I am entertaining the idea of pursuing a DO degree and was wondering if anyone can offer some advice/general input.
Here’s my background: I have a PhD in biomedical physiology from a medical college and decided to move into ecological physiology after graduating in 2009 (I’m 32 years old). I am currently a scientist in the public sector doing disease ecology research (on marine fish) and I am starting to realize that research may not be the career I would like to commit myself to. I love science but bench work is not something I enjoy immensely and I am not thrilled about having an income dependent upon grants.
I have an interest in the “whole patient” approach of natural medicine but after visiting an ND program and reading many forums on the topic, I am not comfortable taking on a debt of $150-200K for a career that is largely dependent upon being a salesman (among other concerns). From my understanding, DO programs teach a similar “patient first” approach (I do not intend to demean MD’s - I know they care deeply for their patients).
I recently sent my transcripts to a DO school for input on what courses I would need to fulfill in order to have a competitive application (considering GPA and pre-reqs). I also need to take the MCAT, shadow a DO, volunteer in health care, visit some schools etc. The main thing I would like input on is the education process, myths versus reality. Many of the forum posts that I have read regarding the education process of medical school discuss how horrible it is. They also often complain about rigorous 80+ hour/week residencies. Should I expect this from a DO program? During graduate school I took medical school courses and I understand that studying consumes the better part of your life, should I be expecting to hate my life for the full 6-7 years I am training to become a DO?
I am potentially interested in rural family medicine, maybe neurology or emergency/wilderness medicine (I understand wilderness medicine is not really a specialty, but it sounds exciting). If I volunteer at a hospital, will this be a good setting for me realize whether I want to be a DO or not? Any advice on what I should do to realize whether this is the right path for me? As a DO will I be required to do hospital rounds and be on call? Or does it depend upon the route I take?
Finally, how is a residency at a DO clinic/hospital different from a residency in a traditional setting other than the MD/DO ratio? Are there advantages/ disadvantages for one versus the other?
Any other advice/input/questions?
THANK YOU!!!
I’ll leave the questions about the application process and med school experience to some of our DO grads, and address your questions about residency. Disclaimer: I’m an MD; associate director of a dually-accredited family med residency.
Residency is basically the same regardless of whether you graduated DO or MD. As of this year, most family medicine residencies are now dually accredited with ACGME and AOA (the accreditation bodies of allopathic and osteopathic medicine respectively). This move toward dual accreditation is in response to the rise in numbers of DO grads in recent years, many of whom choose primary care. I don’t know how many emergency programs are dually-accredited, or if there are any neuro programs.
In family med, the major difference between the two programs is in clinic, where DOs are expected to have a certain number of patient encounters reserved for osteopathic manipulation therapy. There is also a didactic learning component reserved for OMT training. Depending on the program, you may be required to sit for both allopathic and osteopathic boards on completion of residency. There are exclusively AOA accredited family med programs too.
Osteopathic grads are not required to attend AOA accredited residencies. They can participate in the DO match, MD match or both. While it is still true that MDs match higher in most specialty programs, that appears to be a shifting tide as well. Obviously, if you attend a residency program that is ACGME (allopathic) accredited, you play by their work hour rules; i.e. 80 hrs per week max, one day in seven off (averaged over four weeks), no more than 16 hrs continuous time in hospital for interns, 24 hours for upper level residents.
Hope that is helpful. Welcome to OPM!
I can address a few of your concerns, from the perspective of being an (older) 2nd year medical student at an osteopathic medical school. Should you expect to hate your life for the next 6-7 years? I hope not!
Actually, I find I am enjoying this year (so far) - but it’s the kind of enjoyment one might find in running a marathon. Bear in mind that for many of us in medical school, we are really motivated by the patient encounter and “helping people”. Anytime we get to do something clinical turns the day into a good day. I gather that in third and 4th years of medical school (the clinical years…) one’s day (or night) is almost exclusively that.
There is certainly a drain from the rigorous schedule. But I didn’t hate all of 1st year. A lot of the material, I WANTED to study. This was stuff that was going to relate to my care of patients. So putting in extra book hours can have some intangible rewards as well.
I’m consciously taking a little time this year for playing an instrument or doing a tad of outside reading, and I like my life much better. The week before the test, little of that happens, but there is always the unwinding evening after the test to look forward to.
From talking with my niece who is in an MD program, it seems that at least at my osteopathic school, we spend a little more time in the classroom each week, making getting the studying done more of a challenge. THat may be because of the required additional 300 hours of instruction in Osteopathic Principles and Practices. You’ll get training on hands-on diagnosis and treatment focused partially on musculoskeletal/fascial issues, but also supporting health in other areas. There is certainly an emphasis on caring for the whole person, body , mind and spirit. You will probably NOT get a lot of additional training in use of herbs, homeopathics, etc but our class has had lectures in accupuncture, and on spiritual assessment and care thus far. There remains an emphasis (which I think is good) on evidence-based practice - applied to whatever therapeutic modality you are utilizing.
Residency, from my understanding, will look very similar for DO and MD residents. Though,as alluded to, DO students have to have a certain proportion of their time using OSteopathic Manipulative Medicine (so as to keep current and refine their skills). There are many osteopathic physicians and students just coming in who have a very preventive, holistic approach (1st principle of osteopathic medicine is that the body is a unit and is capable of self-healing. A lot of what we do is look at how to support that.
I know my residency years will be a challenge and that my free time will be almost non-existant, and my sleep time inadequate, but I hope to still like my life. Maybe I’ll be able to keep it in perspective.
Many doctors have told me that their hours after residency, as a physician, are even worse. However, the docs I know in rural practices have often very irregular hours, but not at the same overwhelming number of them.
Don’t know if that helps.
Kate
Kate and JMDMD,
Thank you for your insight. It is extremely helpful as I am trying to piece together my future (physician or not). More than you probably realize.
Does anyone know a good route to obtaining valuable volunteer experience in medicine? Something that will make me say “yes, I want to be a doctor” or “no, this makes me sick.” There are probably numerous posts on the topic, which I will search for, but I thought I would throw it out there.
Best Regards
Valuable volunteer experience …outside of the hospital is to volunteer at a free clinic. That will expose you to more of an office-based practice. As a family physician, more of your practice will be office based, and if you admit to a hospital that has hospitalists, you won’t do a lot of the in-hospital care. But realistically, as a rural physician, you are likely to be managing your pts in the hospital as well. The docs I worked with in rural Tennessee started at 7, rounded on their patients in the hospital, and then went on to the office. Went back to the hospital around 4 pm. Not a lot of hospitalized patients as it was a small community.
In-hospital experience: see if there is a sizeable hospital near you that uses “scribes” in the ER. That exposes you to quite a bit of what comes in to the ER and gives you some patient interaction.
For shadowing opportunities, you can call your state osteopathic medical association and ask if they can give you contact info for a D.O. in your area whom you could contact regarding shadowing.
Kate
Thanks again Kate!
I have two rural walk in clinics near where I work - one is fully staffed with nurse practitioners. Is it just as beneficial to volunteer at a walk in clinic such as this? Or should I seek one out that is staffed by physicians? Also, I found several DO’s at our county hospital. I will write to them and see what I can work out.
In terms of volunteer schedules, as you were preparing to apply for school were you also working full time? I’m trying to envision how to fit my job with a regular medical volunteer experience. It will be important for me to volunteer enough to make a solid decision on entering medical school, and I will continue until I have made that decision. However, I’m wondering if admissions committees will consider 1 day a week for few months as ‘meaningful.’ I suppose I will need to quit my job eventually to finish pre-reqs and do further volunteering. I’m just curious what course of action others took while having a full time job to prepare for the application process. I do realize it varies depending on individual circumstances.
One more quick question - I contacted a DO school and they told me that admissions committees like to see a solid semester of course work within the two years before applying. Do you have any insight on this?
Thank you!!!