m.d. or d.o?

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  • #29538
    brown_eyed_girlbrown_eyed_girl
    Participant

    how did you decide which direction to go in?

    #29539
    CassieCassie
    Participant

    I am still a pre-med, but I have never felt so certain about anything in my life. It is my understanding both M.D.’s and D.O.’s have the same medical education; however, D.O.’s have the advantage of malipulative medicine and they approach medicine from the perspective of patient care instead of disease treatment. There is also emphasis on maintaining a well body instead of waiting for disease to occur before problems are addressed. I think it is the person that makes a great physician and not the letters behind their name, but I would head for the school that most closely follows your own personal philosphy.

    #29540
    MelissaGrayMelissaGray
    Participant

    Good question, brown_eyed_girl!

    There are philosophical differences between MDs and DOs (as Cassie explained). While the subtle differences in philosophy exist in training, in practice physicians practice as they choose. Therefore, in their practices you’ll find DOs that *look* like MDs and MDs that *look* like DOs. DO schools also tend to emphasize primary care and rural medicine. As a result, a large percentage of DOs go into some area of primary care, although they are able to specialize in any area.

    The DOs also are have manipulation available as a treatment option.

    I chose to go DO because I prefer the philosophy & manipulation and my state’s DO school is a much better atmosphere than the MD school. (also, the MD school almost always automatically turns down mom-applicants 😮 …although I still wouldn’t have applied).

    #29541
    womansurgeonwomansurgeon
    Participant

    I want to be a little (a lot) careful here to try to avoid offending anyone.

    Osteopathic (DO) schools do tend to wind up with far more nontraditionals – to the detriment of allopathic (MD) schools in my opinion. I was certainly non-traditional, but had high enough grades and scores that MD schools looked at me anyway.

    Allopathic schools are associated with universities and receive state support to train their students. Consequently, your tuition is largely subsidized. My tuition at Ohio State was 9k per year, while the tuition at the DO school here in town is almost 30k per year.

    University affiliations mean large training hospitals with structured clinical rotations during your 3rd and 4th years. At the DO school (this one anyway – which I’m told is supposed to be one the better ones), the students have to SET UP THEIR OWN ROTATIONS. There aren’t nearly enough opportunities in town, so most students end up doing rural rotations in surrounding small towns, and even going out of state for some. Because it is so unstructured, their education becomes hit-or-miss: maybe you find a decent preceptor and actually learn something, maybe you don’t.

    In my surgery training program, we have MD students from the U rotate with us. Without exception (honestly – we’ve never had a bad one), they are bright, well read, understand the system, and function very autonomously from the start.

    We (the residents) have to rotate at the VA and the local charity hospital on occasion. In comparison with our main hospital campus, the care is so poor and the support facilities so inadequate that we often joke, “well, it LOOKS like a hospital”. Yet, these are the prize rotations for the local DO students – they vie for them. It’s the best they can get.

    The DO students that we work with in these hospitals are tremendously variable. No wonder – who knows what training they’ve had to that point, maybe just a few clinic rotations with local FPs. It may be their first time in a ‘real’ hosptital. Some have been good, but the majority are very, very weak. I’ve had a finishing fourth year student, getting ready to graduate and practice medicine, who DID NOT KNOW HOW TO DO A HISTORY AND PHYSICAL. Literally had never done one before. He was a smart guy, but his training had been inexcusably inadequate, through no fault of his own.

    Because of this fluctuation in student competency in the DO training system, our main hospital stopped hosting DO students for clinical rotations long ago. Now, if a staff or a resident sponsers a DO student – goes on the line and states that they have worked with you, and that can attest to your competency – then it’s possible to arrange. But here we have this 600+ bed tertiary care hospital right down the street from a medical school, refusing to participate in student training because they don’t want to accept the medicolegal liability of hosting poorly trained students.

    Many specialty residencies (surgery, OB/GYN, etc) rarely, or not all, will interview DOs. The choice of parallel osteopathic training programs is FAR more limited.

    To us, it seems as though this DO school is just ripping people off – charging EXORBITANT fees, and for what? Two years of classroom training – after that the students are on their own (although they are still paying full tuition!)

    Now, I know there are good DO schools – Oklahoma, Ohio and Michigan come to mind. These programs have their own affiliated hospitals.

    But look at what you’re getting when you apply. I think admission at an accredited allopathic school is a pretty solid guarantee of graduating with a baseline degree of skills and knowledge, and of having most doors open to you in terms of graduate level training. Osteopathic training seems much more of a crapshoot.

    Okay, those are my observations. I know there are other sides to the story – so lets talk about them!

    Womansurgeon

    #29542
    efex101efex101
    Participant

    I know that DO’s versus MD is for some a matter of the last two letters, but for me I am not even considering the DO route period. Not because I think that they are lesser of a doctor but because many many people do not know what a DO is or does. I have worked way to hard to eventually gain acceptance to a medical school to then have someone ask “now what is a DO?” I do not want to explain not even once what the letters behind my name stand for.

    #29543
    SpiritDoc2B_dup1SpiritDoc2B_dup1
    Participant

    Hi,

    Check out the US News and World Reports’ rankings of medical/osteopathic schools. In the primary care ranking, I think there are 2 or 3 Osteopathic schools that are in the top 50 or so of ALL schools of medicine. That being said, when was the last time you heard a story about a DO removing the wrong leg 😮 during a surgical procedure (no offense womansurgeon).

    In my own personal case, I think if I don’t get into the medical school where I’ll be doing graduate study, I would certainily consider a top notch Osteopathic school. As a child, I had the pleasure of having a DO as my pediatrician. Just like anything else, there are pros and cons to either choice in my opinion.

    #29544
    CassieCassie
    Participant

    Womansurgeon has pointed out how important it is to check out the quality of the school you plan to attend. I know the osteopathic school close to my home starts students taking medical histories in the first year and everyone takes the same, set clinical rotations in the third and forth year (with electives in the fourth year) like other allopathic schools. While it produces physicians in many diverse specialities, it does rank as the 39 top school for primary care. I have no doubt osteopathic and allopathic schools alike have the ability to turn out both excellent and inferior doctors. If you plan to go into a speciality outside of family medicine and you want to go to an osteopathic school, I would check out where previous students have done their residencies and in what specialities for the particular school you want to attend.

    #29545
    MelissaGrayMelissaGray
    Participant

    Originally posted by Cassie:
    Womansurgeon has pointed out how important it is to check out the quality of the school you plan to attend.

    Agreed! This is important when looking into any school!

    I’m discouraged when I hear of DO schools that put out incompetant (sp?) students. It certainly doesn’t help the DO image!! On the other hand, MD schools are not immune to doing the same thing…which leads back to the *check out the quality of the school* suggestion.

    #29546
    womansurgeonwomansurgeon
    Participant

    Cassie,

    You, and Melissa, are the voices of reason.

    You’re exactly right that both excellent and awful doctors come out of each training philosophy. Looking into your individual program carefully is good advice.

    MDs and DOs face different demons.

    MDs bear the predjudice of the public about being the traditional, cold hearted, unfeeling physician, interested only in the disease and not in the patient. This is despite great efforts on the part of allopathic programs to recruit diverse classes, to emphasize a humantistic and holistic approach, and to discourage that awful diefication of doctors which has been traditional. So while times-they-are-a-changin’, the sterotype is based somewhat on reality (I deal with those types of physicians nearly every day – mostly older and nearing retirement age).

    On the other hand, I think DOs bear the predjudices of the MEDICAL COMMUNITY with regards to inadequacies in education and training. Again, while osteopathic training has become more and more legitimate, there is some basis in fact here too, this program I’ve talked about being one example.

    Thus, graduating DOs may suffer due to the reputations of some colleagues. Two extremely bright students I know come to mind, one who would have been an orthopedic surgeon and the other an OB/GYN, but both experienced closed doors to graduate specialty training because of their DO training. Both are general practioners now.

    Melissa, you’ve embraced osteopathic philosophy and seem satisfied with the training, so it seems like a good fit. (Actually I know Oklahoma Osteopathic to be a very good school, so no worries…) But potential barriers on higher training might exist for you.

    On the other hand, I can list several examples of talented DO grads who specialized and subsequently have done very well in the mainstream medical community – so it’s possible to overcome the obstacles.

    Having said all that, if I had been accepted at an osteopathic school and didn’t have acceptance at a decent allopathic school, you bet your buttons I would be a DO right now. And if I wasn’t accepted there, I’d be a Foreign Medical Graduate, because I would have done whatever I needed to do to get my medical training and get my foot in the door. Then I would have worked my bum off to establish my reputation and get where I needed to be.

    I love being a doctor and never wanted to do anything else. I think that sounds like a lot of us.

    Cheers!

    #29547
    Brenda MayBrenda May
    Participant

    I was relieved to see that womansurgeon had added an additional response as her first one was VERY OFFENSIVE because it seemed as though she were making the generalization that all DO schools produce bad students. Those kinds of postings only propagate a continued discrimination against DO’s in the medical community and it seems that she was only referring to one school in particular. I recommend that we all stay away from making generalizations about MD or DO training and be specific when making comments.

    For every story about a bad DO experience, there are just as many (if not more by simple ratio of students) for MD’s. Ultimately, we need to make the choice based on what is the best school and best philosophy for the individual student.

    As for not wanting to explain “what does DO stand for?” The local cardiologist wear I live is a DO. Not one of the MD’s that I have worked with in the ER even needs to explain to patients what it means, they simply refer to him as the doctor.

    #29548
    efex101efex101
    Participant

    Brenda what I tried to say or imply was that many patients may not be aware of what DO stands for, not physicians themselves. Of course physicians know what a DO is, they are physicians just as an MD. That is my personal take on this issue, and well everyone has personal reasons for applying DO, or MD, or both. No one needs to get offended just because some of us *chose* not to apply DO. I believe that MD can also provide a more holistic approach and I have seen that in action at the Mayo Clinic, so going back and forth that MD’s do not treat the whole person is a mute point for me, I know that it can be done period.

    #29549
    GracieThreeGracieThree
    Participant

    Hmm… I just reread womansurgeons first post and thought she did a very good job of NOT making sweeping generalizations regarding DO training…. I think it would be unfair to NOT tell students considering DO training that there is a bias against that type of training within *some* medical communities. Better to go into any situation with all the facts, dastardly as they may be.

    I have to say, those students in womansurgeons’ program sound horribly ill-prepared for ANY residency, generalist or subspecialist! Jeesh. But that is absolutely not the educational standard elsewhere, because the DOs (attendings and residents) that practice at the university where I trained are VERY well thought of, and very very bright. I know two of them went to OK – after reading this forum now I know why, it sounds like a great program!

    Your education is largely dependent upon what you put into it, no matter where you go. I can think of a few students at this allopathic COM who are slackers, and they won’t be doing neurosurgery or derm with that attitude. Maybe I haven’t been beaten down enough by life yet, but I still think that hard work pays off. So if the DO philosophy appeals to you, good for you that you’ve found your niche and what you feel good in doing. And if it’s allopathic medicine, same thing goes.

    Best of luck to those of you starting med school in the next few weeks!! 🙂

    #29550
    MelissaGrayMelissaGray
    Participant

    Originally posted by womansurgeon:
    [b]
    Melissa, you’ve embraced osteopathic philosophy and seem satisfied with the training, so it seems like a good fit. (Actually I know Oklahoma Osteopathic to be a very good school, so no worries…) But potential barriers on higher training might exist for you.[/b]

    Fortunately, in my state there is no real barrier for DOs (I don’t intend to move away). The MD school in Tulsa actually holds residency spots for DOs. That’s in addition to the DO residencies in town. I can stay here and specialize in family practice, internal med, pediatrics, anesthesiology, diagnostic radiology, emergency medicine, general surgery, OB/GYN, orthopedic surgery, or otolaryngology/facial plastic surgery (all DO residencies). Or I can do these through the MD school: family practice, rural family practice, family practice/psychiatry, internal medicine, internal medicine/pediatrics, OB/GYN, pediatrics, psychiatry, or general surgery (and remember that they hold some spots for DOs). There also is a non-school affiliated family practice residency here.

    These are not including the residency opportunities in Oklahoma City (where one can complete a wider variety of specialties).

    I know that I can stay here and fulfill any specialty desire that I may have. Is that true everywhere? No…but I believe that things are getting better most everywhere.

    #29551
    ElisabethElisabeth
    Participant

    Hmm. I concede my ignorance, but it wasn’t until beginning the med-school application process that I had ever really considered DO programs. (I live in NC, where we have 4 awesome med-schools: Duke, UNC, Wake, ECU- but any osteo schools? I’d never heard of any.) But even the most cursory examination of the programs out there convinced me that the MD route was right for me. After reading this discussion, I am even more sure of that fact. What’s more, I appreciate that medicine is a big enough and broad enough field for different philosophies of care. I am glad that aspiring doctors (women especially) have both options available to them, but I won’t for one moment be persuaded that because I am “non-traditonal” (my age- 22- is fairly traditional, my status- as a single parent of a 5 year old, is not) that I have to settle for a program that I don’t feel is best suited for me, my plans, and my talents. Thank you all for the insight.

    #29552
    futr_babyDOcfutr_babyDOc
    Participant

    I definitely recommend that you research every school that you consider applying to. Remember, however, your medical education is as much YOUR responsibility as it is the responsibility of your institution.
    There are poor clinicians who come out of universities such as Johns Hopkins. There are also excellent clinicians who come out of the smallest medical schools you have never heard of.
    My husband and I attend New York College of Osteopathic Medicine (NYCOM). I can tell you that this Osteopathic Medical College has some of the best clinical affiliation in the country. There are 4 400+ bed major tertiary hopsitals that we can rotate throughout New York City. Good Samaritan Medical Center, St. Barnabas Hospital Bronx, NY, Maimonides Medical Center Brooklyn, NY, and Long Island Jewish Medical Center. This does not include the list of 17 clinical campuses and auxillary sites through which we can rotate including North Shore University Hospital which was ranked as the number 1 hospital in the nation for overall care according to the AARP magazine. All located right here in the city of NY.
    We also have Osteopathic residencies located at many of these large hospitals ranging from Dermatology (Saint Barnabas Medical Center) to Neurosurgery (Long Island Jewish Medical Center.
    As far as allopathic residency possibilities, we had 5 match into allopathic gen surge programs-4 cat, 1 prelim….we also had 1 allopathic GU, 1 allopathic Optho….not to mention 3 allo radiology, 4 allo EM….(information from last years match)
    I don’t mean to rant, but it can be done. Choose the school that best fits you personally. Do not discount an excellent DO education by listening to the words of a few misinformed students. Good luck to you, and I wish you the best in your decisions.

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