I’m sorry if this topic has come up many times before, but I am truly baffled. So many posts here on CC discourage medicine as a career path because the chances of med school admission are so low. However, the median GPA for Do schools is 3.5 and average MCAT is 501. These seem like reasonably achievable goals by a hard working motivated student. So why are people being warned away from medicine rather than advised to consider DO? Recently, my eldest daughter needed surgery and the surgeon assigned to us was a DO. The attending physician was a DO. They were all wonderful. What am I missing?
I’m not sure about DO, but I also wonder why there’s not more talk here of taking the PA path vs med school.
WARNING: long winded answer ahead!
People are not being told to walk away from medicine rather than become a DO. If anything it’s the opposite.
However, you should know that although the average GPA/MCAT for DO schools are lower than MD schools, the competition for admission to osteopathic med schools isn’t less. If anything, it’s actually more competitive. The number of total applicants per seat is higher for osteopathic schools than it is for allopathic schools. (And no, a rough meta analysis shows the reason it’s higher isn’t due to MD applicants throwing “safety” applications at DO schools.)
Why don’t more people consider DO?
Part of the issue is that osteopathic doctors are not evenly distributed nationally. Some states (Michigan, Pennsylvania, for example) have large numbers of osteopathic physicians practicing there so DOs are a familiar quantity. Many states, however, don’t. I grew up in PA near Philadelphia where osteopathic physicians were common and DOs had their own separate hospital system until the 90’s, but I now live in a large western state where there are a grand total of 32 DOs in the entire state. I couldn’t find a DO if I tried. (OK, I could but it would take significant effort on my part plus travel to a distant corner of the state.)
Another reason is that osteopathic physicians are only found in the US. In every other country in the world, a osteopath is a health care provider that is limited to only doing body adjustments and massage. US DOs are also unable to get medical licenses** to practice in countries outside the US. Often immigrants–even after a couple of generations in the US-- don’t understand that’s a DO is just another type of medical doctor OR they view DO as a “second rate” degree for those who have failed to get into an allopathic school.
** Canada does allow US-trained DOs to get medical licenses but the process is long & onerous and DOs are limited in what geographic areas and specialties they’re allowed to practice.
There is some lingering prejudice against DOs in the medical community-- lack of familiarity is one reason, but another is that some osteopathic schools have notoriously poor clinical training. (For example, many DO programs have clinical rotations that are completely out-patient with zero or extremely limited in-hospital exposure in fields like pediatrics, family medicine, IM, psych and neurology. WIn contrast, when each of my MD Ds did psych, they spent at least half their time doing in-patient rotations with severely psychotic/delusional patients and half in out-patient settings. How is anyone supposed to know they want to be a X specialist when they’ve only seen a portion of the field?) Already as part of the AOA-ACGME merger a number of AOA residency programs have been closed since they failed or will fail to meet the stricter ACGME educational requirements.
Then there is the looming ACGME and AOA merger which will happen in 2020. After the merger, all residency positions whether they are sponsored by an allopathic program or an osteopathic program are open to all applicants. The current osteopathic-only residency/fellowship programs in competitive specialties like ortho, general surgery, neurosurgery, cardiology, REI, etc will be open to all comers. There is speculation that allopathic students with higher stats/more research & better clinical experience are going push DO students out of them. DO already has reputation as being for those who want to go into direct primary care (principally FM, psych, general IM, geriatrics) and it’s likely that the merger will only intensify that.
Lastly, there is the issue of exams. Osteopathic med students take the COMLEX; Allopathic students take the USMLE. In order to apply to allopathic residency programs, DO students have to take both sets of exams (which are similar, but cover different material and have different emphases.) The cost of taking 2 sets of exams–in time, effort and $$-- is not insignificant. DOs who want to do ACGME fellowships and subspecialize (like cardiology, infectious diseases, oncology, reproductive endocrinology & infertility, etc) MUST graduate from a ACGME (allopathic) accredited residency.
FWIW, the merger was shotgun marriage. The ACGME wanted the AOA’s residency sites. The AOA wanted their students/residents to be able to enter ACGME fellowships. Both the ACGME and AOA wanted to have greater lobbying power w/ the state and federal government and both wanted to push Caribbean students out of the dwindling number of hospital based 3rd & 4th year clinical rotation sites.
Probably because this forum is for pre-meds. There’s another forum for other healthcare careers.
Try: http://talk.qa.collegeconfidential.com/careers-medicine/
@WayOutWestMom Sorry! I usually browse latest posts and don’t notice the forum. :">
Among educated advisors, the obvious advice is DO over foreign but the Caribbean schools spend a lot of money on marketing and as above, there’s still a bias of MD over DO and so kids would rather go foreign so they can have the MD after their name.
Data:
In the 2016-17 application cycle, 20,836 unique individuals applied to US osteopathic programs. There are 6778 seats available. Admission rate: 32%
In the 2016-17 applications , 44,802 unique individuals applied to US allopathic programs. There are 18,762 seats available. Admission rate 41%
@wayoutwestmom How does that correlate with the lower GPA averages? Is it a less qualified applicant pool or are DO schools really looking extremely holistically or both?
All med schools–MD and DO – evaluate applicants holistically.
The lower average GPA/Mcat seem to correlate with a greater incidence of non-traditional students in DO schools together with a greater institutional risk tolerance for academic outliers. Also ACOMAS calculates both GPAs and sGPAs differently than AMCAS does. So there’s another area of difference, as is the consideration of graduate coursework by osteopathic schools when making admission decisions.
There are some (older) studies that showed that anyone who scores at least a 26 MCAT (equivalent to a 501-502 on the new scale) has a reasonably good chance (IIRC ~85%) of passing USMLE Step 1.
So anyone with a 501-502 MCAT (which is the average for DO matriculants), if admitted to med school, has reasonably good chance of passing STEP 1 and going on to graduate. So why do MD programs have higher MCAT scores and GPAs? Because they can. Because it’s a buyer’s market.
Note also that the drop out/fail out numbers (attrition rates) for DO programs are higher than those for MD programs. For US MD, 94% of students graduate within 5 years. (NOTE: the 6% not graduating include multiple degree students: MD/PhD, MD/MS, MD/JD, MD/MBA, MD/MPH who take longer complete their degrees. After 8 years, the graduation rate is 98%.) Hard data for US DO programs is difficult to come by but the graduation rate appears to be in the 88-94% range.
Right. The credentials needed to get the degree are far more arduous then the ability need to do the job. This is a bitter pill to swallow for many passionate dedicated kids who would make great physicians in a different system.
Medical education is a privilege not a right. There are far more qualified applicants for med school than there are slots to train them. There is an even bigger pool of people who want to become doctors but may lack (or maybe not) the academic horsepower to be successful.
Providing a medical education to a student costs the med school in excess of $150,000 per student per year. (That number comes from a 2005 economic study. I’m sure medical education costs more in today’s dollars.) Since it’s the med schools’s money, they have the right to select for the students they feel will most likely to be successful. High GPAs and high MCAT scores are pretty strong predictors for graduation/success.
Is it fair? No, but there are so many things in life that aren’t fair.
@wayoutwestmom Tone of voice is difficult to assess online, but you seem angry. I get the sense that you believe I am saying something that I don’t intend. I have not said, and I do not believe that anyone is owed a medical education. All I said is that it is frustrating for kids to be unable to access the training to perform a job they are capable of performing. Believe me, my family and I have been through enough in our lives that we all know life isn’t fair. DO seems to be a way in to the practice of medicine for kids whose grades and intellect predict success in medicine, but who can’t access training at an allopathic school. I assume it also weeds out the kids who only want the prestige of “MD” after their names.
I am surprised that I don’t hear more about it when people talk about the dismal statistics for entering med school. I do not mean to imply that any medical school should be bound to accept any particular student or class of students.
I remember when I was preparing to graduate from college in 1980 and some of my friends had applied to med school, the really, really smart ones went to allopathic medical schools and the ones who were just a little less so–as measured by GPA, etc.–went to osteopathic medical schools. Seems to still be true today…
I assure I am not angry.
Many careers that have high entry requirements. Medicine is one of them. Allopathic and osteopathic.
Because the odds for getting admitted to a DO school are just as bad as getting admitted to MD school?
(For the record, DO admissions have been subject the same stats creep that MD admissions have seen, Every year the stats of admitted students go up. And DO programs have eliminated a number of policies that made it easier for late bloomers and other student with academic blemishes to get accepted–such as the elimination of grade replacement in 2017. )
If you spend any time of this forum, you’ll see DO being mentioned to lower GPA/MCAT students as an alternative to MD by the experienced parents who have been through this process. (Including me!)
You’ll also see podiatry school, PA school, NP/APRN, AA/CRNA and other healthcare career pathways.
And that’s still way above the Caribbean
It definitely still is true and in my opinion, with the shifts in both DO and MD training over the last 35+ years towards each other, DO school is even more “2nd tier MD school” now than it was in 1980.
Some of it is pure math. There are roughly 4x as many MD students in the USA as DO. The reject pile for MD is as big as the entire DO applicant pool.
@iwannabe_Brown
I assume this is a positive for someone who just wants to practice medicine and not particularly interested in needing to be in a “top school?”
@gallentjill yeah, you could say that. My point was more that in 1980, you could claim to feel more aligned with osteopathy than allopathy and it would feel like a real statement. Today they are virtually indistinguishable. I guess by extension that means if you want to just do 100% clinical medicine (and especially primary care) going into DO school now is better than it was in 1980.
And anecdotally, my understanding is that in the past, Caribbean schools were actually considered to be better, but that’s definitely not the case anymore.
All that being said, even if someone doesn’t care about being at a top school, it’s better to go to MD than DO school.
Not really. Attending a MD school–even a low ranked one–gives students more opportunities than a DO program would. More opportunities to engage in scholarly research, a broader choice of specialty options and a greater access to a broader range of residency programs. (There are still a number of residency programs --even primary care ones-- that never or seldom rank DO grads for their programs. See: http://www.nrmp.org/wp-content/uploads/2016/09/NRMP-2016-Program-Director-Survey.pdf )
Plus MD students don’t need to spend hours and hours mastering OMM, which the majority of DOs never use in their practices anyway. Or take two sets of board exams.
As for wanting to practice clinical medicine–MD schools produce the vast bulk of clinical practitioners in the US. Even in primary care fields. Academic medicine is career trajectory for only very small number of MD grads.
@wayoutwestmom What do you suggest for a student who has the scores to be accepted by DO but not MD? Assuming that student still wants medicine as a career?
You go where you get accepted. That’s the first rule of applying for medical school.
However, IIRC, your child is still in high school. So this is all a moot point. Four or more years from now, she may have changed her mind about medical school. That happens with the vast majority of pre-med students–they find other careers that are more appealing than medicine.