Hello meds and pre-meds,
I've been researching the option of becoming a D.O instead of an M.D becasue it seems the D.O concept is more compatible to my way of thinking.
I have a few questions to anyone with knowledge on this subject. What is the biggest diffrence between these two types of doctors? Any advantages or disadvantages from being eithier? I know most D.O's are in primary care (which is where I want to go) but does this limit them? Can D.O's be surgeons?
What is up with residency for D.O's I know following graduation there is a 12 month rotationg internship, but I get the impression that residency following this is optional. How can this be competitive with M.D's who are required at least 2 years of residency? Is there clerkships and hands on patient care during the 4 years at a D.O school? Or is the 12 month roatating clerkship pretty much a 5th year?
Sorry for the many questions, please fill me in.
The only difference between D.O.s and M.D.s is that D.O.s learn manipulative therapy while in medical school. Once the D.O.s graduate and begin residency they can either continue in a D.O. residency or move into the allopathic (MD) system for their residency. 65% of D.O.s go allopathic! If they do they work side by side with the MD residents. Even if they take a DO residency they are often trained side by side with the MD residents! A D.O. can take a residency in any specialty including radiology, pathology, anesthesiology, and surgery. Many go into primary care but many MDs go into primary care too. I think a lot of D.O.s do orthopedic surgery. In the past ten years D.O. has become indistinguishable from M.D. (except for the letters after their name!)
|QUOTE (skypilot @ Jan 21 2003, 10:49 PM)|
|The only difference between D.O.s and M.D.s is that D.O.s learn manipulative therapy while in medical school. Once the D.O.s graduate and begin residency they can either continue in a D.O. residency or move into the allopathic (MD) system for their residency. 65% of D.O.s go allopathic! If they do they work side by side with the MD residents. Even if they take a DO residency they are often trained side by side with the MD residents! A D.O. can take a residency in any specialty including radiology, pathology, anesthesiology, and surgery. Many go into primary care but many MDs go into primary care too. I think a lot of D.O.s do orthopedic surgery. In the past ten years D.O. has become indistinguishable from M.D. (except for the letters after their name!)|
Ummm...maybe this is a stupid question but doesnt a DO going into an MD residency kinda defeat the purpose of going to DO med school in the first place? Probably 90% of what you learn is in residency anyways, and MD residencies have nothing to do with OMM or the other osteopathic concepts.
Seems like a DO going into an MD residency would be a good way not to use the unique skills that DOs have.
Glad to see someone researching the DO-pathway. I am also ecstatic to see that this question on OPM elicits an intelligent & mature discussion vs. other on-line forums where it becomes a childish free-for-all.
There are many points, overt & covert, that need to made regarding your inquiry. I cannot hope to hit them all, so do not hesitate to respond with additional questions…I am most happy to answer them. Furthermore, I will do so in the brutally honest style that I am so well known for.
Regarding opportunities for DOs vs MDs – legally, if an MD can do it, train it or claim it – a DO can as well. Legally, the two degrees are indfferentiable. You will find far greater differences in curriculum by comparing individual MD & DO schools than you would by a lump comparison of MD vs DO curricula. Excepting the inclusion of manipulative medicine (interchangably referred to as: OMM, OMT, OTM…), there is no significant differences b/t what you are taught in an MD or DO program. However, there are significant “syle” differences. But, again, you will find that this variance is far more related to the individual programs than their status as MD or DO conveying institutions. For example, I am about to graduate from the founding DO school – the place where it all began. And, I figured that we had to be the most touchy-feely, I love everyone school out there. BUT, when I began working with the Mich St MD students here in Sagainw, I learned that my belief was a delusion…they indeed are much more touchy-feely and more strictly adherent to many classically “Osteopathic Tenets” than even the ‘mother ship’, from whence I came.
In essence, as a DO, you can anything from become a pediatric orbitologist to a genuine horse & buggy, rural family practice Doc. Virtually all schools, MD & DO, blare their trumpets and fly the flag of primary care at full staff because that is the politically chic thing to do. If you recall the initial predications of an extreme specialist oversupply & primary care shortage by those well-known healthcare industry experts, the Clintons (please note the extreme sarcasm as their are probably not any two people who know less about the true nature of healthcare than the Clintons), that occured in the early-90s. That climate, coupled with a rapidly expanding managed care system, greatly over-emphasized the potential imbalance of primary care vs specialist – but medical schools dutifully caught on an began touting their deeply seated desire to turn primary care docs. I suspect, with the impending shortage of specialists - largely due to the over-reation to the aforementioned potential imbalance that never manifested, that were someone to rally around producing specialists to offset this impending shortage that the medical schools would begin trumpeting their now deep-seated desire to produce specialists…but I digress.
DOs & residency – I will provide too much detail here, as it is quite complex. I will, however, be including an in-depth description of all of this in my diary – once I have the time to sit down and author more entries. Suffice it to say that as a DO, you can enter both AOA post-grad (DO programs) and ACGME post-grad (MD programs) training. If you undertake an AOA program, you must complete the DO Rotating Internship - which is 12 months long and emcompasses 12 rotations in several of the classic medical specialties: OB/Gyn, Peds, surgery, IM, FP & Psych. It is much like repeating your third year of medical school only with more authority & responsibility. I will not go into whether I feel that this is merited or not…please see my diary.
After completion of the DO Internship, you can continue on with either your AOa or an ACGME residency in what ever you have chosen. Now, the first question that usually comes to mine is, “Doesn’t this add a year to my training?” The answer is: yes & no. For some AOA programs, it will not & others it will. Some IM, FP & OB/Gyn programs “fast-track” - which means your internship & first year of residency are simultaneous. For things such as surgery, radiology & anesthesiology - will not add on to it as they already entail an internship for the first year anyhow. For things like ER, yes…the DO programs are generally 4 years instead of the three that is more common with the ACGME; however, there is a significant number of ACGME ER programs that are 4 years as well.
As a DO undertaking ACGME post-grad training, MD residencies, you are open to apply to any ACGME program…period. There are a few that are historically difficult to match into as DOS. These tend to be the ones that the AOA already has ample training programs, i/e surgery, derm, radiology…Again, the question fot he extra year, due to the DO internship arises…and it is even more complex on this side of the fence. If you are undertaking an ACGME post-grad program, you are not required to do your DO internship, with a couple of caveats. Therefore, the extra year question becomes moot.
Now, if you do not either do a DO internship or have your MD internship retroactively approved by the AOA, you cannot hold a faculty position or Dean-ship at any DO school nor ever be an elected officer in the AOA. Also, there are 5 states that require you to have done the DO internship to get a permanent license there: MI, WV, OK, FL & PA. Of these 5, both MI & WV require you to do the DO internship to even apply for a training license…the license you operate under as a resident. There is a route that permits you to have your ACGME intern year approved after-the-fact to meet these requirements and avoud all of these problems…if they even represent a problem for you.
Furthermore, you a significant number of DO grads elect to do their DO intership and then enter an ACGME post-grad program. Whether or not the program will grant you full, partial or zero credit for your DO internship against thier own internship requirements is up to the discretion of the Program Director; therefore, you need to contact them individually to answer this questions. ACGME programs that have a long history of accepting DOs frequently readily accept the DO intern year. For example, I have yet to come across an anesthesiology program that even hesitates to accept the DO intern year. I also understand that FP programs have a similar policy. Others may or may not, but generally, it is not a huge issue.
Regarding your comment about requiring 1 or 2 years of post-grad training…I think you may be getting several related bits of info a little too mixed together. First of all, all licensure issues are dictated at the state level by the individual state’s licensure board or boards, some states have one board and others have both DO & MD boards. The number of years required to practice in a state is set by the state licensing board and has nothing to do with the AOA, AMA, DO or MD – those bodies may lobby for modifications in policy, but they do not set it. That said, the preponderance of states only require 1 year of post-grad training, a significant number have upped it to 2 and a smattering are even requiring 3 years. It has only been w/i the last 15 years that Family Practice was even a residency trained Doc…and around 10, maybe less, that an FP residency was even required to call yourself an FP. There are still a lot of Docs, who are not even all that old, who are FPs and never did a residency…only an internship. Those antiquated state licensure laws reflect this old criteria. Furthermore, even though you could technically still hang out your shingle to practice medicine after 1 or 2 years of training, not being board certified or even eligible, you will find it next to impossible to apply for hospital priviledges or to even get malpractice insurance.
Lastly, sorry for the long post, as ‘skypilot’ points out – having worked alongside many DOs & MDs over the years…they are largely indistiguishable. Many years ago, the “DO Philosophy” of a people-centered & wholistic
approach to medical care was uniquely “DO”. However, as medicine has become a progressively more consumer oriented business, all medical schools have adopted & adapted this perspective in thier educations…and with well-received results --> Docs are becoming more “human” and less ‘god-like’ – the consumer-public has demanded this. To be perfectly honest, the type & style of Doc that YOU will become is more reflective of the person that dwells within you. If you take an @$$hole and send him to a DO school, you will not remold him into Mother Theresa anymore than sending Mother Theresa to an MD school will pervert her into a butthole. Those are simply myths perpetueted by those who do not know any better.
in excess of 65% of DO grads undertake ACGME post-grad training…some of this 65% will have also done their DO internship as well. And the art of OMT – most DOs use it infrequently. I do not see this as abandoning our roots, as many of the flag-waiving, OMT hardcores assert. With every single mode of intervention, be it pill, surger or OMT, appropriate patient selection is the cornerstone of success – no single intervention is appropriate for every ailment or every patient. Selecting interventions is what learning to doctor is all about – the volume of information you must sift thru to derive the appropriate therapy is massive…and highly disease & patient dependent. I see DOs these days as merely being more discerning about who, when & where they apply the art of OMT.
I sincerely hope that this reply generates more questions than answers…please respond with your questions. And, I promise, time permitting, that I will make new entries in my diary that will go into the grisly details. Honestly, I have made two entries recently only to have them lost in cyberspace – very frustrating!
are job opportunities comparable for DOs and MDs? would there be any difference as far as how hard/difficult it is to find a position, and are salaries similar? just curious.
Many DO physicians have chosen to go into primary practice but DOs are not limited to primary care. There are DO residencies in every specialty and all allopathic residencies are open to graduates of osteopathic medical schools. The salary of a DO will depend on what specialty they practice just as with an MD.
There are still some “ill advised” MDs who attempt to discriminate against DOs by not considering them for residencies etc. There are no differences in the practice of a DO as compared to an MD. An MD may learn manipulations and a DO may opt not to learn or include manipulation in their practice. My personal primary care physician at UVA is a DO and a wondeful family practictioner. I actually chose him specifically because he is a DO.
There have been plenty of DO applicants to our residency program this year. My residency director welcomes them and will judge them by the same criteria that he judges the applicants who have graduated from allopathic medical school.
I would encourage any DO or MD candidate to apply to any residency program that they believe will be of benefit to them professionally. While DO residencies are not open to MD candidates, I believe that in the future, DOs will probably be allowed to use MD behind their names instead of the DO. Some patients are confused by the degree but other than that, there is no difference.
|QUOTE (BethJolly @ Jan 22 2003, 12:54 PM)|
| are job opportunities comparable for DOs and MDs? would there be any difference as far as how hard/difficult it is to find a position, and are salaries similar? just curious.|
As I pointed out above, the two are legally indifferentiable...meaning that technically to exclude a DO for being a DO or to pay them less because they are a DO is legally defined as discrimination...just as if you would not hire a minority or tried to pay them less for being a minority.
The opportunities & pay are technically the same. That said, there are definitely regions of the country that are less familiar with DOs and potentially harder to find employment within. However, this is a dying phenomenon and I cannot honestly even tell you that I have heard even a rumor of a DO having a hard time finding a job in geographic region 'X' occuring within the last many years.
Suffice it to say that any phrase where you can utilize the initials "MD", you can equitably substitute "DO" and have a valid statement.
I’m so glad to see this discussion.
I would love feedback.
I applied equally to allo and osteo (8/7). I based my decisions on location, school, curriculum, etc. I feel a draw towards osteo philosophy, and indeed have gotten more responses (interviews) from the osteo camp. I have gotten one acceptance, and think I may get one or 2 more osteo offers(good stats, I interview well). I have also had 2 allo interivews that went well. I am on hold at one, waiting to hear from the other (my state school). I am torn if I get the acceptance in state: the cost is so much lower, but I really like the osteo philosophy. I also LOVED the other allo school, the opportunities seemed great, such as overseas rotations, but it’s private, so the debt would be substantial.
Has anyone out there had to make these kind of decisions? The point may end up being moot, but I am trying to prepare for the possibilty of being fortunate enough to have these choices.
I guess my questions is: how important is choice of school in your eventual career? Any thoughts?
Congratulations on your acceptance. I don't know a whole lot about DO schools but from what I've seen so far, the curriculum is not that much different from MD schools. So it seems to me as long as YOU share the DO philosophy you'll be a DO-like physician no matter which degree you get. The money thing is definitely something to consider. Going to the less expensive school will give you the freedom to do whatever you want as far as career without needing to factor in the big, big loans. So unless you feel that one school is far superior to the cheapest school, going to the cheapest school might be your best bet. The philosophy of medicine is yours to learn from either school.
Congratulations on your acceptances. I, too, went the route of investigating both MD and DO schools, and had pretty much chosen a specific DO school when I got an acceptance at the “touchy-feely” MD school, Old Man Dave refers to. I chose to go there based on the individual program (which matched my philosophy which is rather osteopathic in nature), and some of the other unique offerings of the program- not on whether or not I was getting an MD or a DO, since, as has been pointed out, I felt my career options would be essentially the same. I wanted a program that fit me— I think that matters most. (Although I still regret that I won’t learn OMM).
im a nurse that will be applying to both MD and DO schools this year…