presumptuous. Sure Ortho and Derm are quite a stretch, but gen surg, rads, anesthesia, EM? All attainable and if I get a 235+ step score and don't match into one of those (assuming I want to) then I'll come back and admit my ignorance but until then we'll have to agree to disagree!

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[DrfluffyMD]

Again, making generalizations that someone will only be fine going DO if they want to be a PCP is a little presumptuous. Sure Ortho and Derm are quite a stretch, but gen surg, rads, anesthesia, EM? All attainable and if I get a 235+ step score and don't match into one of those (assuming I want to) then I'll come back and admit my ignorance but until then we'll have to agree to disagree!

It's not a binary, it's a gradient. You can certainly overcome the bias in most places by a good step score (I say 20-40 points more, depends on the ranking of MD school where your competitions are from).

It's deeply unfair, and I am sorry.

FYI I believe last match to ACGME surgery DO had a 55% match rate. ACGME surgery is not easy due to bias.

 

[SurgDoc95]

It's not a binary, it's a gradient. You can certainly overcome the bias in most places by a good step score (I say 20-40 points more, depends on the ranking of MD school where your competitions are from).

It's deeply unfair, and I am sorry.

FYI I believe last match to ACGME surgery DO had a 55% match rate. ACGME surgery is not easy due to bias.

Of those 45% who didn't match what percent truly was competitive Step score and application wise? I understand it's hard to delineate between quality applicants who didn't match and those who had no business applying to surgery programs, but without that information it's not possible to make a concise judgement about true disadvantage for quality applicants.

 

[HMtoDO]

I think that many people fail to realize that many of the competitive DO applicants that apply to these highly competitive fields have forgone the ACGME match in lieu of the AOA. It's not hard to come to the conclusion that to maximize your chances of landing a competitive residency it is exponentially easier when applying to a match with less volume of qualified candidates. That's not to say that these candidates were less competitive than some of their MD counterparts. I am sure there are MD candidates with a more competitive app but there are definitely some DO apps that are more competitive than some of the MD apps. It goes both ways. It will be interesting to see how these truly competitive DO applicants that now will apply to one match will turn out. Some PD's will not be used to seeing this level of competitive apps that will soon be coming across their desk more frequently. That's not to say that this change will be instant but you are completely naive if you think that this will not alter the way some programs look at DO's in the future.


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[neurodjent]

I think that many people fail to realize that many of the competitive DO applicants that apply to these highly competitive fields have forgone the ACGME match in lieu of the AOA. It's not hard to come to the conclusion that to maximize your chances of landing a competitive residency it is exponentially easier when applying to a match with less volume of qualified candidates. That's not to say that these candidates were less competitive than some of their MD counterparts. I am sure there are MD candidates with a more competitive app but there are definitely some DO apps that are more competitive than some of the MD apps. It goes both ways. It will be interesting to see how these truly competitive DO applicants that now will apply to one match will turn out. Some PD's will not be used to seeing this level of competitive apps that will soon be coming across their desk more frequently. That's not to say that this change will be instant but you are completely naive if you think that this will not alter the way some programs look at DO's in the future.


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This has been my line of thinking since the doom and gloom merger posts began. People forget that some of the most competitive individuals for surgical sub's go through the aoa match. There have been some surgical sub matches in acgme by DO's, they just needed to apply. I think DO's are going to fare better in this merger than many think. They're not going to take over all of the top tier programs in competitive specialties, but they'll definitely start getting into more.

 

[DrfluffyMD]

Of those 45% who didn't match what percent truly was competitive Step score and application wise? I understand it's hard to delineate between quality applicants who didn't match and those who had no business applying to surgery programs, but without that information it's not possible to make a concise judgement about true disadvantage for quality applicants.

I misspoke. It's actually 51%, significantly lower than every other specialty tracked there.

It could be that many applied to surgery had no business of being there while people who applied to all other specialties were competitive candidates, or it could be discrimination.

http://www.nrmp.org/wp-content/uploads/2016/09/Charting-Outcomes-US-Osteopathic-2016.pdf

 

[DrfluffyMD]

This has been my line of thinking since the doom and gloom merger posts began. People forget that some of the most competitive individuals for surgical sub's go through the aoa match. There have been some surgical sub matches in acgme by DO's, they just needed to apply. I think DO's are going to fare better in this merger than many think. They're not going to take over all of the top tier programs in competitive specialties, but they'll definitely start getting into more.

The low number is for general surgery, not surgical subspecialties.

 

[neurodjent]

The low number is for general surgery, not surgical subspecialties.

I was referring to @HMtoDO 's post regarding how most of the most competitive DO candidates apply AOA not ACMGE. I was not talking about general surgery.

 

[ThreeCheers]

I misspoke. It's actually 51%, significantly lower than every other specialty tracked there.

It could be that many applied to surgery had no business of being there while people who applied to all other specialties were competitive candidates, or it could be discrimination.

http://www.nrmp.org/wp-content/uploads/2016/09/Charting-Outcomes-US-Osteopathic-2016.pdf

As stated before, that data is useless without showing the distribution of USMLE scores. You have to understand that DO schools tend to have poor advising for surgery. Students probably believed programs when they said they "recognized" COMLEX, or they assumed a score in the 210s would be acceptable since it is for MD students with home programs.

I agree that Surgery will become more competitive with the merger, but I doubt a 230+ step would fail to match at, like, UMMC or some other undesirable location.

 

[DrfluffyMD]

There's that pesky word again...

It's not "discrimination"

Which word should I use? DOs in my residency programs invariably has better stats than MDs on the average. They have to often work harder than their MD counterparts to work at the same programs.

In the radiologyPD AMA, he alluded to a program matching too many DOs can potentially turn off USMD applicants for having too many DOs alone.

 

[DrfluffyMD]

Are you a protected class? Is being a DO somehow a part of your genome or a defined disability?

No. It's a line on your CV that is fair game for evaluation just like any other part of it.

It's no more discrimination than it would be a PD to say they prefer Harvard grads to non-Harvard grads, or AOA to non AOA.

"Are you a protected class"? If you are addressing it specifically to me, I am not a DO, I went to a top 20 MD school.

Though you do have a fair point.

I do like to think that whether someone is AOA or not can be affected by what they do in med school.

Whether someone is a DO or MD have nothing to do with their accomplishment in med school.

I went through my wife's residency roster for the general surgery residents, and it does not seem like this program matched a single DO in the past 7 years. I know the stats of some of her classmates. One of those resident is a close friend of ours and we know she had a step 1 of 240 or so, no significant research and is from a top 40 USMD school. I have a hard time believe DOs with 260+ step score and otherwise comparable stats have never once applied to this program in the past 7 years. It only means none of them matched there.

It seems to me, that some program chose to filter out DO applicants.

I am not sure if I feel that's entirely fair.

 

[Scrubs101]

Pardon my ignorance but does the data for DO applicant to ACGME gen surg show the number of them that matched AOA gen surg or withdrew? I feel as though this could be a contributing factor as well considering well advised DOs will know their chances are better in the AOA match(prior to merger) and will have more than likely put all their eggs in the AOA basket while just putting their feelers out their for ACGME match. While id imagine the match rate overall is worse than USMD for gen surg, my guess is once we start getting more comprehensive data itll show matching % not as abysmal as 51%


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[DrfluffyMD]

Pardon my ignorance but does the data for DO applicant to ACGME gen surg show the number of them that matched AOA gen surg or withdrew? I feel as though this could be a contributing factor as well considering well advised DOs will know their chances are better in the AOA match(prior to merger) and will have more than likely put all their eggs in the AOA basket while just putting their feelers out their for ACGME match. While id imagine the match rate overall is worse than USMD for gen surg, my guess is once we start getting more comprehensive data itll show matching % not as abysmal as 51%


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I got a feeling that if they withdrew, it would not be a part of the statistics.

 

[Geraltofrivia]

I'd make the counter argument that a lot (not all) of DO students self-selected into DO in the first place. Yes, there are prospective opthos and orthos and dermies, but I think the vast majority of DO students realize that they're more likely to end up in a primary care specialty and are okay with that from the beginning (otherwise they would have only applied MD).

I didn't know going DO was going to limit me to just primary care. I'm NOT okay with it, and my biggest regret in life is not applying to more MD programs. Maybe it sounds pathetic to some, but I hate the fact that I'm going to end up being a DO

 

[ortnakas]

I don't know if a majority or even a significant minority of student SELF select into DO.

I didn't know going DO was going to limit me to just primary care. I'm NOT okay with it, and my biggest regret in life is not applying to more MD programs. Maybe it sounds pathetic to some, but I hate the fact that I'm going to end up being a DO

Maybe my post wasn't clear. I know DO isn't plan A for probably the majority of DOs, and I know not all DO students want to do primary care. But I was under the impression that the majority at least recognized what we were getting ourselves into and that we'd be less competitive than our MD brethren... but still doctors.

@Geraltofrivia DO doesn't limit you to primary care. There are DOs in pretty much every specialty and subspecialty-- it's just an even steeper uphill climb to get there.

 

[SurgDoc95]

Maybe my post wasn't clear. I know DO isn't plan A for probably the majority of DOs, and I know not all DO students want to do primary care. But I was under the impression that the majority at least recognized what we were getting ourselves into and that we'd be less competitive than our MD brethren... but still doctors.

@Geraltofrivia DO doesn't limit you to primary care. There are DOs in pretty much every specialty and subspecialty-- it's just an even steeper uphill climb to get there.

I swear this site convinces DO students that "I'm inferior and doomed to be a PCP" despite 40% or so going into non pcp specialties

 

[W19]

It's a strange world out there. There are good DO students that PD won't even look at their applications while that same PD will select students from Meharry/Howard etc....

 

[DrfluffyMD]

It's a strange world out there. There are good DO students that PD won't even look at their applications while that same PD will select students from Meharry/Howard etc....

Any wisdom on this? @SouthernSurgeon

 

[DrfluffyMD]

I don't even want to get near the racial implications therein, but suffice to say it's largely a false dichotomy

Agreed. I suspect those Howard/Meharry grads bring other things to the table in addition to their MD degree.

 

[CCmetal94]

I didn't know going DO was going to limit me to just primary care. I'm NOT okay with it, and my biggest regret in life is not applying to more MD programs. Maybe it sounds pathetic to some, but I hate the fact that I'm going to end up being a DO

Yeah, that does sound pathetic.

 

[Carbon090]

I didn't know going DO was going to limit me to just primary care. I'm NOT okay with it, and my biggest regret in life is not applying to more MD programs. Maybe it sounds pathetic to some, but I hate the fact that I'm going to end up being a DO

It sounds far worse than pathetic.

Don't want to end up in primary care? Do something about it.

 

[Goro]

There's that pesky word again...
It's not "discrimination"

I think the word "prejudice" can be applied. We know that there are programs that won't accept DOs, period. Good DO grads are tarred by the weaker schools and their lousy clinical training.

For the life of me, I can't remember which attending posted it, but he gave a very damning indictments of poor DO clinical training and why it makes it more difficult for him to justify ranking or interviewing a DO candidate. I wish I had that post, because I need to show it to our clinical Deans to say "see, this is what the profession is up against."

Are you a protected class? Is being a DO somehow a part of your genome or a defined disability?
No. It's a line on your CV that is fair game for evaluation just like any other part of it.
It's no more discrimination than it would be a PD to say they prefer Harvard grads to non-Harvard grads, or AOA to non AOA.

SS has a point here....but how many Albany/Drexel grads would be automatically ****canned by PDs in the way that some programs refuse to rank/interview DOs?

It's a strange world out there. There are good DO students that PD won't even look at their applications while that same PD will select students from Meharry/Howard etc....

SDNers are advised NOT to confuse UG GPA and MCAT stats with actual performance in med school, and quality of said med schools.

 

[AnatomyGrey12]

I misspoke. It's actually 51%, significantly lower than every other specialty tracked there.

It could be that many applied to surgery had no business of being there while people who applied to all other specialties were competitive candidates, or it could be discrimination.

http://www.nrmp.org/wp-content/uploads/2016/09/Charting-Outcomes-US-Osteopathic-2016.pdf

Talking to people who were going into surgery they all said that the low number is a combination of prejudice and bad advising. They said that there are too many people who think they can match just fine with simply a COMLEX, no research, or apply narrowly to a specific region. Surgery definitely is one of the last strongholds of bias, but often DO candidates have no idea how to apply to surgery. From what I've been told a good candidate with a 230+, a little bit of research, some good LORs, and who applies broadly will most likely match somewhere.

My own personal opinion is that how competitive GS is for DOs will depend on how many AOA programs ultimately make the merger. If none make it then it will become very competitive, and if they all make it then it will remain at mild-medium competitiveness. The truth will probably be that it will be more competitive than EM but a lot less competitive than the subs, somewhere in the middle. Only time will tell.

 

[Dharma]

Lol. Talk about wishful thinking. The overwhelming majority go to DO schools because they couldn't get into MD schools. If they "self-selected" it was on a basis of their own perceived inability to get into a MD program.

There are three basic populations of DO students:

1. Those who couldn't get into an MD program
2. Those who genuinely chose a DO program over an MD program
3. Members of group (1) who claim to be members of group (2) as a form of ego massaging.

Group 2 is by far the smallest.

All these years later and we're still having this discussion. (If I had a dime for every time). SDN doesn't change much. (Back to the psychiatry forums I go...)

 

[Dharma]

This site has a long and strong tradition of pro-DO slant from the founder on down and is, if anything, more optimistic than the real world.

I would disagree with the bolded. If anything I have seen the opposite in the so-called real world. But whatever. No use going back and forth on that. People should go out there, practice medicine for the sake of their patients, and leave the pre-med worries behind, where they belong.

 

[DrfluffyMD]

I would disagree with the bolded. If anything I have seen the opposite in the so-called real world. But whatever. No use going back and forth on that. People should go out there, practice medicine for the sake of their patients, and leave the pre-med worries behind, where they belong.

What happens in the "real world" is specialty and location dependent. A title of DO will not be held against them
once they work with MDs side by side.

Problem is with access of GME and jobs. All you need are prejudice from people who are in charge of those.

 

[SLC]

What happens in the "real world" is specialty and location dependent. A title of DO will not be held against them
once they work with MDs side by side.

Problem is with access of GME and jobs. All you need are prejudice from people who are in charge of those.

I've never detected even an ounce of prejudice when applying for jobs. Was given an offer, quickly, at every single place I talked to.

 

[DrfluffyMD]

I've never detected even an ounce of prejudice when applying for jobs. Was given an offer, quickly, at every single place I talked to.

Sounds like you are IM. There isn't really any prejudice in nonacademic IM outside of perhaps the most competitive area.

 

[SLC]

Sounds like you are IM. There isn't really any prejudice in nonacademic IM outside of perhaps the most competitive area.

No offense, but it sounds like you're a bit of a know-it-all. What do you know about academic IM job prospects for DO's? Aren't you a Radiology PGY-2 or something?

There are DO's in "academic IM" all over my university's program in the North East. It's just one program, I admit, but it doesn't jive with your assertion.

 

[LutGholein]

It's a strange world out there. There are good DO students that PD won't even look at their applications while that same PD will select students from Meharry/Howard etc....

You're treading into dangerous waters--- we can make the same arguments for the folks from Marshall(WV public) and other mission based schools with comparable stats and it's still a lousy argument. Don't go there man.

 

[DrfluffyMD]

No offense, but it sounds like you're a bit of a know-it-all. What do you know about academic IM job prospects for DO's? Aren't you a Radiology PGY-2 or something?

There are DO's in "academic IM" all over my university's program in the North East. It's just one program, I admit, but it doesn't jive with your assertion.

No offense, but I am not a radiology PGY2 (you are gettig your PGY years mixed up), and as a matter of fact, I do know quite a bit about job prospect in IM for DOs due to my professional network.

Like I said earlier, it's a gradient from MGH to family practice in Dakota, not a binary, and certainly not "You don't need to worry, I get offer everywhere I go" kind of situation.

If you read my posts further, you will realized that I am on your (DO's) side also.

 

[W19]

You're treading into dangerous waters--- we can make the same arguments for the folks from Marshall(WV public) and other mission based schools with comparable stats and it's still a lousy argument. Don't go there man.

I just chose two lower ranked schools to make my argument. You can extend the argument to Marshall or any other low tier MD schools far that matter. Maybe you are reading too much into my post.

 

[hallowmann]

I didn't know going DO was going to limit me to just primary care. I'm NOT okay with it, and my biggest regret in life is not applying to more MD programs. Maybe it sounds pathetic to some, but I hate the fact that I'm going to end up being a DO

For one thing, unless you do/did really poorly and don't really know how to network and interview well, chances are you can go into something other than primary care. I really wouldn't be surprised if the majority of DOs who go into primary care do so because they want to. Sure, maybe 25% of DOs end up in PC because they have no other choice, but easily the other 30-35% are doing it because they want to, at least based on my anecdotal experience with my class.

In any case, even if you just do OK, you'll have a shot at a number of specialties, or even IM --> Endo or something. There are plenty of not particularly competitive fellowships, and if you're willing to go almost anywhere, you could easily find one.

Also, honestly, come on, just work hard and you'll be fine. If you can't work hard enough to be competitive for something else, just be thankful you're a doctor, because honestly there'd be no chance of you doing any better.

This site has a long and strong tradition of pro-DO slant from the founder on down and is, if anything, more optimistic than the real world.

If this was ever the case, at the very least the last 1-2 yrs or so have if anything shown an anti-DO slant even on the DO forums.

All these years later and we're still having this discussion. (If I had a dime for every time). SDN doesn't change much. (Back to the psychiatry forums I go...)

I would disagree with the bolded. If anything I have seen the opposite in the so-called real world. But whatever. No use going back and forth on that. People should go out there, practice medicine for the sake of their patients, and leave the pre-med worries behind, where they belong.

Yup. Pretty much.

 

[LutGholein]

I just chose two lower ranked schools to make my argument. You can extend the argument to Marshall or any other low tier MD schools far that matter. Maybe you are reading too much into my post.

Maybe you're right. To be frank low tier MD is a catch-all term -- I think the range is huge-- and yes some schools definitely overlap with solid DO schools in regards to numerical stats.

 

[JamesPotterMS-3]

I SWEAR if I hear the word "discrimination" thrown around one more time to describe the preference of MD over DOs by PDs, I'm going to lose it. God forbid, if I needed a brain tumor removed, would I pick the UCSF trained surgeon with a CV the size of a dictionary or the doc who received his training at a 150-bed community hospital? Would that be discrimination too? JESUS. And this is coming from a DO student going into surgery.

 

[SLC]

I SWEAR if I hear the word "discrimination" thrown around one more time to describe the preference of MD over DOs by PDs, I'm going to lose it...And this is coming from a DO student going into surgery.

I'm confused...based on what you wrote in your other thread:

Help me figure out my future:: Ob/Gyn vs. Gen Surg

• I have no research and a mediocre step score. I'm also coming from a low tier, newer MD school

Which is it? And why can't you just tell the truth?

 

[FourniersGreenGang]

For one thing, unless you do/did really poorly and don't really know how to network and interview well, chances are you can go into something other than primary care. I really wouldn't be surprised if the majority of DOs who go into primary care do so because they want to. Sure, maybe 25% of DOs end up in PC because they have no other choice, but easily the other 30-35% are doing it because they want to, at least based on my anecdotal experience with my class.

In any case, even if you just do OK, you'll have a shot at a number of specialties, or even IM --> Endo or something. There are plenty of not particularly competitive fellowships, and if you're willing to go almost anywhere, you could easily find one.

Also, honestly, come on, just work hard and you'll be fine. If you can't work hard enough to be competitive for something else, just be thankful you're a doctor, because honestly there'd be no chance of you doing any better.



If this was ever the case, at the very least the last 1-2 yrs or so have if anything shown an anti-DO slant even on the DO forums.




Yup. Pretty much.

I'll agree with this. Anecdotally, right around 65 percent of my MS1 class wanted to go into primary care right off the bat. Only maybe 5-10 percent wanted to go into something considered to be a competitive specialty. There are definitely more people at DO schools who voluntarily choose primary care because, at least at my school, it's heavily emphasized. Of course, thats not to say that there will be no students forced to go into it by nature of scores.

 

[Staphylococcus Aureus]

Often said on SDN and anecdotally confirmed is the generalization of the older a student is, the less likely they will be interested in a residency over 3-4 years length. I believe it is still true that more DO students are older and non-traditional.

 

[Peach Newport]

Often said on SDN and anecdotally confirmed is the generalization of the older a student is, the less likely they will be interested in a residency over 3-4 years length. I believe it is still true that more DO students are older and non-traditional.

No one talks about it, but I've noticed this too. In my (DO) class, the older students (26+) pretty much all talk about wanting IM/FM/EM/OB. It's the younger ones straight out of college that seem to want surgery.

 

[Winged Scapula]

No one talks about it, but I've noticed this too. In my (DO) class, the older students (26+) pretty much all talk about wanting IM/FM/EM/OB. It's the younger ones straight out of college that seem to want surgery.

That's not specific to osteopathic schools

 

[Peach Newport]

That's not specific to osteopathic schools

Of course it's not. I would guess that it's pretty constant. The poster before me was talking about how osteopathic schools have more older/Nontrad students, making the student body as a whole less interested in surgery. I was agreeing

 

[Winged Scapula]

Of course it's not. I would guess that it's pretty constant. The poster before me was talking about how osteopathic schools have more older/Nontrad students, making the student body as a whole less interested in surgery. I was agreeing[/QUOT
Got it.

Excuse me while I back out of the conversation.

 

[Señor S]

SS has a point here....but how many Albany/Drexel grads would be automatically ****canned by PDs in the way that some programs refuse to rank/interview DOs?

Some, but as I said earlier, with a sufficient combination of scores + grades any US MD is essentially guaranteed an interview at certain programs (in IM at least) that do not consider DOs. I'm speaking from experience here.

 

[Señor S]

There are DO's in "academic IM" all over my university's program in the North East. It's just one program, I admit, but it doesn't jive with your assertion.

Pretty sure I interviewed at your program and didn't see a single DO on the resident roster or amongst the applicants or any of the faculty. Where were they all hiding?

 

[Prehealth1011]

No one talks about it, but I've noticed this too. In my (DO) class, the older students (26+) pretty much all talk about wanting IM/FM/EM/OB. It's the younger ones straight out of college that seem to want surgery.

This is literally me I'm 27 and starting this year. Here's hoping i don't develop a passion for cutting people up during rotations.

 

[SLC]

Pretty sure I interviewed at your program and didn't see a single DO on the resident roster or amongst the applicants or any of the faculty. Where were they all hiding?

I'm guessing you probably don't have my program correct then.

But trust me, there are DO's all over here.

 

[Lexdiamondz]

I'm guessing you probably don't have my program correct then.

But trust me, there are DO's all over here.

If I remember correctly you're FM not IM though

 

[SLC]

If I remember correctly you're FM not IM though

Yes, and we work very closely with the IM department.

 

[DrfluffyMD]

Yes, and we work very closely with the IM department.

I am guessing you are at Yale? It's known to be friendly to DOs.

 

[Lexdiamondz]

I am guessing you are at Yale? It's known to be friendly to DOs.

Probably Brown. Yale isn't that friendly to DOs if I remember correctly, whereas Brown's FM dept is full of them.