DO or MD...That is the Question!

Hi,


So I returned to school in full force with the vision of becoming the best possible, patient centered, Family Pract. DO this side of the Mississippi… for reasons i won’t go into here, I really see myself as more of a DO. However, recently i was talking with a friend who manages the largest OB/GYN group practice in our city and she questioned my choice; informed me that there is still some bias in the medical community toward DOs (their practice doesn’t have any!). This got me thinking - would I go through all these years of hard work and still be limited on how/where I can work? Am I better off to reconsider the MD route? If I do, can I take additional courses in Osteopathic medicine to complement MD training? Old Man Dave - I know you’re a DO - if you’re out there, what do you think?


Christina

  • In reply to:
So I returned to school in full force with the vision of becoming the best possible, patient centered, Family Pract. DO this side of the Mississippi..

"

First question. . . which side of the Mississippi?

  • In reply to:
there is still some bias in the medical community toward DOs



While there may still be some bias, it is continually lessening. In most major medical centers, you will find DOs and MDs working side-by-side, with department heads being both DO and MD.

  • In reply to:
I really see myself as more of a DO.



First, make sure you really understand what osteopathic medicine is. The major difference between osteopathic and allopathic medicine is the use of manipulative medicine as an adjunct to other therapies.

  • In reply to:
i was talking with a friend who manages the largest OB/GYN group practice in our city and she questioned my choice; informed me that there is still some bias in the medical community toward DOs (their practice doesn't have any!).



I would talk to your friend and ask her why. It could be as simple as the fact that ob/gyn is a field that has faced exorbitant malpracticue insurance increases, and therefore fewer people are choosing that occupation. I know a lot of ob/gyn doctors that are DOs. I also know a lot that are MDs. . . and they quite often share practices.

I think your main decision should be whether or not you want to be a physician and then what is necessary to get there. Leave your options open to both allopathic and osteopathic medical schools until you have time to visit and see where you feel you fit best!

I am an Emergency Physician and a DO. I work in a community setting where I am the only DO. However I am not treated any differently. There are several IM, FP, radiologists,…that are DOs and I don’t think anyone really pays any mind to it. My husband is also an EP, but a MD. He works at a large academic center that has very few DOs in their ED, they actually just took their 1st DO as a resident. Not because she is a DO perse, they are very into names and have in the past only wanted those from Ivy league schools. I think they have seen the errors in their ways, but only time will tell.


I don’t really see a problem, especially if you are planning on doing IM/FP.


Rachel Yealy, DO



Your friend may be reflecting some prejudices within the group she works for, but she is NOT reflective of the face of medicine as a whole. Here in Northern Virginia, where the closest DO schools are in West Virginia, southwest Virginia, or Philadelphia (i.e. none nearby, and lots of academic MD centers close by), there are DOs in E-med, FM, IM, Peds, Ortho, Cards… etc. etc. My MD program at GWU had a faculty member who was a DO… I believe Georgetown did too.


What Linda is saying is that the stuff you read about ‘DO philosophy’ being somehow different is, to a great degree, a PR effort that isn’t really reflected in how DOs work every day. You would not be able to tell the difference between me, an MD, and my DO classmates in residency. And I think that more and more “mainstream” MDs have realized that - there just really isn’t any substantive difference.


So do what appeals to you. Your friend’s comments constitute an N of 1 and there is a whole world out there, changing all the time.


Good luck!


Mary

Hi Christina - and others considering which route to take:


Deciding which route to take of all your options requires that you know all your options. Like you, I thought I was limited to MD, explored DO, and later learned about doctors of chiropractic medicine, doctors of naturopathic medicine, and doctors of traditional Chinese medicine. The scope of practice for each in the State in which you intend to practice makes is to be considered, too. In Illinois, for example, while the focus of the different medical branches are different, there is no different scope of practice between DC, DO and MD, except that DCs are not licensed to prescribe meds or give injecibles. Because of the Illinois scope for DCs, the chiropractic college in Illinois, National University of Health Sciences (www.nuhs.edu) has comprehensive basic and clinical sciences programs so that the graduates are fully prepared to be primary care family physicians.


I have only one more class for my bachelor degree in Biomedical Sciences and graduation in December. In January, I will begin the doctorate in chiropractic medicine and am looking forward to having a rural primary care family practice.


You have more options than you realize!!


– Lisa

I would have to say that there is some observational evidence of minor bias, mostly due to lack of knowledge, against DO. However, it appears that this highest at the the premedical end of the spectrum. That is, the majority of traditional premeds know little of DO as they start in college. This can be inferred as most DO schools have a strong recruiting effort (ie will seek students, will exhibit at conferences like ours) where as the MD schools have much less desire or marketing to recruit for students. However, it would also appear as students enter medical school and apply for residency this bias seems to greatly lessen. If I recall, when I looked closely at the 2008 residency data 90% of Osteopathic medical school seniors were accepted to allopathic medical residencies in all areas. It should also be noted that there are about 4,000 Osteopathic medical school graduates a year compared to 14,000 Allopathic graduates, yet DO graduates fill fully half the primary medical care PGY-1 specialties a year. So the DO philosophy that centers on treating the whole person seems to have much influence to enter practices that treat a whole person as well. While it would also seem that there certainly there are medical residencies, practices, and individual doctors who still hold some bias, that may be due in a large part, as one poster previously mentioned, more on wanting a “big” name school. Of course our very own, OldManDave, who did his residency and fellowship at Dartmouth, shows that is minor at best. As an aside, I have a MD friend who is a EM professor at Brown Medical School and who is the only one in his department who did not go to either Brown Medical School or Brown Residency, showing how name-conscious and incestuous some places really are. The politics and name-recognition in the more “prestigious” medical centers has little with bias against DO as much as just wanting “ivy-league” status.



  • CWeaver Said:
Hi,

So I returned to school in full force with the vision of becoming the best possible, patient centered, Family Pract. DO this side of the Mississippi... for reasons i won't go into here, I really see myself as more of a DO. However, recently i was talking with a friend who manages the largest OB/GYN group practice in our city and she questioned my choice; informed me that there is still some bias in the medical community toward DOs (their practice doesn't have any!). This got me thinking - would I go through all these years of hard work and still be limited on how/where I can work? Am I better off to reconsider the MD route? If I do, can I take additional courses in Osteopathic medicine to complement MD training? Old Man Dave - I know you're a DO - if you're out there, what do you think?

Christina



Christina,

Thanks for asking & as clearly pointed out here, from both sides of the "fence", the DO vs MD debate is predominently a manifestation in the pre-med world. I can assure you that once you graduate from med school, overwhelmingly, no one could give a rat's ass where you went to med school, the nature of the 2 illegible initial's behind your sig nor your GPA or Board scores. Once you hit the wards as an intern/resident, earning the respect of the staff, fellow trainees, allied health professionals &, most critically, your patients is all about how you perform, how hard you work & how well you treat others with respect. Yes, there are some 'inbreed' places that seek to only hire/match fellow Ivy Leaguers - I know because I trained in one that is in the midst of attempting to reform away from that predisposition - but they are fortunately few & far between. And, they tend to be so culturally & procedurally homogenous as to degrade the overall experience anyhow.

Yes, there are jobs or programs out there that may discount you for being a DO...there are also those out there who will do the same because you are female or will do so because someone is a minority - all of which is BS, but that is reality and all of which is blatantly illegal. One day, maybe all of that wil go away...maybe.

However, your question & thoughts should not be focused upon passive, external control of your career pathway. EVERYONE, even the Ivy Leaguers, will face adversity & be placed under the microscope of scrutiny - it is a dog eat dog world. The only way to maximize your potential to succeed is to chose the path best suited for you & your professional aspirations and always perform at your personal best. If you fulfill this, then the cards will fall where they will & you will yourself standing where ever you earned to stand. No one has any more control over you than you allow them to have.

I have personally never felt discounted for being a DO and that has been while training in place populated by loads of Dartmouth, Harvard, Stanford, UCSF, Hopkins, Mayo, Brown grads...and many many fellow DOs as well. Again, earning your stripes involves very hard work & nothing to do with your alma mater.

I have frequently encountered fellow DO-students who used "I am (or will be) a DO" as an excuse for not achieving what they sought to achieve. It is far easier to make an excuse than it is to accept responsibility for the task. If you want to do IM/FP at an Ivy, then you need to set that as your goal & made strides towards it. But, I must admit, I do not really perceive that there is a golden chalice at the end of Ivy residency grads...they go into jobs & are expected to work hard, provide excellent quality pt care & produce just as those of us who did not go Ivy.

In the end, I would not sweat 1 drop about MD vs. DO. But, I would toil & sweat to ensure I performed at my personal best so that I am able to secure opportunities to facilitate the fulfillment of those goals.

Also acting in your favor is the nationwide shortage of residency applicants with your awesome enthusiasm about family practice.

I am applying to an equal mix of allo- and osteo- schools. I picked based on other factors than which “philosophy” they promote or degree type they award.


Interestingly, though, one of the associate medical directors in the ED where I work asked me with a perfect poker face, “So, do you want to be a DO or a real doctor?”

  • ViceroyPlain05 Said:
"So, do you want to be a DO or a real doctor?"



I hope he was kidding, although I fail to find the 'humor' in it.

I didn’t think it was funny either. I’m not sure what her intent was. It just struck me as an extremely bold implication. It really didn’t affect what I thought about anything…unless it was that maybe she doesn’t use fabric softener in the wash.

Old Man Dave,


Thank you for your thoughtful response. I appreciate you taking the time. After looking at my class schedule I just discovered I can step it up a notch; actually taking the MCAT and applying to schools this next spring (09). I decided to apply to my first choice: A.T. Still University in Mesa, AZ for DO and the U of Arizona’s MD program, however if given the choice I feel much more confident about following my dream of becoming a DO. I know how hard I work, and somehow I also know it will be exactly what it is meant to be. I never said “I want to be a doctor” until I read about Dr. Fullford and Dr. Strutherland so I guess that says it all…


Thanks Again!


Christina

Christina,


Good luck with the MCAT & your application! We look forward to hearing how things work out.


Rachel Yealy, DO


Emergency Medicine