Things You Might Not Know About Residency

[carml]

Got this today from my state's medical society and thought I'd forward it on.

Possibly the scariest two words in medical school are “The Match.” Residency is the epitome of everything that we medical students have worked, and often sacrificed, to attain. We have all spent so much time learning about it; learning the tricks to increasing our odds of matching to our #1 choice, learning the strengths of each program, and generally thinking we ‘get’ residency. I think that perhaps there are much more important things to know about residency. I think there are things about residency that you have no clue about, and you may even believe the exact opposite of the reality. Below you’ll find four things about residency that you probably don’t know, but really need to.

- Residency is not a sure thing, a “given” for any American graduate who can pass the boards. Recently, the New England Journal of Medicine released a report on the future of residencies. The basic conclusion of the report is that there are currently three likely growth patterns that residencies will take in the future and all three show that in the next few years we will RUN OUT of residencies by 2015 or 2020, depending on the projection This means that unless there is dramatic change in congress to secure more spots we may very well have students in United States medical schools right now that will NOT have a job when they graduate.

- The residency “freeze” doesn’t really exist, despite everyone seeming to think it does. Pretty much everyone has heard, to some extent, about the balanced budget act of 1997 (BBA-1997). Yes it does free future growth of existing programs, but it does nothing to prevent new programs from opening, and almost 2,000 new spots open every year. Graduate medical education is growing, just not at the speed we need it to grow at.

- As shown above, blaming stagnation of Graduate Medical Education (GME) for too few residencies is not the answer, the blame falls on rapid expansion of schools. In the past five years 15 medical schools have opened in the US and 12 more will open in the next 2 years. Among those numbers are two new medical schools in New York, Touro and Hofstra. It also is happening far too quickly for the system to react to, and the massive influx of students that has already began pouring in with the graduating class of 2011 will only continue to rise precipitously as each new school has its first graduating class.

- The last misconception is that it’s a lost cause and we, as students, don’t have the time or power to stop anything. It’s not a lost cause. There is so much more to be done. There are bills in the federal government looking to raise the residency training slots dramatically. There is written support for residency training expansion by the State Society, and there are students across the state working hard to make sure you know what issues are on the horizon.

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[DrBowtie]

Not a big deal for US MD students at the moment. With the elimination of pre matching next year and rising MD enrollments, it will keep getting tougher for the DOs and IMGs in the ACGME match.

 

[Aislinn]

Not a big deal for US MD students at the moment. With the elimination of pre matching next year and rising MD enrollments, it will keep getting tougher for the DOs and IMGs in the ACGME match.

As a fellow MD student, I think that's a tad bit arrogant and presumptuous, especially when it comes to DO students. What makes you think that an ACGME program director wouldn't choose and DO or IMG over a U.S. MD if their scores are better or if they're just better clinically/personality-wise?

 

[PMPMD]

Got this today from my state's medical society and thought I'd forward it on.

- The residency “freeze” doesn’t really exist, despite everyone seeming to think it does. Pretty much everyone has heard, to some extent, about the balanced budget act of 1997 (BBA-1997). Yes it does free future growth of existing programs, but it does nothing to prevent new programs from opening, and almost 2,000 new spots open every year. Graduate medical education is growing, just not at the speed we need it to grow at.

Not sure where you get 2,000 spots/year. Above data from the NRMP. Since 1990, I see less than 4,000 spots added. So maybe you meant 2,000 spots per decade.

 

[turkeyjerky]

Not a big deal for US MD students at the moment. With the elimination of pre matching next year and rising MD enrollments, it will keep getting tougher for the DOs and IMGs in the ACGME match.

I really do believe that this is wishful thinking. There's no reason to believe that PDs who routinely prematch all their spots w/ DOs and FMGs will switch to american MD grads in the next few years.

Not sure where you get 2,000 spots/year. Above data from the NRMP. Since 1990, I see less than 4,000 spots added. So maybe you meant 2,000 spots per decade.

I think he means 2000 residency spots per year, which would translate to about 5-600 pgy1 spots per year. I have no idea whether this figure is accurate or not.

 

[PMPMD]

I really do believe that this is wishful thinking. There's no reason to believe that PDs who routinely prematch all their spots w/ DOs and FMGs will switch to american MD grads in the next few years.



I think he means 2000 residency spots per year, which would translate to about 5-600 pgy1 spots per year. I have no idea whether this figure is accurate or not.

Maybe so. Then the other 300-400 spots must be out of the match

 

[DrBowtie]

The ACGME is already laying the way to crowd out DO students. See their boards about requiring ACGME internships for advanced ACGME residencies.

Its naive to think the political influence of the AAMC won't be in full effect if the numbers of US MD students who go unmatched start to rise due to shortages in ACGME spots with a plethora of AOA spots unmatched that only DO students can apply for.

 

[Dr Love]

We need to halt this insane idea that we need to build all these new medical schools to address the looming "physician shortage" that will kill all our grandparents. The physician shortage isn't real, plain and simple.

 

[officedepot]

As a fellow MD student, I think that's a tad bit arrogant and presumptuous, especially when it comes to DO students. What makes you think that an ACGME program director wouldn't choose and DO or IMG over a U.S. MD if their scores are better or if they're just better clinically/personality-wise?

DO students did not go to an allopathic school and they should have a significantly harder time matching or not even be considered solely because of that purpose. It has been discussed before but I will reiterate it: DO students on average are not the same caliber students as MD students. Stats show this (see a wikipedia article). If they were they would have no trouble matching against MD students.


on topic: there's more than enough residency spots for all US medical graduates. Allopathic schools are trying to expand to fill them all with US MD students as they are the most highly sought after. Residencies do not go looking for DO and IMG if they have MDs willing to take the spots. So there should be no concerns for US MD students if they apply broadly and to a field within their means.

 

[werd]

while residency is never a sure thing, it's as close to it as possible for US allopathic grads. each year there are ~16k allopathic grads competing for ~25k residency spots. the rest are filled by DO's and IMG's. well over 90% of allopaths match into residency on their first try, unlike the other groups. the recent rapid expansion of allopathic med school spots (in contrast to the slowly growing number of allopathic residency spots) may put some pressure on allopathic grads, but is more likely to put pressure on the other groups competing for those spots.

 

[ccmonopolies]

glad I'm graduating in 2014!

Seriously though, US MD students have it nice. Oh wait, US MD students had higher GPAs/MCATs to start with, it might be logical to assume that maybe we will generally have the ability to learn more in med school than other applicants.

This is really only a problem for DO and IMG graduates.

 

[carml]

Not a big deal for US MD students at the moment. With the elimination of pre matching next year and rising MD enrollments, it will keep getting tougher for the DOs and IMGs in the ACGME match.

On the match as a whole it may not be a big deal for US allos as of now, but within certain more competitive specialties, it will/has a big impact. In those specialties, the competition isn't between DO vs MD as mostly allos apply.

The fact the a specialty is popular to begin with, now combined with even more allos applying to it and no increases in spots isn't going to be very fun.

 

[2012mdc]

On the match as a whole it may not be a big deal for US allos as of now, but within certain more competitive specialties, it will/has a big impact. In those specialties, the competition isn't between DO vs MD as mostly allos apply.

The fact the a specialty is popular to begin with, now combined with even more allos applying to it and no increases in spots isn't going to be very fun.

But by and large the increase in allos will be from allos who previously would have gone the DO/Carib route or not gone to med school at all. Only a small number of these students will be competitive for the most competitive residencies.

I think if you handle your business and choose a realistic field, allos will still be fine

 

[ccmonopolies]

But by and large the increase in allos will be from allos who previously would have gone the DO/Carib route or not gone to med school at all. Only a small number of these students will be competitive for the most competitive residencies.

I think if you handle your business and choose a realistic field, allos will still be fine

^this.

 

[CodeBlu]

But by and large the increase in allos will be from allos who previously would have gone the DO/Carib route or not gone to med school at all. Only a small number of these students will be competitive for the most competitive residencies.

I think if you handle your business and choose a realistic field, allos will still be fine

Finally some clear thinking.

 

[Dral]

But by and large the increase in allos will be from allos who previously would have gone the DO/Carib route or not gone to med school at all. Only a small number of these students will be competitive for the most competitive residencies.

I think if you handle your business and choose a realistic field, allos will still be fine

True, but it'll suck for the allos who go through med school, decide that plastics is what they want to do, and find out that the match rate is like 15 percent. heh.

 

[2012mdc]

True, but it'll suck for the allos who go through med school, decide that plastics is what they want to do, and find out that the match rate is like 15 percent. heh.

Because of self selection I doubt the match rates for plastics/derm/nsurg will change that much.

Like the large majority of med students now, these added students won't be even interested in the hypercompetitive specialties let alone qualified enough to even seriously consider them.

 

[Dral]

Because of self selection I doubt the match rates for plastics/derm/nsurg will change that much.

Like the large majority of med students now, these added students won't be even interested in the hypercompetitive specialties let alone qualified enough to even seriously consider them.

There will be some people that will be disappointed, but in general I think you're correct. The big picture is that more Allo AMGs will go into primary care and what not.

 

[BabyKangaroo]

Yes, DOs are stupid idiots who walk around with drag marks on their knuckles. Hail to the superior MDs! Even though DOs have more hours in medical school (OMM), can and do take both board exams and score better than most MDs on average (my school at least), they are so inferior and are not allowed to acquire the same residencies as the jackwagons that post on this thread. You guys sound ridiculous, like a bunch of squirrely people waiting in line to get a rescue boat on the Titanic while you push the "inferior" people out of the way. I turned down 3 offers to go to an MD school so I could get superior teaching at a DO school. Guess what? Already showed up 3 MD students on my rotations, JUST DOING manipulation, not counting the great knowledge base I have. My preceptors favored me over the superior MDs. Grow up. I'm not an exception.

 

[phenylacetone]

I turned down 3 offers to go to an MD school so I could get superior teaching at a DO school.

Caribbean MD schools don't count.

 

[2012mdc]

Yes, DOs are stupid idiots who walk around with drag marks on their knuckles. Hail to the superior MDs! Even though DOs have more hours in medical school (OMM), can and do take both board exams and score better than most MDs on average (my school at least), they are so inferior and are not allowed to acquire the same residencies as the jackwagons that post on this thread. You guys sound ridiculous, like a bunch of squirrely people waiting in line to get a rescue boat on the Titanic while you push the "inferior" people out of the way. I turned down 3 offers to go to an MD school so I could get superior teaching at a DO school. Guess what? Already showed up 3 MD students on my rotations, JUST DOING manipulation, not counting the great knowledge base I have. My preceptors favored me over the superior MDs. Grow up. I'm not an exception.

Relax man.

No one said all DO's are stupid or anything crazy like that.

But in general those students who chose to go the DO/Carib route go that route because they don't have the numbers. Of course there are exceptions but MOST people choose US allo over DO/IMG when given the choice.

Most of the new allos will come from the group that was previously borderline for acceptance. It is safe to say most of these students will be not be competing for the most competitive residencies just like most current allopaths are not.

And dude get over yourself, you complain about our snobby attitude (when I really didn't see one) and then go ahead to claim your teaching is superior and your knowledge base is great.

 

[Aislinn]

Its naive to think the political influence of the AAMC won't be in full effect if the numbers of US MD students who go unmatched start to rise due to shortages in ACGME spots with a plethora of AOA spots unmatched that only DO students can apply for.

It's naive to think that PDs are more concerned with the AAMC than hiring the best residents for the job. And by the way, the number of U.S. allo students who are unmatched is rising. If I'm not mistaken, it was at 7% last year, as opposed to a few years ago when it was only at 2%.

DO students did not go to an allopathic school and they should have a significantly harder time matching or not even be considered solely because of that purpose.

And yet, they are considered. I've met some DO students I wouldn't trust with a hangnail, but I've met some MD students I wouldn't trust with a paper cut. Based on my experience, I wouldn't know an MD from a DO unless someone told me, so lose the superiority.

It has been discussed before but I will reiterate it: DO students on average are not the same caliber students as MD students.

Aren't you the same person who thought it was illegal to post a dating ad online and told another poster that if he/she didn't turn in the person who did it, he/she would be committing an honor code violation? Don't think you're in any position to be putting down anyone else there, skippy.

Stats show this (see a wikipedia article).

Ah, the good old stats line. Because we all know that what makes a good doctor is a 35 MCAT.

Residencies do not go looking for DO and IMG if they have MDs willing to take the spots.

So for every residency spot taken up by a DO or IMG, it means that there were no MDs applying to it? Does that go for the Mayo derm spot a DO matched last year? How about the allo plastics spot a DO edged out thousands of MD students to get last March?

Seriously though, US MD students have it nice. Oh wait, US MD students had higher GPAs/MCATs to start with, it might be logical to assume that maybe we will generally have the ability to learn more in med school than other applicants.

This one takes the cake! Higher GPA and MCAT scores equate to learning more in med school? LOLOL. Boy, you've got a lot to learn. Don't be so smug. A DO may just knock you off your pedestal. And I say this as an MD student myself. I just can't stand people like you because you make us all look bad with your arrogant air of superiority.[/quote]

No one said all DO's are stupid or anything crazy like that.

I don't know about that. The above posts pretty much imply that MDs must be smarter since the averages to get into MD schools are often higher (though not by much these days). If I was a DO, I'd be pretty insulted too. I thought this kind of macho ego flexing only took place in pre-allo.

But in general those students who chose to go the DO/Carib route go that route because they don't have the numbers.

You must not have gotten the memo. There are many DO schools whose numbers are at the same level or just below the MD average in that state/city.

Examples:

TCOM's Class of 2013 had an MCAT average of 29 while the C/O 2013 MD schools in TX had an MCAT average of 30.

KCUMB's Class of 2013 had an MCAT average of 27 while UMKC's Class of 2013 had an MCAT average of 27 as well.

LMU's Class of 2013 had an MCAT average of 25 while Meharry's Class of 2013 had an MCAT average of 25 as well.

And dude get over yourself, you complain about our snobby attitude (when I really didn't see one)

If you didn't see a snobby attitude in this thread, then you read it with your eyes closed.

 

[tiedyeddog]

TCOM's Class of 2013 had an MCAT average of 29 while the C/O 2013 MD schools in TX had an MCAT average of 30.

KCUMB's Class of 2013 had an MCAT average of 27 while UMKC's Class of 2013 had an MCAT average of 27 as well.

LMU's Class of 2013 had an MCAT average of 25 while Meharry's Class of 2013 had an MCAT average of 25 as well.

If you didn't see a snobby attitude in this thread, then you read it with your eyes closed.

GPAs? Also, I think the above posters had a point. MOST(there is a slim majority that don't, I get it) people go to DO schools because they could not get an MD acceptance. Those that maybe in the past got MD interviews but did not get an MD acceptance will now have greater chances at MD schools because of expanding/new schools.

Since there is (it's a fact....) a correlation between MCAT scores (albeit a low correlation) those people who do get those new MD spots will probably not want/do well enough in the first two years/score high enough on step to go into one of the hypercompetetive specialties, like plastics or derm. Thus is probably won't make hyper competitive programs that much more competitive.

I just want to say before Aislinn, or anyone else, flames me, that I do not think the DO route is subpar, if they pass steps and get great scores they might as well be learning the same stuff MD people are. But there is no denying most people go to DO schools because they couldn't get an MD spot...

 

[NickNaylor]

Aislinn, it's nice that you can pull out data, but the observation remains that very few people that could get into a US MD school choose to forgo that opportunity and attend a DO or Caribbean school. I'm not saying it doesn't happen, but the reality is that, for most applicants, DO and Caribbean schools are a tier below US MD institutions. It doesn't mean the other schools mill out bad physicians. But I do think there's something to be said about people not choosing the other routes despite the wide understanding among most applicants that they're very similar if not indistinguishable (at least in the case of MDs vs. DOs).

 

[DrBowtie]

You guys are spiralling this thread into it being about DO students, when its really not.

Big moves are going to occur on the institutional, or organizing, accrediting body level. As the crunch starts to occur, there will be pressures for residencies to take only LCME students at the institutional level.

The growth of students is unsustainable with residency programs. The first to be pushed out are the FMGs as a whole. I've met some great ones and some terrible ones, but as I said, these changes will be blanket and not made at the Program director level.

Then will be the DO students who have their own exclusive residencies. The onus is on the AOA to keep pace with your demand for places, not the ACGME and as a crunch becomes even worse, I think many places, especially those affiliated with MD schools will be strong armed to accept only LCME students.

 

[cetac]

We need to halt this insane idea that we need to build all these new medical schools to address the looming "physician shortage" that will kill all our grandparents. The physician shortage isn't real, plain and simple.

Dr Love speaks the truth.

It's a matter of distribution and use of time. Currently, physicians are not distributed across the country to the areas that need them most - a problem of incentive. In addition, and more important IMO, we have a current medical climate that gives more incentive to non-evidenced based care of an individual patient than evidence-based care of more patients. Partly this is due simply to the culture of physicians, and partly this is due to the absurd hoops physicians must jump through in the form of paperwork for insurance.

Nobody is going to argue that there needs to be more primary care doctors, for instance, but it all boils back down to the formula above. When physicians are compensated in a fashion that incentivizes procedures, scans, etc... you have people going into those specialties for the increased compensation (or, conversely, avoiding primary care for its lower compensation) in the face of staggering medical school loans. A change in the method by which physicians are compensated will not only incentivize going into primary care, particularly for those who currently wish to pursue it but avoid it due to economic concerns, but it will, over time, correct the red herring "physician shortage."

 

[HardToStarboard]

Yes, DOs are stupid idiots who walk around with drag marks on their knuckles. Hail to the superior MDs! Even though DOs have more hours in medical school (OMM), can and do take both board exams and score better than most MDs on average (my school at least), they are so inferior and are not allowed to acquire the same residencies as the jackwagons that post on this thread. You guys sound ridiculous, like a bunch of squirrely people waiting in line to get a rescue boat on the Titanic while you push the "inferior" people out of the way. I turned down 3 offers to go to an MD school so I could get superior teaching at a DO school. Guess what? Already showed up 3 MD students on my rotations, JUST DOING manipulation, not counting the great knowledge base I have. My preceptors favored me over the superior MDs. Grow up. I'm not an exception.

Turned down three MD school offers? No sir, I don't believe you.

 

[Law2Doc]

You guys are spiralling this thread into it being about DO students, when its really not.

Big moves are going to occur on the institutional, or organizing, accrediting body level. As the crunch starts to occur, there will be pressures for residencies to take only LCME students at the institutional level.

The growth of students is unsustainable with residency programs. The first to be pushed out are the FMGs as a whole. I've met some great ones and some terrible ones, but as I said, these changes will be blanket and not made at the Program director level.

Then will be the DO students who have their own exclusive residencies. The onus is on the AOA to keep pace with your demand for places, not the ACGME and as a crunch becomes even worse, I think many places, especially those affiliated with MD schools will be strong armed to accept only LCME students.

Agreed. The AAMC push to have US allo med school slots meet US residency needs largely turns on a need to have LCME oversight of education to ensure a certain level of quality. When push comes to shove nobody equates good USMLE scores with good resident skills. But having very specific LCME required rotational training limits some of the uncertainty for PDs in selecting it's residents. It's why the IMGs with high board scores and limited US clinical exposure don't do well in the match. Nobody is saying many DO schools aren't giving very solid medical education. But we are saying that many are not meeting the specific LCME requirements, because they don't have to and are not overseen by this organization. I've been a resident at a hospital which allowed DOs to do some core rotations there and can tell you with certainty that the rotation was not the same as a rotation required by LCME. I'll leave judgement as to whether this rotation provided adequate pre-residency training to the PDs, but can assure you that it wasnt the equivalent rotation to what many allo students endured. That being said, I have worked with some very good DO doctors, so clearly the training isn't uniformly lacking. But this lack of LCME governance means there isn't the same kind of standardization you see in the allo schools, and that will present a problem for DOs as the allo match spots start to become short in supply.

 

[2012mdc]

It's naive to think that PDs are more concerned with the AAMC than hiring the best residents for the job. And by the way, the number of U.S. allo students who are unmatched is rising. If I'm not mistaken, it was at 7% last year, as opposed to a few years ago when it was only at 2%.



And yet, they are considered. I've met some DO students I wouldn't trust with a hangnail, but I've met some MD students I wouldn't trust with a paper cut. Based on my experience, I wouldn't know an MD from a DO unless someone told me, so lose the superiority.

Aren't you the same person who thought it was illegal to post a dating ad online and told another poster that if he/she didn't turn in the person who did it, he/she would be committing an honor code violation? Don't think you're in any position to be putting down anyone else there, skippy.

Ah, the good old stats line. Because we all know that what makes a good doctor is a 35 MCAT.

So for every residency spot taken up by a DO or IMG, it means that there were no MDs applying to it? Does that go for the Mayo derm spot a DO matched last year? How about the allo plastics spot a DO edged out thousands of MD students to get last March?



This one takes the cake! Higher GPA and MCAT scores equate to learning more in med school? LOLOL. Boy, you've got a lot to learn. Don't be so smug. A DO may just knock you off your pedestal. And I say this as an MD student myself. I just can't stand people like you because you make us all look bad with your arrogant air of superiority.

I don't know about that. The above posts pretty much imply that MDs must be smarter since the averages to get into MD schools are often higher (though not by much these days). If I was a DO, I'd be pretty insulted too. I thought this kind of macho ego flexing only took place in pre-allo.



You must not have gotten the memo. There are many DO schools whose numbers are at the same level or just below the MD average in that state/city.

Examples:

TCOM's Class of 2013 had an MCAT average of 29 while the C/O 2013 MD schools in TX had an MCAT average of 30.

KCUMB's Class of 2013 had an MCAT average of 27 while UMKC's Class of 2013 had an MCAT average of 27 as well.

LMU's Class of 2013 had an MCAT average of 25 while Meharry's Class of 2013 had an MCAT average of 25 as well.

If you didn't see a snobby attitude in this thread, then you read it with your eyes closed.[/QUOTE]

It's not snobby to say that on average MD matriculants have better numbers than DO. It's just a fact. In general those students with better numbers end up doing better in med school. The correlation is weak but it's there. Doing better =/= being a better doctor but it does make you more attractive to residency programs in general.

I like how you used 3 examples to support your argument but completely ignored the most important/relevant one. MD's as a whole vs DO's a whole.

It's not a leap to say most of the students going the DO route now would be hard pressed to match the most competitive residencies as allos. Heck, most allos are hard pressed to. The new allos are likely to end up in PC like most allos and will push out IMG's, not other allos. They are not gonna come in and take a bunch of plastics and derm spots

 

[El Dooderino]

Like people said earlier, the DO's and FMG's will get pushed out when push comes to shove. I'd think long and hard about going to a DO school in the coming years, might be worth reapplying at least a couple times. Their system is incredibly broken and one push from the ACGME and it collapses

 

[NickNaylor]

Like people said earlier, the DO's and FMG's will get pushed out when push comes to shove. I'd think long and hard about going to a DO school in the coming years, might be worth reapplying at least a couple times. Their system is incredibly broken and one push from the ACGME and it collapses

How is it broken?

 

[CodeBlu]

Agreed. The AAMC push to have US allo med school slots meet US residency needs largely turns on a need to have LCME oversight of education to ensure a certain level of quality. When push comes to shove nobody equates good USMLE scores with good resident skills. But having very specific LCME required rotational training limits some of the uncertainty for PDs in selecting it's residents. It's why the IMGs with high board scores and limited US clinical exposure don't do well in the match. Nobody is saying many DO schools aren't giving very solid medical education. But we are saying that many are not meeting the specific LCME requirements, because they don't have to and are not overseen by this organization. I've been a resident at a hospital which allowed DOs to do some core rotations there and can tell you with certainty that the rotation was not the same as a rotation required by LCME. I'll leave judgement as to whether this rotation provided adequate pre-residency training to the PDs, but can assure you that it wasnt the equivalent rotation to what many allo students endured. That being said, I have worked with some very good DO doctors, so clearly the training isn't uniformly lacking. But this lack of LCME governance means there isn't the same kind of standardization you see in the allo schools, and that will present a problem for DOs as the allo match spots start to become short in supply.

Interesting. So, when do you foresee this happening? 5? 10? 20 years?

 

[El Dooderino]

How is it broken?

Increasing med school spots at an alarming rate when even right now there aren't enough AOA spots for all the osteopath med students. Nevermind their new med school spots are of questionable quality and they even have a for profit school owned by a dude who used to own Caribbean med schools. The limited amount of AOA residency spots they have now are also of questionable quality, see the new ACGME resolution to not allow people who did AOA internships from doing ACGME residencies and people who did AOA residencies from not doing ACGME fellowship. Basically they tout this seperate nonsense when they rely on ACGME residency spots to train their physicians. Once they get squeezed out of ACGME residencies, either through policy changes or just more graduating US MD's, they are going to start to have DO graduates who have no where to train because their leadership decided to make a ton of med school spots with no residency positions.

 

[BabyKangaroo]

Relax man.

No one said all DO's are stupid or anything crazy like that.

But in general those students who chose to go the DO/Carib route go that route because they don't have the numbers. Of course there are exceptions but MOST people choose US allo over DO/IMG when given the choice.

Most of the new allos will come from the group that was previously borderline for acceptance. It is safe to say most of these students will be not be competing for the most competitive residencies just like most current allopaths are not.

And dude get over yourself, you complain about our snobby attitude (when I really didn't see one) and then go ahead to claim your teaching is superior and your knowledge base is great.

Gese, read the first few posts to look in the mirror. Unlike the rest of those here that illogically lumped their irrational stigma towards DOs to the entire profession, I compared myself to a few students, not everyone. I am stating facts by the way, not boosting my ego. I won't shrink so that you or anyone else here won't feel insecure by my comments. Basically, there is no difference to intelligence between the two professions. However, I do realize my tone is a bit over the top. Calming down...

 

[Aislinn]

GPAs?

I can tell you the three that my husband interviewed at were all 3.6.

Also, I think the above posters had a point. MOST(there is a slim majority that don't, I get it) people go to DO schools because they could not get an MD acceptance.

I never said otherwise. But this mantra of DO students' scored so much lower than MD students just isn't the cardinal rule anymore. There are a lot of reasons applicants don't get MD acceptance. My classmate and close friend just went the interview cycle last year with a 3.67 and a 31. She got four MD interviews, ended up with two waitlists and two rejections. She didn't get in. She applied using the exact same application this year and already has one MD acceptance with two more interviews to go. But had she applied DO last year and gotten in, she may have gone DO, even though her stats were obviously good enough for MD.

Since there is (it's a fact....) a correlation between MCAT scores (albeit a low correlation) those people who do get those new MD spots will probably not want/do well enough in the first two years/score high enough on step to go into one of the hypercompetetive specialties, like plastics or derm. Thus is probably won't make hyper competitive programs that much more competitive.

You may want to look up a thread on the Step 1 forum about this "correlation" between the MCAT and Step 1, more specifically, the thread about posters who bombed the MCAT and murdered Step 1.

But there is no denying most people go to DO schools because they couldn't get an MD spot...

Again, no one denied that. The only thing I'm arguing is that most DO students aren't dumber or less able to learn than MD students, as has been implied and suggested in this thread.

 

[2012mdc]

Gese, read the first few posts to look in the mirror. Unlike the rest of those here that illogically lumped their irrational stigma towards DOs to the entire profession, I compared myself to a few students, not everyone. I am stating facts by the way, not boosting my ego. I won't shrink so that you or anyone else here won't feel insecure by my comments. Basically, there is no difference to intelligence between the two professions. However, I do realize my tone is a bit over the top. Calming down...

"I turned down 3 offers to go to an MD school so I could get superior teaching at a DO school. Guess what? Already showed up 3 MD students on my rotations, JUST DOING manipulation, not counting the great knowledge base I have. My preceptors favored me over the superior MDs. Grow up. I'm not an exception."

You want to tell me which of those bolded statements are facts?

Saying on average MD's have better numbers than DO's =/= saying all MD's are better than all DO's.

Average is the key word. On average Harvard students have better numbers than Southern State U (I go to this tier of med school so I can relate to having a chip on your shoulder, I just got over it quickly). Does it mean that all Harvard students are smarter? No of course not.

 

[BabyKangaroo]

Turned down three MD school offers? No sir, I don't believe you.

Fair enough. I don't believe half the people on SDN are even who they claim to be anyways. However, it is true. Only one of those three was an offer. I just withdrew my app from the other two. Some think I am crazy. I did it after I had shadowed multiple Docs, osteo and allo, all phenominal. I couldn't not go to a D.O. school afterwards. I felt I would be doing a disservice to my patients by not providing them with that option in my care (I knew and know I want to go into PMandR, OB/GYN, or Fam med).

 

[CodeBlu]

"In 2008, 4,214 programs participated in the match and a total of 25,066 positions were offered: total applicants were 35,956, 15,692 of whom were from accredited US schools and 20,264 who were independent. How’s that for fierce competition for a match? Of the almost 36,000 applicants, 28,737 submitted rank lists, of whom 20,940 matched."

Source: http://studentdoctor.net/2009/03/the-scramble-how-it-works-and-how-it-can-be-improved/

15,692 US Allopathic Students in the NRMP ERAS match...

for 25,066 spots... in ACGME residencies.

I really think that increasing the number of medical spots in Allopathic US schools isn't going to impact the US students. The offshore students and DO students are going to have a tougher time matching. This is what I've garnered from my limited time on the circuit.

I know a few DO students at MSUCOM who are 10x more intelligent and motivated than their MD counterparts, but they say the same thing... "Just cuz I have DO after my name, I'll get weird looks like I'm some witch doctor"

It's the sad reality of the state of healthcare in the US.

 

[Aislinn]

Aislinn, it's nice that you can pull out data, but the observation remains that very few people that could get into a US MD school choose to forgo that opportunity and attend a DO or Caribbean school.

When did I say otherwise?

It's not snobby to say that on average MD matriculants have better numbers than DO. It's just a fact.

Except, that's not all that was said. If that was all that was said, I never would have commented on the snobby attitude. But what was said was: "Seriously though, US MD students have it nice. Oh wait, US MD students had higher GPAs/MCATs to start with, it might be logical to assume that maybe we will generally have the ability to learn more in med school than other applicants."

In general those students with better numbers end up doing better in med school. The correlation is weak but it's there.

Assuming that the MCAT is anything like the Step exams. Consider this, every single DO school in the nation has superstars who earn a 4.0 GPA. Are you going to say the 4.0 at DO schools isn't equivalent to a 4.0 at an MD school? My MCAT score wasn't the greatest, but I'm in the top 25 of my class, ranked higher than many who scored in the mid-30s. But according to this theory that may have been true at one time, I should be in the bottom 25 since I didn't score nearly as high as many of my classmates.

Doing better =/= being a better doctor but it does make you more attractive to residency programs in general.

The only thing that makes you more attractive is (a) clinical grades, which has nothing to do with how you scored on the MCAT or what grade you got in Physics II, and
(b) how you scored on Step 1, which has little correlation to the MCAT.

I like how you used 3 examples to support your argument but completely ignored the most important/relevant one. MD's as a whole vs DO's a whole.

Because that comparison doesn't work and I'll tell you why. There are 26 DO schools, so obviously when two DO schools have low averages, it brings the average down. There are, what, 180 MD schools? So who cares what Meharry's stats are? Who cares what UMKC's stats are? It doesn't matter because it takes a lot more schools to bring the average down. The point is, there are many DO schools, the established ones usually, that have equal stats to their MD counterparts in that region/city/state.

It's not a leap to say most of the students going the DO route now would be hard pressed to match the most competitive residencies as allos.

Nope, I agree. Same goes for most MD students. That wasn't the point. The point was that with more applicants as a whole, unless there's some rule that states a PD must take allo students before filling spots with osteo students, expect BOTH to feel the crunch. If I'm a PD, I don't give a damn if a person is an MD or a DO if they can impress me. I have 5 slots to fill and I found two DO applicants who I believe would be perfect. I'll fill those slots with the two DO applicants and say tough luck to the two MD applicants that would have gotten it had DOs not been allowed to apply or had I been not allowed to pick DOs over MDs.

My point is simply, it's arrogant to assume MD students will be just fine despite the influx of applicants and it'll only be DOs feeling the pinch. ALL of us are going to be affected.

 

[El Dooderino]

Nope, I agree. Same goes for most MD students. That wasn't the point. The point was that with more applicants as a whole, unless there's some rule that states a PD must take allo students before filling spots with osteo students, expect BOTH to feel the crunch. If I'm a PD, I don't give a damn if a person is an MD or a DO if they can impress me. I have 5 slots to fill and I found two DO applicants who I believe would be perfect. I'll fill those slots with the two DO applicants and say tough luck to the two MD applicants that would have gotten it had DOs not been allowed to apply or had I been not allowed to pick DOs over MDs.

My point is simply, it's arrogant to assume MD students will be just fine despite the influx of applicants and it'll only be DOs feeling the pinch. ALL of us are going to be affected.

The whole point of this is youre not a PD, and frankly i'm alarmed about how naive you are about the process, especially being a DO student. Whether fair or not, programs prefer MD's over DO's, in fact some won't even take a DO. Despite what some people think, this isn't just the super-elite programs either. This will only be worse in the future, ACGME PD's will not leave MD students out in the cold, especially since DO students have their own match which MD students cannot participate in. There will be enormous pressure, even more than now, to make MD's over DO's. To bury your head in the sand doesn't help

 

[DrBowtie]

My point is simply, it's arrogant to assume MD students will be just fine despite the influx of applicants and it'll only be DOs feeling the pinch. ALL of us are going to be affected.

Its not arrogant at all. Why? Because this isn't about individual students or even individual schools. Its as you just mentioned the 180 MD schools collectively under the LCME and AAMC vs. the 26 DO schools under COCA and the AOA.

 

[CodeBlu]

The whole point of this is youre not a PD, and frankly i'm alarmed about how naive you are about the process, especially being a DO student. Whether fair or not, programs prefer MD's over DO's, in fact some won't even take a DO. Despite what some people think, this isn't just the super-elite programs either. This will only be worse in the future, ACGME PD's will not leave MD students out in the cold, especially since DO students have their own match which MD students cannot participate in. There will be enormous pressure, even more than now, to make MD's over DO's. To bury your head in the sand doesn't help

This is what I don't understand... the DO students can participate in our match... but we can't participate in theirs?

I agree with the sentiment that PDs will not leave MD students out in the cold. I've heard it many times... from many MDs and DOs that work in the ED I scribe at. A few of the DOs even said... you should definitely go for the MD since it'll be easier to get the residency you want.

 

[BabyKangaroo]

"I turned down 3 offers to go to an MD school so I could get superior teaching at a DO school. Guess what? Already showed up 3 MD students on my rotations, JUST DOING manipulation, not counting the great knowledge base I have. My preceptors favored me over the superior MDs. Grow up. I'm not an exception."

You want to tell me which of those bolded statements are facts?

Saying on average MD's have better numbers than DO's =/= saying all MD's are better than all DO's.

Average is the key word. On average Harvard students have better numbers than Southern State U (I go to this tier of med school so I can relate to having a chip on your shoulder, I just got over it quickly). Does it mean that all Harvard students are smarter? No of course not.

Sigh. Again, compariing one DO school, to my choices of MD schools, not the whole MD profession. And all statements are factual b/c they are events that took place, for a fact. You know, I am no proponent for separating DOs and MDs. It's people like you and others here that continually try and do so with your superiority complexes. I disagree with AOA's stance in the past of the "DO movement" b/c they treated it like a social revolution. I hate that, but Osteopathic Medicine is so beneficial to patients, so I go to a DO school. Not to be different, superior, etc., but to be able to provide patients with a little more (not better, just more, please don't read too much into this) is all. I weighed the consequences of going to a DO school, like the ones you are all talking about here on this thread. I knew it may be an uphill climb. What I didn't expect was the inherent bias and pompus attitude displayed so eloquently. Fortunately, plenty of ACGME residencies do not see DOs the way you do. We all practice medicine, and you are acting like there is this special reserved parking spot for you b/c you have different letters after your name. Also, it would behoove you to read the reply that your fellow sane colleague provided you with.

 

[cetac]

I hate that, but Osteopathic Medicine is so beneficial to patients, so I go to a DO school. Not to be different, superior, etc., but to be able to provide patients with a little more (not better, just more, please don't read too much into this) is all.

Explain.

Word on the street is most DO graduates wouldn't touch manipulation with a 10 foot pole, this admittedly from an N of 1 (Acquaintance who attended NYCOM). In our discussions we've come to the conclusion that, just as MD students have a superiority complex with respect to DO students, so do DO students have an inferiority complex to MD students that they express via the catchy "We care for patients more/differently/better." Both show insecurities, and both are only espoused by a minority of either student population. In the end, we're all going to be colleagues practicing the same medicine. We're going to have to trust one another, not act like insecure teenagers.

 

[Barcu]

Come on guys, let's not turn this into a MD/DO thing.

Dr. Bowtie and Law2Doc are right. This is an organizational issue, and it will force out DOs in favor of MD grads.

You see it now with IMGs. Many of them with higher scores are passed over for American grads (both MD and DO). DO students have had great success in the match because they are American grads, and there are so many extra spots. As the spots become more scarce, however, DO grads will be forced out, even if they have better scores. It will just happen due to pressure from the LCME, who will favor their own graduates for a variety of reasons (they can verify the training, bias, etc).

You can argue until your face turns blue, but that's not going to change anything.

 

[BabyKangaroo]

Explain.

Word on the street is most DO graduates wouldn't touch manipulation with a 10 foot pole, this admittedly from an N of 1 (Acquaintance who attended NYCOM). In our discussions we've come to the conclusion that, just as MD students have a superiority complex with respect to DO students, so do DO students have an inferiority complex to MD students that they express via the catchy "We care for patients more/differently/better." Both show insecurities, and both are only espoused by a minority of either student population. In the end, we're all going to be colleagues practicing the same medicine. We're going to have to trust one another, not act like insecure teenagers.

Word on the street is unfortunately correct. However, to explain osteopathic medicine and its benefits would be trying to take 220 hours of training in the subject and condense them here. Basically, it is an adjunct tool to use for the manipulation of joints, tissues, bones, muscle, tendons, ligaments etc. (i.e. musculoskeletal system) to aid in the process of treating the patient. Personally, I will use it albeit on a limited basis, but even using it on those select patients will have benefits. The last two sentences in your statement is also what I said in my previous post.

 

[kazuma]

I'm a DO intern and I will be doing an ACMGE gas residency next year. IMO there is no doubt that the increased allo enrollment will put the squeeze on DO/FMG students as a whole. Take three applicants US Allo/DO/FMG, all else being equal including personalities, scores, etc, the US allo student is going to get the residency position.

However, the bottom line is that many if not most PD's make their rank lists based on USMLE scores mainly because it's the best predictor they have of future performance on specialty boards. No anesthesiology PD wants a resident that can't pass the written or oral boards. They want to produce ABA board certified anesthesiologists. So there will still be spots available for DO/FMG students who outperform their US allo colleagues. The notion that a PD's will start taking US Allo students with significantly lower USMLE scores than DO students is absurd. Just like we are seeing now, the FMG/IMG's will feel the squeeze first, followed by the DO's. It will be interesting but sad to see it play out. Graduates with astronomical debt being forced into a specialty they have no interest in or worse, not matching into any specialty.

I chose to go to a DO school based on cost as the only US MD school I had an offer from was significantly more expensive (I was wait-listed at my cheap in-state school). In hindsight I don't regret it because it didn't make a difference in my residency plans. But if I was faced with that same decision today, I most likely would have chosen the more expensive US MD school.

 

[phltz]

Wow, the merest hint of a comparison between MD and DO schools sure can derail a thread.

I didn't realize that the residency freeze was on expansion of existing programs, not the creation of new programs. From the perspective of effectively training doctors, this seems ass backwards. We could either create new spots in established programs with organization, experience, and a proven track record, or we could create new spots in totally new programs without any of that. Whose idea was it to go with the second of these options?

One of the scariest things about the way medical school fits together with residency is that students start medical school with no idea of how their residency match is going to go. They have to put in four years, and likely accumulate on the order of a hundred thousand dollars in debt, before they find out what sort of program they get into (or, as the OP suggests may be the case in the near future, if they get in anywhere at all). There may not be any way to do away with this gap, but it seems to me that it puts a lot of students into a tough bind, and it'll just get worse if the trends go the way the OP thinks they will.

 

[Aislinn]

The whole point of this is youre not a PD, and frankly i'm alarmed about how naive you are about the process, especially being a DO student.

I'm alarmed at how bad you are at reading comprehension, especially since I mentioned twice in this thread that I'm an MD student.

Whether fair or not, programs prefer MD's over DO's,

And what I have a problem with is generalizations like the above. If that was true, then every single residency in the U.S. would be filled with MDs only and every MD would have a spot at the end of Match Day. It's not the way it works. True, some PDs prefer MDs and some programs within specific hospitals won't take DOs, but let's not pretend like it's the overwhelming majority. It most certainly is not.

 

[Barcu]

I'm a DO intern and I will be doing an ACMGE gas residency next year. IMO there is no doubt that the increased allo enrollment will put the squeeze on DO/FMG students as a whole. Take three applicants US Allo/DO/FMG, all else being equal including personalities, scores, etc, the US allo student is going to get the residency position.

However, the bottom line is that many if not most PD's make their rank lists based on USMLE scores mainly because it's the best predictor they have of future performance on specialty boards. No anesthesiology PD wants a resident that can't pass the written or oral boards. They want to produce ABA board certified anesthesiologists. So there will still be spots available for DO/FMG students who outperform their US allo colleagues. The notion that a PD's will start taking US Allo students with significantly lower USMLE scores than DO students is absurd.

I chose to go to a DO school based on cost as the only US MD school I had an offer from was significantly more expensive (I was wait-listed at my cheap in-state school). In hindsight I don't regret it because it didn't make a difference in my residency plans. But if I was faced with that same decision today, I most likely would have chosen the more expensive US MD school.

Really? How do you explain high-scoring IMG students now?

I'm not trying to be argumentative. And I agree that a DO student in the future with significantly better scores will probably get the spot over the MD student. But that doesn't mean that DOs shouldn't be worried.

I don't know how STEP correlates with board passage, so I'll use the MCAT example. Studies have shown that MCAT scores correlate with STEP 1 scores, but after an MCAT score of 30, the correlation disappears. So, someone with a 30 on the MCAT can do just as well as someone with a 35 or a 40. Using this logic, a residency program can easily select an MD graduate with lower scores who will still have few problems passing the boards. In the future when residency spots become scarce, PDs may be pressured into taking that MD grad, even though they have lower scores.