Things You Might Not Know About Residency

[HolySmokes]

Actually, they were all from the Big 4 (if by big 4, you're referring to SGU/Ross/AUC/Saba). I don't think we've interviewed a Carib grad from outside of those 4 in the time I've been there.

Sure, some of them were awkward and bad interviewers. But, for the most part, they were fine, and had no real red flags. We just had so many really good kids from US allopathic schools that we had a hard time picking among the AMGs that we interviewed. We may have ranked one Carib grad (I don't remember off the top of my head), but he/she wasn't high on our list at all.

For the AMGs...I felt like it helped that they WERE AMGs. Not just because of a bias against Carib grads, but you'll always have more to talk about with people who have a similar background. One of the interviewees rotated with us when he did his core med student rotation, so that was an automatic in. Another did his sub-I with us, and went to the same med school that one of our interns had gone to, so that was another automatic bond. Another went to the same med school that one of our faculty went to...again, they had more to talk about and discuss. That definitely helps.

How do you think the elimination of pre-matching will affect Carib grads? If they're already having a hard time finding residencies with a 240+ step score, I can't imagine what it will be like when you suddenly throw all the grads who would have normally pre-matched at a program into the regular match upping the competition among Carib students.

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[gravitywave]

Actually, they were all from the Big 4 (if by big 4, you're referring to SGU/Ross/AUC/Saba). I don't think we've interviewed a Carib grad from outside of those 4 in the time I've been there.

Sure, some of them were awkward and bad interviewers. But, for the most part, they were fine, and had no real red flags. We just had so many really good kids from US allopathic schools that we had a hard time picking among the AMGs that we interviewed. We may have ranked one Carib grad (I don't remember off the top of my head), but he/she wasn't high on our list at all.

For the AMGs...I felt like it helped that they WERE AMGs. Not just because of a bias against Carib grads, but you'll always have more to talk about with people who have a similar background. One of the interviewees rotated with us when he did his core med student rotation, so that was an automatic in. Another did his sub-I with us, and went to the same med school that one of our interns had gone to, so that was another automatic bond. Another went to the same med school that one of our faculty went to...again, they had more to talk about and discuss. That definitely helps.

cool, thanks for writing that up. i definitely understand about taking the US grad who is competent over the 260 Carib superstar whose clinical rotations might have been suspect.

again: it's worth considering that as things stand, LCME has far and away more rigorous standards for clinical education than COCA, not to mention the variation in and within the Carib schools. it's not so difficult to foresee a future in which the US MD advantage increases over everyone else, especially if we start to see a drop in the number of US MD seniors who match.

edit: i can't speak to whether those standards actually mean much in terms of the delivery of patient care down the road. I can see it being used as a discriminator for creating match lists, much as Step scores are used now.

 

[DocEspana]

oh no, don't get me wrong, i believe that the ACGME don't think it will come to that. i don't think it will come to that either. the guy who was quoted in the NEJM article we both cited was talking about "american grads" vs "non-american grads" and i'm sure that's how he sees it. as things stand, it's entirely to everyone's benefit to present a united front. but if you're on the Titanic and there aren't seats on the boats, things could get ugly. do you think everyone on these councils is entirely comfortable with how quickly DO enrollment has been expanding the last few years, given the current political climate towards increasing Medicare funding for residency? they would prefer not to ever have to confront this issue directly, i'm sure.....

Well there I agree. I just know theyll do some crazy stuff to stay united before going off on the 'us or them' mentality. I can't look the stat up right now, but I'm pretty sure the majoroty of the 15 new schools in the next few years are allo. Everyone is expanding rapidly now. Something has to give and I'd like it to be a policy or funding change we choose, not a reality thrust upon us.

Personally I think there is something of a cultural xenophobia driving it too, but that's just my opinion.

 

[DocEspana]

cool, thanks for writing that up. i definitely understand about taking the US grad who is competent over the 260 Carib superstar whose clinical rotations might have been suspect.

again: it's worth considering that as things stand, LCME has far and away more rigorous standards for clinical education than COCA, not to mention the variation in and within the Carib schools. it's not so difficult to foresee a future in which the US MD advantage increases over everyone else, especially if we start to see a drop in the number of US MD seniors who match.

edit: i can't speak to whether those standards actually mean much in terms of the delivery of patient care down the road. I can see it being used as a discriminator for creating match lists, much as Step scores are used now.

Except for the lack of a for profit ban, the standards are identical. Not that the truth changes the fact that everyone repeats the mantra that lcme accreditation standards are xfferent. Ive had to quote them enough times to know coca more or less plaigarises lcme.

 

[carml]

Aren't there any mods on these boards?

I've been an active participant on a few other popular BBs for over a decade and this is the first one I've seen with such blatant lack of moderation of off-topic activity and member infighting.

 

[dr zaius]

Aren't there any mods on these boards?

I've been an active participant on a few other popular BBs for over a decade and this is the first one I've seen with such blatant lack of moderation of off-topic activity and member infighting.

Your logic and administrative skills are not welcome here.

 

[DrBowtie]

Except for the lack of a for profit ban, the standards are identical. Not that the truth changes the fact that everyone repeats the mantra that lcme accreditation standards are xfferent. Ive had to quote them enough times to know coca more or less plaigarises lcme.

I believe there is also a difference in endowment amounts required too.

 

[El Dooderino]

I believe there is also a difference in endowment amounts required too.

This is the biggest difference to me. Why DO schools can have subpar clinical experience:


Academic environment

* The LCME document contains six standards under the title Academic Environment. These standards include requirements that (1) medical students should learn in clinical environments where graduate and continuing medical education programs are present, (2) the medical education program must be conducted in an environment that fosters intellectual challenge and a spirit of inquiry, and (3) the medical school should make available opportunities for medical students to participate in service-learning activities.
* The COCA standards make no mention of the academic environment or of such specific issues as intellectual challenge, spirit of inquiry, or student participation in service-learning activities.

No GME, CME, or research required

 

[MedStudentWanna]

you're a weird guy,

I'm not the one calling total strangers liars. You are. I'd say that makes you pretty weird.

where have I spewed venom in this thread and where have my MD peers said i'm a piece of crap.

I'm saying you're a piece of crap. This thread is soiled with your assholish venom, but I wouldn't expect you to have an ounce of self-awareness about that.

 

[HardToStarboard]

I'm not the one calling total strangers liars. You are. I'd say that makes you pretty weird.



I'm saying you're a piece of crap. This thread is soiled with your assholish venom, but I wouldn't expect you to have an ounce of self-awareness about that.

So, last time....are you an MD student? (Not sure why you or Aislinn won't answer this.)

 

[MedStudentWanna]

So, last time....are you an MD student? (Not sure why you or Aislinn won't answer this.)

BOTH of us have answered it and both of us have said that we are in fact MD students. Just because you're apparently blind doesn't mean we haven't answered it.

 

[HardToStarboard]

BOTH of us have answered it and both of us have said that we are in fact MD students. Just because you're apparently blind doesn't mean we haven't answered it.

My apologies; I guess I missed exactly where you said it.

EDIT: The fact that you were so unkind in your last sentence of response and the fact that others here are accusing you of being a DO is interesting.

 

[smq123]

This is the biggest difference to me. Why DO schools can have subpar clinical experience:

Like so many things in life, the difference between DOs and MDs seems to matter more in the abstract (and on SDN) than it does in real life.

I am in a dually accredited program; I'm on the MD side. The DOs in my program are all hard working, clinically skilled people who came out of med school extremely well prepared to take care of patients. I would not hesitate to have any of them take care of my own parents - that's how much I respect them as clinicians.

The DOs that I work with all came out of med school having written numerous progress notes, placed many foleys, and started quite a few IVs. Compare that to students from a local top 10 allopathic med school, where student notes get discarded and are never placed in the chart, they're literally told not to touch central lines, and many will never have experience drawing blood.

In our residency program, the difference between the MDs and the DOs is largely administrative. We see the same number of patients, do the same types of procedures, take the same amount of call, and complain about the same things (i.e. how crazy our patients are, how many of them we have to see, and how much call we have to take. ). I often forget which attending is a DO and which is an MD. I have had DO colleagues do OMT on my back (I have chronic upper back pain), and I have recommended OMT techniques to patients, because I think it's a fairly benign treatment that offers some benefits.

I find all this "MD vs. DO" nonsense in this thread kind of amusing/irritating, because it really doesn't matter all that much in the real world.

As an aside, any personal insults will not be tolerated. If it continues, the thread will be shut down and infractions will be given out.

 

[Spatula]

I personally will be avoiding any residences run by SDN Pre-Meds so I'm not too worried.

 

[valkener]

This thread shows that MD and DO degrees don't protect from stupidly.

MDs on average have a higher mcat/gpa, etc. but that means absolutely nothing when there are DO schools and DO students that are smarter and more successful (boards, real life work) than MD students. To think that two letters make that much of a difference to a director/HR manager when it comes to residency or hiring is wishful thinking of MDs.

Here is why:
Real medical education begins after admission to medical school. Some students bloom late, or wake up from their college hibernation.. Performance is fluid, which is why people get fired or go up in ranks as well as down. Some of you should be spending time networking and studying rather than spreading angst. This could increase your chance of getting your dream residency rather than complaining about the currently lower degrees.

Mcat/gpa don't matter even though they can serve as a predictor, they are only a small variable in what makes a good physician. If programs were interested in MCAT scores, they would ask - but they almost never do.

Programs simply want the best applicants. That's why DOs can get into Mayo etc. and will continue to do so. It depends on their qualification. There might be some residency programs that are biased against DOs, but this is lessening as I am typing, as more DOs graduate and prove to be just as good physicians as other MDs (or bad). There just isn't a strong trend that would discourage programs from DOs.

IF residency slots become more scarce and if we really end up having more DO/MD graduates than total residencies, this only means that screening/interviewing is going to be more complex filtering out the best and most fit applicants from both degrees. I predict that board scores will matter more and more in the future.

 

[TheLesPaul]

To think that two letters make that much of a difference to a director/HR manager when it comes to residency or hiring is wishful thinking of MDs.

To think that it doesn't, is naive. I don't mean to condescend but you're a premed, you just don't understand. While what you say is ideal and I love my DO colleagues and think they make excellent physicians/surgeons/etc., there is a bias among PDs for MD applicants, especially in more competitive (i.e. ROADS) specialties. That's just how it is. To dislike it is natural. To attempt to change it is noble. To deny it is foolish.

 

[Bacchus]

To think that it doesn't, is naive. I don't mean to condescend but you're a premed, you just don't understand. While what you say is ideal and I love my DO colleagues and think they make excellent physicians/surgeons/etc., there is a bias among PDs for MD applicants, especially in more competitive (i.e. ROADS) specialties. That's just how it is. To dislike it is natural. To attempt to change it is noble. To deny it is foolish.

This is the truth.

 

[drctother]

To think that it doesn't, is naive. I don't mean to condescend but you're a premed, you just don't understand. While what you say is ideal and I love my DO colleagues and think they make excellent physicians/surgeons/etc., there is a bias among PDs for MD applicants, especially in more competitive (i.e. ROADS) specialties. That's just how it is. To dislike it is natural. To attempt to change it is noble. To deny it is foolish.

Im a DO student. He speaks the truth. For the most competitive specialties (Rad Onc, Ophthalmology, Neurosurgery) having M.D. is just one less hurdle. I have never heard of a DO matching ACGME for any of those...although I havent really looked. I have seen DOs in gen surg, diagnostic radiology though.

For everything else (all other specialties), there is no difference except DOs can give you the best massage of your life

 

[valkener]

I am a first-year medical student.. Plenty of DOs have matched into ROADS (including plastics or dermatology at mayo clinic), including last year, but it is obvious that it is much easier for MDs.

However, some DO schools are already producing equal results (board scores), and the statistics show that DOs do beat MDs for good amount of residency spots. MDs have an advantage but programs do look at all applicants and I can't see them favoring a weaker MD over a stronger DO from a board-score and interview-score perspective. It may depend on the program, and yes this is my limited opinion from looking at the statistics.

DOs are also increasing in numbers more drastically which is resulting in more lobbying and representation, I am not trying to say DO will eventually surpass MD. That will probably never happen, MD is the stronger degree currently but programs are not interested in degrees but people. People that will do their work, care for their patients, do their research and represent their clinic in the most competent way. The degree is only a small variable in that equation.

I do agree with the bias, and currently there is still some bias against DOs but it has become less and less (which can be seen in the match statistics, more DOs securing better residencies, including ROADS).

Just because someone had a better MCAT score 4 years prior to residency doesn't equal a better board score.

In the end it doesn't matter. We should all work together as physicians hoping and working towards the ideal that the most qualified people get the best spots, or does anyone disagree? Someone else in here said to pick a residency that matches one's caliber. I couldn't agree more.

 

[theprodizzle]

I'm gonna go out on a limb and be ignorant by not looking up the facts. I'm just confused and would like a better understanding. Let's say that DO students are doing just as well as MD students. Why would DO students want to apply to ACGME residencies? I understand that ACGME residencies can pay more or may be perceived to be more prestigious or whatever. However, I mean, if DOs want to talk the talk about Osteopathic medicine, then walk the walk and own up to their system...If DOs want to make the difference between them and MDs, then they should stick by their guns.

ACGME has allowed DOs to apply and DOs surely have taken up the opportunity to participate in more ACGME programs than those approve from COCA (http://www.jaoa.org/content/104/5/212.long. Outdated from 2004, I know). So, seriously, I don't understand why DOs are tooting their horns about applying to ACGME residencies and proving themselves when they're kind of deserting their own system...I understand DOs can still practice OMM in ACGME residencies, but, really, can DOs just do that at COCA residencies and leave ACGME alone?

Finally, I surely do not want animosity among professional physicians, but this whole MD vs. DO thing has gotten stupid since everyone will become physicians. It's just that one group has OMM training. Sure, MDs may have better stats and whatnot, but we should all treat patients, not our individual ego.

 

[Bacchus]

We all deserve the best training possible. It isn't our fault that the AOA gives us more ****ty-than-not sites to be residents at.

 

[Just Joshin]

There are a lot of reasons DOs choose not to do AOA residencies.

First, there aren't that many. If you want family med, you may get one, but there are only 4 PM&R residencies in the whole country, for example, only 12 anesthesiology residencies, only 14 psych residencies, etc etc.

Second, the majority of DO residencies are in the midwest. If you're a DO who wants to live on the West Coast or East Coast, you're going to enter the MD match, unless you want FM or IM.

Third, future job opportunities sometimes hinge on AOA versus ACGME residencies, depending on the region of the country you're in and the anti-DO bias that exists there.

 

[officedepot]

Someone else in here said to pick a residency that matches one's caliber. I couldn't agree more.

the point is DOs are not of the same caliber based on stats alone. Like it or not lots of DO students are DO students because they couldn't get into MD schools. Not all but lots. That intrinsicly makes them lower caliber.

I am not sure how DO rotations are compared to MD so it's hard for me to say what their abilities are coming out of med school. I will say I notice a very significant difference in the type of students from different caliber US MD schools. I work often with students from other schools and they just are not that good compared to pretty much everyone in my class (top 20 med school). Sure students at other schools get good scores but on average they are of lower caliber in my opinion in med school for a variety of reasons including patient interaction, presentations, critical thinking, procedural skills, sometimes knowledge base, ability to pick up new concepts, etc. This speaks not only to that school's ability to train students but also to the student's intrinsic ability. That student did not get into a higher ranked MD school for one reason or another (likely grades, mcat score, undergrad institution, etc) and that definitely makes them lower caliber.

None of this is to say that by the end of residency DOs and lower tier US MD students won't be good physicians. But it is a harder road for them in general.

I would be very interested if there is any research that is able to compare US MD docs vs DO docs or even a stratification of US MD docs from where they went to med school using some sort of final outcome to measure how good they are. Not sure if that exists but would definitely be interesting to see. No one is going to change their mind on this unless there is some sort of research done on the topic.

 

[adaptation1]

... sometimes i think you are just trying to earn a reputation here on sdn. am i right?

the point is DOs are not of the same caliber based on stats alone. Like it or not lots of DO students are DO students because they couldn't get into MD schools. Not all but lots. That intrinsicly makes them lower caliber.

I am not sure how DO rotations are compared to MD so it's hard for me to say what their abilities are coming out of med school. I will say I notice a very significant difference in the type of students from different caliber US MD schools. I work often with students from other schools and they just are not that good compared to pretty much everyone in my class (top 20 med school). Sure students at other schools get good scores but on average they are of lower caliber in my opinion in med school for a variety of reasons including patient interaction, presentations, critical thinking, procedural skills, sometimes knowledge base, etc. This speaks not only to that school's ability to train students but also to the student's intrinsic ability. That student did not get into a higher ranked MD school for one reason or another (likely grades, mcat score, undergrad institution, etc) and that definitely makes them lower caliber.

None of this is to say that by the end of residency DOs and lower tier US MD students won't be good physicians. But it is a harder road for them in general.

I would be very interested if there is any research that is able to compare US MD docs vs DO docs or even a stratification of US MD docs from where they went to med school using some sort of final outcome to measure how good they are. Not sure if that exists but would definitely be interesting to see. No one is going to change their mind on this unless there is some sort of research done on the topic.

 

[officedepot]

... sometimes i think you are just trying to earn a reputation here on sdn. am i right?

lol what do you mean? but nah. I'm not trying to be mean. It's just my opinion and I think it is almost an unwritten code at top schools (not necessarily mine but from conversations with students it is what I've gathered) that lots of people think like that. I did say that I'm sure most people are competent physicians in the end after residency and by that point I think it matters less where you went to school but more where you trained and how much work you put in to learning.

I should have said before that post "what I am about to write may push some buttons but don't take it personally".

 

[MrBeauregard]

None of this is to say that by the end of residency DOs and lower tier US MD students won't be good physicians. But it is a harder road for them in general.

You make me laugh.

I should have said before that post "what I am about to write may push some buttons but don't take it personally".

Or more appropriately, "What I'm about to say here has no basis in reality and is instead the pure extension of my own unfounded beliefs."

 

[MRSAful Fate]

Just curious, is anyone's school/student body making a big deal about this? It seems like this issue is pretty under the radar at my progam. Are any schools organizing mass email drives to legislators, etc? It seems appropriate considering the possible results in a few years.

 

[officedepot]

Or more appropriately, "What I'm about to say here has no basis in reality and is instead the pure extension of my own unfounded beliefs."

maybe more along the lines that it is just my opinion but I have talked to others at my school and I feel that is the general consensus whether it is actually spoken or not.

It is not opinion that DOs and lower tier US MD schools have lower stats than higher tier schools, which I subsequently generally equate with lower caliber for those students overall. Not everyone will agree but it makes sense.


Here's an exercise: compare interns from higher tier schools with lower tier ones or DOs or IMG. Which are better? I'd definitely say the ones from higher tier schools for sure. The difference however does becomes less distinct as they progress through residency but usually, not always, the best older residents went to great MD schools.

 

[MrBeauregard]

It is not opinion that DOs and lower tier US MD schools have lower stats than higher tier schools, which I subsequently generally equate with lower caliber for those students overall. Not everyone will agree but it makes sense.

I just read in another thread (http://forums.studentdoctor.net/showthread.php?t=867255) that you do not think that board scores equate to the caliber of a student. Yet in the above quote you state that DO students and lower tier US MD students have lower stats, which you do equate to lower caliber students. I don't see how you can say that GPA and MCAT equate to a lower caliber student and yet say that a high board score, which is much more indicative of medical knowledge base, does not correlate to a higher caliber student. It simply doesn't make sense to me.

 

[officedepot]

I just read in another thread (http://forums.studentdoctor.net/showthread.php?t=867255) that you do not think that board scores equate to the caliber of a student. Yet in the above quote you state that DO students and lower tier US MD students have lower stats, which you do equate to lower caliber students. I don't see how you can say that GPA and MCAT equate to a lower caliber student and yet say that a high board score, which is much more indicative of medical knowledge base, does not correlate to a higher caliber student. It simply doesn't make sense to me.

hmm yes I did say that didn't I... to explain my thought process briefly I would say that there is far more to becoming a doctor than a score on 1 test. Step 1 tests one's ability to memorize tons of facts. Schools prepare students for the test differently. Tons of IMG get super high score but when you interact with them in a patient environment it becomes clear they are just not in the same league as you are. I think we can agree that being a doctor encompasses more than one's abilities to memorize facts for a test.

Now, the MCAT is less about memorizing facts and more about application of knowledge and how one does with seemingly new material and their ability to critically think. Undergrad gpa, depending on the institution, will show how well a student does with a large variety of material not really seen in medical school. I think this stuff speaks more to the caliber of a student than said student's ability to spend 2 months memorizing first aid and doing 5000 practice questions.

Medicine does encompass one's knowledge base yet as we can agree there is more to being a doctor. These things include critical thinking ability, patient interaction, team interaction, presentation skills to simplify information, ability to pick up on new concepts and procedural skills, application of knowledge, etc. These things are not tested on step 1 and speak more to the intrinsic nature of the student which I feel is best shown by undergrad gpa (institution dependent), mcat score for the most part, interviewing skills, etc. The process isn't perfect but right now there really isn't a better way to do it.

In that post I also said the caliber of a school is based on the number of high caliber students present at that school (which correlate in my opinion with the things mentioned in the preceding paragraph). High caliber students do not necessarily all get 240 or 250 or whatever for a variety of reasons including time given to study, if the school teaches to the test, etc. I think residency programs look at students differently and will rank students differently based on where they went to school and their previous experience with students from that school.

 

[adaptation1]

Let me get this straight. You talk to your_own_classmates about the medical students from lower tier schools whom you presumably work with. And your classmates agree with you that those students are of a lower calibre. And their agreement somehow substantiates your belief....

maybe more along the lines that it is just my opinion but I have talked to others at my school and I feel that is the general consensus whether it is actually spoken or not.

It is not opinion that DOs and lower tier US MD schools have lower stats than higher tier schools, which I subsequently generally equate with lower caliber for those students overall. Not everyone will agree but it makes sense.


Here's an exercise: compare interns from higher tier schools with lower tier ones or DOs or IMG. Which are better? I'd definitely say the ones from higher tier schools for sure. The difference however does becomes less distinct as they progress through residency but usually, not always, the best older residents went to great MD schools.

 

[officedepot]

Let me get this straight. You talk to your_own_classmates about the medical students from lower tier schools whom you presumably work with. And your classmates agree with you that those students are of a lower calibre. And their agreement somehow substantiates your belief....

yeah pretty much. It is also sunstantiated by looking at interns from different schools as well and comparing them. In the previous post I mentioned why I think that is the general trend as it is more than just purely my opinion based on no stats. I use stats and personal interactions to formulate my opinions.

I think everyone here can agree there are good and bad doctors. What makes a bad doctor? How can one tell if a med student will become a bad doctor? This is another thread in and of itself but I wonder if it relates to the caliber of the med student and where that student went to school. Maybe I'm biased but personally I think it makes a huge difference where a doctor did his/her training (med school and residency) in how "good" a doctor turns out to be. Where a doc did training, in my opinion, is correlated with the caliber of said doc when he/she was a student. Again not always true for sure but I'd call it a trend.

Anyway I don't think there is a lot more I can really say on this subject as I have pretty much said most everything I can think of at this time.

 

[Bacchus]

So you say how scores aren't important and qualify that further. What makes an upper-school student so much better at conversing with patients and the team? What makes him or her better at performing procedures? What makes him or her a better user of medical literature because let's be honest, we all have to look things up. What makes him or her better at physical diagnosis?

It appears to me you say undergrad GPA. Let's be honest, undergrad is straight memorization. It doesn't require social skills to do well. You can be so ****ing oblivious to your surroundings or how to hold a conversation and can still do very well.

You're contradicting yourself over and over. It's not the numbers. It's how the person handles himself that matters. Oh, by the way, I base this all off of an undergraduate GPA.

Give me a break.

 

[2012mdc]

So you say how scores aren't important and qualify that further. What makes an upper-school student so much better at conversing with patients and the team? What makes him or her better at performing procedures? What makes him or her a better user of medical literature because let's be honest, we all have to look things up. What makes him or her better at physical diagnosis?

It appears to me you say undergrad GPA. Let's be honest, undergrad is straight memorization. It doesn't require social skills to do well. You can be so ****ing oblivious to your surroundings or how to hold a conversation and can still do very well.

You're contradicting yourself over and over. It's not the numbers. It's how the person handles himself that matters. Oh, by the way, I base this all off of an undergraduate GPA.

Give me a break.

 

[officedepot]

So you say how scores aren't important and qualify that further. What makes an upper-school student so much better at conversing with patients and the team? What makes him or her better at performing procedures? What makes him or her a better user of medical literature because let's be honest, we all have to look things up. What makes him or her better at physical diagnosis?

It appears to me you say undergrad GPA. Let's be honest, undergrad is straight memorization. It doesn't require social skills to do well. You can be so ****ing oblivious to your surroundings or how to hold a conversation and can still do very well.

You're contradicting yourself over and over. It's not the numbers. It's how the person handles himself that matters. Oh, by the way, I base this all off of an undergraduate GPA.

Give me a break.

IMO social stuff is taught better at certain institutions, i.e higher tier schools --> thus leading to the higher caliber students getting better training in general leading to better med students. Yeah sure some people at those schools are douche bags but as a trend I feel that's the case. How are "social skills" taught? professionalism classes, interacting with patients early on, interacting with faculty and residents that can serve as role models, etc. These things likely are done better at higher tier schools (they wouldn't be higher tier if they weren't better, right).

And it's more than just being nice to patients. It's about extracting information in an efficient manner and getting all the necessary history which is done differently by every med student. How to use the physical exam to help your differential is important as well which in my experience is taught better and learned more effeciently by those higher caliber students.

Agree that we all have to look stuff up... but you do different schools teach you to do that, if at all. Is your first choice google, uptodate, or the primary literature and how do schools teach students to approach the aspect of looking up information quickly and efficiently.

It's not that a higher caliber students can perform procedures better. It's more along the lines that said student can probably adapt more quickly. A monkey can do a LP, but how many monkey's can clearly picture the vertebra and and angle the needle in perfectly getting the csf with relative ease every single time? So that's the sense I was going for. Yeah yeah students at lower tier schools can do this as well but on average higher tier ones do it better IMO.

And again the lower caliber students can learn to do the necessary stuff, look up the necessary guidelines, and get the patient on the correct treatment plan. Lower caliber students can learn to do procedures and operations. It's just how the process of learning is done and how it is applied in the future. Some surgeons can do procedures quicker, more efficient, and with fewer complications over a period of time than others with the same general outcome (bowel successfully resected). I would argue those surgeons are of higher caliber and probably had better training. Same thought process can be applied to med students in a similar fashion.

not sure how I can better explain this. If you don't agree then fine. For better or worse this is what it thought from my experience. Again if all med students were the same then we'd all get the same grades, the same evals, and be equally competent doctors in the end. That is not the case in the real world. Some are better than others and I argue there is a higher concentration of "better"/higher caliber students at higher tier schools than lower tier ones.

who among you would say a gpa 2.8 mcat 23 carib med student is the exact same as you with whatever stats you have (I assume better) at a US MD school? What about those of you who go to harvard or JH or a similar tier school, are you guys the same as those from small town med school with 40 people or whatever your home state school is? If you think we are all the same why would you then choose a more expensive school? What is your money good for if the education is the exact same? Fact is that it is not the same.

 

[MiracleforMD]

I can't believe that someone interviewed you and thought that you should be allowed in any medical school.

 

[smq123]

Agree that we all have to look stuff up... but you do different schools teach you to do that, if at all. Is your first choice google, uptodate, or the primary literature and how do schools teach students to approach the aspect of looking up information quickly and efficiently.

If you're relying on your med school to teach you which resources are good or not, and are not able to figure this out ON YOUR OWN at this juncture, you have problems. I mean...dude. Yeah, your school is supposed to teach you things, but there's such a concept as "self-directed learning," too.

not sure how I can better explain this. If you don't agree then fine. For better or worse this is what it thought from my experience.

<sigh>

There are a few things YOU need to consider.

- Your claim is that your experience supports your belief that higher tier medical schools produce higher-quality med students. But, perhaps, did you consider that the WAY that you perceive your experience is biased by your preconceived notion that a student from a higher tier school is of higher caliber? Did you stop and think that, perhaps, you remember examples where a great med student/intern came from Harvard, but subconsciously choose to forget the mediocre intern that came from Hopkins? Or choose to forget the stellar intern that came from the local State U? My point is, how sure are you that your perceived experience isn't colored by recall bias?

- The plural of anecdote is NOT evidence.

- Based on your past posts, I take it you are an MS4. So what makes you think that you can judge who is a good intern or a bad intern at this point in your career? I've had med students gush about so-and-so who was a "great resident." But when I've worked with said resident, as a fellow resident...yeah, not so great. Your perception of who is a good resident and who is not is very different when you're a med student vs. when you're a resident. Or I've had residents that I thought were great, but have overheard attendings complain about how bad they were.

The thing is, my experience does not mesh with yours. One of the WORST residents I worked with as a med student was an intern who had graduated from Penn Med the year before. I actually modeled my behavior to be the OPPOSITE of what he would do. One of the best med students I have had in the past couple of years was an osteopathic student who functioned practically on the level of an intern. And one of the worst med students that I interviewed for residency last year came from a top 25 school - her answers were so vague and poorly thought out that I ended the interview early, because I couldn't take it anymore. So, sorry, but I don't find your personal experience to be all that compelling.

 

[MrBeauregard]

I had a huge response typed out, but I deleted it. You're too thick for it to make a difference anyways. I wish you all the luck in the future, and I'm really happy that you're going to be a "good" doctor since you're at a top 20 school. I'll live my life as a bad doctor all the while wishing I had gone to a school like yours.

 

[2012mdc]

IMO social stuff is taught better at certain institutions, i.e higher tier schools --> thus leading to the higher caliber students getting better training in general leading to better med students. Yeah sure some people at those schools are douche bags but as a trend I feel that's the case. How are "social skills" taught? professionalism classes, interacting with patients early on, interacting with faculty and residents that can serve as role models, etc. These things likely are done better at higher tier schools (they wouldn't be higher tier if they weren't better, right).

And it's more than just being nice to patients. It's about extracting information in an efficient manner and getting all the necessary history which is done differently by every med student. How to use the physical exam to help your differential is important as well which in my experience is taught better and learned more effeciently by those higher caliber students.

Agree that we all have to look stuff up... but you do different schools teach you to do that, if at all. Is your first choice google, uptodate, or the primary literature and how do schools teach students to approach the aspect of looking up information quickly and efficiently.

It's not that a higher caliber students can perform procedures better. It's more along the lines that said student can probably adapt more quickly. A monkey can do a LP, but how many monkey's can clearly picture the vertebra and and angle the needle in perfectly getting the csf with relative ease every single time? So that's the sense I was going for. Yeah yeah students at lower tier schools can do this as well but on average higher tier ones do it better IMO.

And again the lower caliber students can learn to do the necessary stuff, look up the necessary guidelines, and get the patient on the correct treatment plan. Lower caliber students can learn to do procedures and operations. It's just how the process of learning is done and how it is applied in the future. Some surgeons can do procedures quicker, more efficient, and with fewer complications over a period of time than others with the same general outcome (bowel successfully resected). I would argue those surgeons are of higher caliber and probably had better training. Same thought process can be applied to med students in a similar fashion.

not sure how I can better explain this. If you don't agree then fine. For better or worse this is what it thought from my experience. Again if all med students were the same then we'd all get the same grades, the same evals, and be equally competent doctors in the end. That is not the case in the real world. Some are better than others and I argue there is a higher concentration of "better"/higher caliber students at higher tier schools than lower tier ones.

who among you would say a gpa 2.8 mcat 23 carib med student is the exact same as you with whatever stats you have (I assume better) at a US MD school? What about those of you who go to harvard or JH or a similar tier school, are you guys the same as those from small town med school with 40 people or whatever your home state school is? If you think we are all the same why would you then choose a more expensive school? What is your money good for if the education is the exact same? Fact is that it is not the same.

My lower tier school has those same professionalism classes and we start patient contact in M1.

Higher tier schools are only considred higher because of research money and name recognition. They attract better students on paper because students love rankings, the schools typically have better facilities and more money, and they know they will face ppl like you who are obsessed with tiers/ranking. Go to a bigger name school and you will have more doors open for you.

I have friends at a wide range of med schools. I'm not gonna sit here and pose like I'm an expert on every school's curriculum but overall what people learn is the same in med school (it is regulated), it just differs in method (pbl, lecture based, graded, p/f etc).

And of course not all med students are the same but there is more variation within schools than between them.

 

[Bacchus]

IMO social stuff is taught better at certain institutions, i.e higher tier schools --> thus leading to the higher caliber students getting better training in general leading to better med students. Yeah sure some people at those schools are douche bags but as a trend I feel that's the case. How are "social skills" taught? professionalism classes, interacting with patients early on, interacting with faculty and residents that can serve as role models, etc. These things likely are done better at higher tier schools (they wouldn't be higher tier if they weren't better, right).

And it's more than just being nice to patients. It's about extracting information in an efficient manner and getting all the necessary history which is done differently by every med student. How to use the physical exam to help your differential is important as well which in my experience is taught better and learned more effeciently by those higher caliber students.

Agree that we all have to look stuff up... but you do different schools teach you to do that, if at all. Is your first choice google, uptodate, or the primary literature and how do schools teach students to approach the aspect of looking up information quickly and efficiently.

It's not that a higher caliber students can perform procedures better. It's more along the lines that said student can probably adapt more quickly. A monkey can do a LP, but how many monkey's can clearly picture the vertebra and and angle the needle in perfectly getting the csf with relative ease every single time? So that's the sense I was going for. Yeah yeah students at lower tier schools can do this as well but on average higher tier ones do it better IMO.

And again the lower caliber students can learn to do the necessary stuff, look up the necessary guidelines, and get the patient on the correct treatment plan. Lower caliber students can learn to do procedures and operations. It's just how the process of learning is done and how it is applied in the future. Some surgeons can do procedures quicker, more efficient, and with fewer complications over a period of time than others with the same general outcome (bowel successfully resected). I would argue those surgeons are of higher caliber and probably had better training. Same thought process can be applied to med students in a similar fashion.

not sure how I can better explain this. If you don't agree then fine. For better or worse this is what it thought from my experience. Again if all med students were the same then we'd all get the same grades, the same evals, and be equally competent doctors in the end. That is not the case in the real world. Some are better than others and I argue there is a higher concentration of "better"/higher caliber students at higher tier schools than lower tier ones.

who among you would say a gpa 2.8 mcat 23 carib med student is the exact same as you with whatever stats you have (I assume better) at a US MD school? What about those of you who go to harvard or JH or a similar tier school, are you guys the same as those from small town med school with 40 people or whatever your home state school is? If you think we are all the same why would you then choose a more expensive school? What is your money good for if the education is the exact same? Fact is that it is not the same.

You need to get your head out of the clouds... or your ass. I'd put my physical diagnosis skills or tactile skills (in procedures I've done) against any other student. Of course, I'll probably fail because I'm a osteopathic medical student.

 

[MikeS 78]

Are you out of your head.....The last thing we want is more doctors out there. The less of us the better period. Look at Japan or Italy where they overtrain doctors and you will find people underemployed and/or making 40K a year after more years of training that we go through. I say more years because they end up doing open ended residencies because there are no jobs when they get out.

The only people who want more doctors out there are medicare and the insurance companies because then they can treat us badly and pay us less. This is basic economics and the examples of this are multitude

In addition, it is extraordinarily rare for even the worst american medical student to not find a spot in anything eventually. I have met some pretty bad medical students over the years and they have all matched....the main people who will suffer, as always, are otherwise qualified FMG's....it would have to get a whole lot worse for this to be a problem

Again I cannot believe you posted something like this. The best thing about this job is that not many people are allowed to get into it which is pretty nice after the 11 years of hell I went through to earn that priviledge

 

[45408]

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?

Because they haven't done it all along. Why would they change now?

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.

Who does this?

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.

We get it. You have a huge chip on your shoulder. All of your class takes the USMLEs and has an average above the national average?

 

[45408]

IMO social stuff is taught better at certain institutions, i.e higher tier schools --> thus leading to the higher caliber students getting better training in general leading to better med students. Yeah sure some people at those schools are douche bags but as a trend I feel that's the case. How are "social skills" taught? professionalism classes, interacting with patients early on, interacting with faculty and residents that can serve as role models, etc. These things likely are done better at higher tier schools (they wouldn't be higher tier if they weren't better, right).

professionalism classes and early pt interaction are the biggest scam

Some surgeons can do procedures quicker, more efficient, and with fewer complications over a period of time than others with the same general outcome (bowel successfully resected). I would argue those surgeons are of higher caliber and probably had better training. Same thought process can be applied to med students in a similar fashion.

Better surgical training often happens at places that aren't big academic research centers. Taking two years out in the middle of your residency to do bench research, standing three people deep in an OR where they're doing a Whipple on a patient who just had a liver transplant, and doing the cases that the fellows didn't want != ideal training. Yes, I'm making huge generalizations, but training at a big academic research institution is meant to make you an academic research surgeon, not a technically-skilled guru. They're not mutually exclusive, but it's hard to do two things simultaneously.

who among you would say a gpa 2.8 mcat 23 carib med student is the exact same as you with whatever stats you have (I assume better) at a US MD school? What about those of you who go to harvard or JH or a similar tier school, are you guys the same as those from small town med school with 40 people or whatever your home state school is? If you think we are all the same why would you then choose a more expensive school? What is your money good for if the education is the exact same? Fact is that it is not the same.

Top research schools are trying to make top research physicians. If you want a physician/surgeon who is facile at diagnostics and procedures and competent with patients, I don't see a correlation between going to a top research school and that.

 

[45408]

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

There aren't enough US MD residents to fill every spot.

and every MD would have a spot at the end of Match Day. It's not the way it works.

Yes, it is. Three people in my class of 200 didn't match. Two were going for competitive specialties, and one had just failed Step 2. By match day, they all had spots. For all practical purposes, every US MD grad gets a spot.

 

[Spatula]

Are you out of your head.....The last thing we want is more doctors out there. The less of us the better period. Look at Japan or Italy where they overtrain doctors and you will find people underemployed and/or making 40K a year after more years of training that we go through. I say more years because they end up doing open ended residencies because there are no jobs when they get out.

The only people who want more doctors out there are medicare and the insurance companies because then they can treat us badly and pay us less. This is basic economics and the examples of this are multitude

In addition, it is extraordinarily rare for even the worst american medical student to not find a spot in anything eventually. I have met some pretty bad medical students over the years and they have all matched....the main people who will suffer, as always, are otherwise qualified FMG's....it would have to get a whole lot worse for this to be a problem

Again I cannot believe you posted something like this. The best thing about this job is that not many people are allowed to get into it which is pretty nice after the 11 years of hell I went through to earn that priviledge

I'm guessing you're not in primary care. Ask one of them what it's like to work in a practice with about half as many physicians as they need.

 

[ensuii]

I can't believe this thread is on page 4...are you guys seriously arguing about what might happen? Why don't all you guys just worry about trying to put together the best application possible, apply broadly and let the cards fall where they may?

 

[Spatula]

I can't believe this thread is on page 4...are you guys seriously arguing about what might happen? Why don't all you guys just worry about trying to put together the best application possible, apply broadly and let the cards fall where they may?

You're right, worrying about future problems is a waste of time. So what if Iran wants nukes, we'll deal with that later when they actually have them. The economy MIGHT collapse in the future but for now let's just go on completely like normal and deal with it when it does.

 

[drctother]

I can't believe that someone interviewed you and thought that you should be allowed in any medical school.

 

[Butler]

There aren't enough US MD residents to fill every spot.

Yes, it is. Three people in my class of 200 didn't match. Two were going for competitive specialties, and one had just failed Step 2. By match day, they all had spots. For all practical purposes, every US MD grad gets a spot.

Thank you Prowler. We can always count on you to come in and crush some of the nonsensical anecdotal bull that spreads around these forums like wildfire. And to Officedepot...I haven't seen one shred of evidence in any of your posts. A good physician is someone who goes above and beyond for his patients. More often than not, this is a matter of time, effort and energy spent and has nothing do with the "tier" of medical school you attended or the 260 you scored on Step 1. The "tier" of your medical school has very little to do with the quality of instruction provided there. I am sure we have all experienced horrible lectures from superstar MD/PhDs. Your research and education credentials do not directly compare with superior teaching skills.

It stinks that we are all judged based on standardized tests and grades that don't directly correlate to your potential skills as a physician giving the right opportunity. I have a number of friends that are attending DO schools because they did not get MD acceptances. They are caring people, with great interpersonal skills and a hard work ethic. They will probably make excellent doctors. Objective measurement does not directly correspond with your ability as a physician. But admissions committees and PDs need some form objective measurement. Those be the strokes folks.

 

[Kevin Baker]

Just to put things in perspective, but for PGY1, aren't there close to 23.5 K spots and a smidge over 16k US MD grads/seniors applying (with about 1.5k DO applicants) ? I understand this stress over not getting the position one wants, but we're pretty far away from this doomsday scenario of US grads going unmatched. We'd need a much bigger expansion of schools, or a lot less bias towards IMGs, for not matching to be a major problem.