Friday, June 1, 2012

DO Discrimination

Because I am in PM&R, people often ask me if I am an MD or a DO. For the record, I am an MD. But I do have equal respect for DOs.

Before I went to med school, I actually didn't even know what a DO (Doctor of Osteopathy) was. According to Wikipedia (the source of all information on this planet):

Osteopathy and osteopathic medicine are terms often used interchangeably for the philosophy and system of alternative medical practice first proposed by A. T. Still MD in 1874. Its practitioners are known as osteopaths. It emphasizes the interrelationship between structure and function of the body and recognizes the body's ability to heal itself; it is the role of the osteopathic practitioner to facilitate that process.

You can't see me right now, but I'm making the little jerk off motion.

Do I think osteopathic medicine is a little bullshit? Uh, yeah. So do most DOs. Most of them will admit to you they think it's bullshit. On my peds rotation in med school, most of the residents were DOs, and I remember there was some patient who was having a pain issue, and the chief (a DO) joked, "Hey, maybe we should do an osteopathic manipulation on him?" And everybody laughed and laughed.

Let's face it, most of the people who go to DO school do it because they don't have the grades for an MD school.

That said, I think many DOs are fantastic doctors, perhaps because your abilities in organic chemistry don't actually predict what kind of doctor you'll be. In general, I've found DOs to have a great bedside manner. And in my field, I think they come to residency with better physical exam skills. Some of the best doctors I've known have been DOs.

Because of the strong physical component to PM&R, people will ask on SDN if they should get an MD or DO. The answer is, if you can, get an MD. Unfortunately, DO discrimination is rampant and will close a lot of doors for you. For example, my own mother refuses to see a DO, even though I tell her they're just as good as MDs.

I remember in my PGY4 year, I worked with a med student who was really amazing. She was the best student I had worked with. She was enthusiastic but not overly so, had a great personality, was intelligent and willing to learn, and she spent her weekend helping us work a race. I wrote an email to the program director telling him how fantastic she was in order to make sure she got ranked highly.

I think she ended up getting ranked third or fourth on our list. As a result, I got to witness a tantrum by an attending (who who worked with her and knew she was awesome), saying, "How could a DO be so high on the rank list?? I know she's good, but she's a DO!"

By writing this, I suppose I'm putting myself at risk for some wrathful comments from DOs. But if you read the entire post and not just react to a single sentence, you should realize that I have tremendous respect for DOs. And if you're in the field, I'm sure you know it can be an uphill battle. (The same could be said of my specialty, so I can certainly relate.)

114 comments:

  1. I'm guessing no one has woken up yet, hence the absence of comments !

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  2. Maybe everyone is so enraged that they require time to gather their thougths.

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  3. There are incompetent DO's. And incompetent MD's. And excellent DO's and excellent MD's.

    Like you said, the organic chemistry grades don't mean much. It's the person behind the degree that matters.

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    1. Very true. Yes, people who go to DO school probably got lower grades in their pre-med courses. Big deal, right? Who cares?

      I expect some people will get upset by this post, but only those who have a chip on their shoulder.

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    2. I am a nontrad pre-med who is more than likely going to be forced to go DO because I allowed my family to pressure me into going to college a long long time ago when I had neither the desire nor the maturity to do so. The results were not pretty. Since I have been back at school (a little more than half way towards my BS), my record has been outstanding but my GPA is dragged down about half a point because of what happened over 10 years ago. My pre-reqs have been all A's and B's (mostly A's). To go MD, it's going to not take my app at face value. So we will see.

      I also want to say that I really love both of your blogs and am a daily visitor!! Keep up the good work!

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    3. Sorry - "To go MD, it's going to *take an adcom* to not take my app at face value.

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  4. The DO degree stands for doctor of osteopathic medicine. DOs are not "osteopaths," that's an antiquated term officially denounced by the AOA and is not to be used for anyone who trained in the US at a COCA accredited school. Which you would know if you had bothered to do any research beyond a crappy Wikipedia article.

    I read your blog every day but I have to say, today I don't like you very much.

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    1. Here we go...

      Whenever I quote Wikipedia, I do it tongue-in-cheek. I think you realize a lot of things I said in this post are true. It may upset you, but as I said in the last paragraph "I have tremendous respect for DOs." I think DOs are good docs (at least, as much as MDs) and a lot of the things I said about "the uphill battle" were told to me by DOs.

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    2. Regardless of what your association wants to call them, I think they DOs are quite commonly called osteopaths.

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    3. I don't see a thing in that post to upset anyone. It's all accurate in my experiences, and respectful. It's not a crime to point out that prejudice exists (whether that prejudice is due to race, religion, gender, title, etc)... on the other hand, it is inappropriate to propagate that prejudice. I think what Fizzy was doing helped squash some of the prejudice, not encourage it.

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    4. Exactly. The DO discrimination is something that annoys me, and I think it benefits the field to have posts that explain that DOs are just like MDs and are good doctors. I certainly wasn't trying to bash DOs.

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    5. The AOA only decided to make the term "osteopath" antiquated because of all the osteopathic schools that opened up internationally. They wanted to distance themselves from those that went to an "osteopath" school and did not learn medicine. It was a completely understandable move from an international perspective, as the AOA is trying to get the DO degree accepted as the equivalent to the MD degree internationally.

      I still see osteopath used by a lot of the older DOs. Old habits die hard. Can't expect everyone to drop "osteopath" and use "osteopathic physician" when the AOA says so. It's not a derogatory term. I am a DO, and honestly, I'd rather be referred to as a "physician" than an "osteopath" or "osteopathic physician." I don't feel the need to differentiate myself just because of my degree. I don't feel like I am any different and neither do a lot of my colleagues. The vocal minority that feel they are so different are the ones that end up going the political route through the AOA and try to make that sentiment trickle-down.

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  5. ...if osteopathic physicians are now equivalent to MDs, even though 50 years ago they were viewed with extreme suspicion, then why not naturopathic or chiropractic physicians?

    I’ll tell you why not.

    The reason that DOs are now generally considered on par with MDs is because the way that osteopathic physicians (DOs) practice medicine, at least in the U.S., is usually indistinguishable from the way that MDs practice medicine. In essence, DOs became the equivalent of MDs by changing their education and practice to become like those of MDs. They now do the same residencies, are subject to the same standards and board certifications, and are licensed in the same way as MDs. In most osteopathic medical schools, osteopathy has been deemphasized to the point where it’s now, more than anything else, a historical vestige that continues to be taught more because of tradition than because of any continued enthusiasm for osteopathy. Indeed, very few DOs actually ever use it or practice it anymore once they graduate. Most, in fact, are rather embarrassed by these reminders of the chiropractor-like beliefs that used to be central to osteopathy.

    http://www.sciencebasedmedicine.org/index.php/defining-what-a-physician-is/#more-17702

    However, it appears that DO's in England and Europe are still trained similar to DC's. Where I live there a lot of DO's since one of the big State Universities (Michigan State) has both a MD and DO program. I believe they there are one of the rare ones that offer both. The hospital I did my nursing OB clinical in actually started at an osteopathic hospital, I think they still did manipulation on newborns.

    I have worked with both and as grumpy said, I have met both good and bad MD's and DO's.

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  6. Uh-oh. There you go, Fizzy. Think someone needs to read this post one more time..

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  7. Hey,

    So I'm going to be a first year DO student. My grades in undergrad were totally fine (only got a C+ in analytical chem), since I graduated with distinction from UNC with a major and 2 minors. Plenty of extracurriculars since I'm into sports. My MCAT was nothing special but I applied to ONLY DO schools because I thought it fit my personality better. I also thought it was cool that we could also match into MD programs so I figured I would have a better chance of where I wanted to go (planning on Path). Do you know any DO's who went just because they thought they would like it better? I don't really care much for OMM, but maybe it will help? I only know 2 DO's and one is chief of ER and the other is in sports med. Also being in a good location for medicine is important...Philly is apparently one of the mecca's of healthcare. Let me know what you think, thanks!

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    1. Hi!
      I'm a third year medical student, soon to be 4th year student at an osteopathic school and I love that I'm here. I have a friend who completed undergrad at UNC with stats identical to yours plus a great MCAT. He came for your same reasons and he's definitely happy with his decision. He also teaches MCAT prep classes. I can think of ten other classmates that would fall into your category off hand, one friend with an acceptance to UNC medical school and chose VCOM instead. While I have heard the stories of discrimination, after doing a year of clinicals patients have all been very interested to hear about my training. They also have loved the manipulation I've been able to provide them. Who wouldn't want the option of a quick back massage on their way out? You're guaranteed to feel better leaving then when you came in and if OMM can keep patients actually wanting to come to see me why wouldn't I want to know OMM? I had a patient request to make an appointment with me personally, that definitely doesn't happen when your a student ordinarily. Last week I had a patient with a major rib dysfunction. I put it back in place and his pain went away. If you have any inclination of going into primary care the DO degree is wonderful. I'm fully planning on incorporating lots of quick manipulation into my family practice. If you think it fits your personality better then it probably does. Also, the OMM sports medicine fellowships are really neat. I had a preceptor who did his sports med fellowship at VCOM and the OMM was another great tool in his medical toolbox. So take what you hear about the osteopathic physicians with a grain of salt. If you think you want to do something really specialized, I agree 100% that the DO degree is not the way to go. The hardest part about doing OMM is that it takes time. The peds residents that the author of this blog overheard probably have what, ten twenty minutes tops per kid? That doesn't leave much time for anything procedural. And since it takes time, it also takes patients money, all things that have to be balanced.

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    2. Thanks for your opinion! Yeah, I mean OMM can really only help. If I won't use it in practice I'm sure my teammates/friends would want me to use it on them! So many people asked me why I did not apply to UNC med...uhhh because I didn't want to? Although undergrad there is AMAZING

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    3. So, I totally just saw this, but I go to the same school at the person above. I think I know who they are talking about when they mention the UNC dude who teaches MCAT classes. Should also be noted that he got into many MD schools, including Penn State, and picked VCOM.

      I also picked a DO school because my mom is a DO, even though I got into MD schools.

      Not everyone goes to DO schools only because they couldn't get into MD schools, but I think my views are skewed because we gets LOTS of people from Virginia Tech who just wanted to stay on campus (and it happens to be a DO school). Maybe some of the smaller, more isolated DO schools are what people think of when they mention the lowers GPAs and MCATs.

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    4. Me too. I respect both MD and DO physicians, and I have had great experiences shadowing both. I applied to both MD and DO programs, but chose to pick DO over MD because I felt that the program was a better fit to the kind of person I am. The other school I got accepted to was a great MD school and the biggest/only MD school in my home state. Till date, I have no regrets for picking my current school. I liked the philosophy that is core to osteopathic teaching and felt that this school will make me the type of physician I wanted to become.

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  8. So I will be a first year DO this fall. I did fine in college: graduated with distinction at UNC with a major and 2 minors and plenty of extracurriculars. I only got 1 C+ in analytical chem. My MCAT was not awesome, just a little above average. Anyways, I was wondering if you knew any DO's who just preferred to go that route because it fit their personalities better?...becuz that's what I did lol insofar as I did not apply MD at all. I also thought it was cool that we would get into MD residencies as well. Locations is probably important too so hopefully being in Philly will benefit me. I only know 2 DO's and 1 is chief of ER and the other is in sports med so from my perspective 100% of the DO's I know specialized. I wanna get into Path I think but I was just wondering if MD's think its hard to match as DO's or if DO's also consistently think that. It was a nice interesting post! Luckily, I strive under pressure.

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    1. You'll probably get into Path just fine, but the MD route would require less learning-you won't use OMM in pathology. But you will use OMM on your friends and family

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  9. As a DO student, I will agree with most of your statements. There are good DOs and bad DOs, just like there are good MDs and bad MDs. You are, to some extent, right about students who apply to DO schools not having the grades for MD schools, as DO schools have lower average MCAT scores and GPAs. However, the reason I chose to attend a DO school had nothing to do with grades, as I did get in to the one MD school I applied to.

    When I visited DO schools (I interviewed at 5 of them), EVERYONE was friendly, and their emphasis was on how their school was going to help me become a good doctor. My conversations with fellow interviewees were about college, our hobbies, our lives, etc.

    The one MD school at which I interviewed was the opposite. All of their focus seemed to be on how much money they got for research, and how they were ranked #4 in the country for this and #5 for that. The other interviewees seemed to only want to talk about how many schools they'd applied to, and what their scores were, and how they really liked a school they'd visited but would choose one they didn't like as well because it was more prestigious.

    This experience was only based on one school, and perhaps it was an anomaly. The DO schools I visited seemed like a better place for me to get a medical education. Even though I had the grades to get into an MD school, I CHOSE a DO school.

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    1. You've hit on something important -- If your career aspirations are primarily patient care, then DO is completely fine. However if your primary goal is academics, then you need to be at a place with good research so that you can receive good mentorship (or at least mentorship from famous people who have been successful at getting lots of grants) so that you can get good training and letters that will get you the fellowship/academic position you desire. Not saying you can't do this with a DO, but for all the reasons Fizzy cited (plus mine), it seems to be easier to go this route from a big name MD school.

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    2. And I'm sure someone will come up with an exception who is a Nobel Prize laureate in medicine with a DO. That doesn't mean what we've said isn't true.

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    3. There are exceptions to every group. I am a DO and I also chose to go to a DO school because it was a better fit. There were a number of people in my class that could have gone anywhere with their MCAT and grades, but chose to go this specific DO school for one reason or another. A number of people who matched impressive MD residencies in my class, but they worked their butts off and got the numbers needed to do so. The competitive residency path was definitely harder having gone the DO route.

      As mentioned above, some people refuse to go to a DO because they don't think they will get the same care as going to an MD. On the other hand, I know people who refuse to go to an MD because they think they better care from a DO. It goes both ways.

      As far as research, you both hit the nail on the head. MD schools and the prestigious MD residencies are more focused on research. Most that go the DO route aren't the least bit interested in research and therefore there aren't many that end up in research. There are always exceptions to the rule, but I'd say that's a pretty safe generalization.

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    4. It's not just about academics. It's about the specialty you want or where you want to live. If you want to do a more competitive specialty or live in a competitive area, going to an osteopathic school WILL close doors for you. And you may think that you want to do primary care going into med school, then discover in your third year that you love ophthalmology and then you're in trouble. Not that you can't do ophtho as a DO (I know one who did), but it's much harder. (The one I knew had excellent grades but still had to interview as an intern.)

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    5. Not all DO's are in primary care. With the way that medicine is heading, there are more and more specialists. I'm a DO hospitalist and saw plenty of my colleagues and fellow residents choose competitive specialties, from Critical Care to Cardiology to GI to Hospice. There are several Ophtho programs that are DO programs throughout the country, so not all DO's do primary care. I chose to do primary care for lifestyle reasons, but not because I was not qualified to specialize. A good friend of mine from my med school class went into Pathology in Chicago, another in Neurology at Georgetown.

      Also, I live in Los Angeles and work at one of the most prominent HMOs in the area, so this whole not being able to live in a competitive area as a DO is complete bogus.

      No doors were closed for me just because I chose to go to a DO school.

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  10. I don't think it's fair to say MDs have higher GPAs/MCAT scores when you take into consideration the MD schools in the Carribean, yet no one questions them because of the two letters after their name.

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  11. What's your opinion on MD's from the Caribbean? Are they > than DO's?

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    1. I can't honestly say I know. I haven't worked with a lot of Caribbean MDs. Or at least, I didn't know I was working with them... which says something in itself, which is that if you get a DO, everyone knows it, whereas it takes research to find out if a doc was trained in the Caribbean.

      In terms of the quality of a doctor, I'd say that the most important thing is where they did their residency training rather than where they went to med school.

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  12. I'd rather have an MD from the Caribbean. No one questions them because they have a Medical Doctor (MD) degree (which gets less discrimination) and because you know they had to work their ass off a lot more just to get back to the U.S.

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    1. You might want to take a look at the match statistics and reconsider that. DO's have a greater chance at matching in an allopathic residency than do Caribbean MD students. No one who goes to the Caribbean does so because they want to be on the island, they do it because they were not able to get into any American MD school and were too proud to go DO.

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    2. I did check the statistics. And I have a lot of friends who went to the Caribbean and got their MDs there and now have US residencies...

      I wouldn't say being " too proud" is always the reason. DO's aren't internationally recognized, but MD's are. That's a good reason to go get an MD.

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    3. http://www.nrmp.org/data/resultsanddata2012.pdf
      Page 11, US citizens attending international medical schools have less than a 50% chance of matching, whereas DO graduates have a 75% chance of matching into an MD residency.

      And here, http://en.wikipedia.org/wiki/Doctor_of_Osteopathic_Medicine#International_practice_rights
      DO's ARE internationally recognized, with "unlimited" privileges in many countries. Several years ago, going to the Caribbean may have been a good plan, but with less than a 50% of getting a job at the end of graduation, it really is no longer wise... and this is not even mentioning the obscene amount of money it costs to attend a Caribbean school with a very low cap on the amount one can borrow in the Stafford loan program. And you still have to pay all that money back if you're in the 51% who don't get a job at graduation.

      If i were a residency program director at this time, I certainly would rather accept a DO student who worked hard and attended a medical school in their country rather than outsourcing themselves to the Caribbean for those two letters so "maybe one day" they could practice in Mozambique if they "wanted to".

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    4. I've actually heard that now is a horrible time for IMGs who want to match in US residencies.

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    5. 50% is mainly because half the people in the Caribbean med schools aren't good students, so half will fail out regardless. But 50% isn't bad.

      Seriously, most people even in the US won't know what a DO is. If people in the US won't know, imagine people outside the US...

      Also, great source, Wikipedia..

      Are you DO? If so, did you apply to MD schools? IF you did, I'd bet on it that you were shooting for MD but SETTLED for DO...that's what the majority of applicants do. Is it not?

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    6. Ha, that 50% is of the students who were competent enough to graduate, yes still did not get a residency. At $200,000+ for the degree, you'd have to be an idiot to take a heads or tails chance that your diploma may be a useless piece of paper. You make the same non-arguments as everyone I have ever known to consider going Caribbean, it doesn't make them logical.
      Yes (as if it wasn't obvious) I am a DO student. No, I did not apply to MD schools. Learning OMM to have as another treatment modality is something I value, and having personally benefited from receiving OMM as treatment, it is quite often useful and helpful. Maybe you need to see a DO yourself to understand. You can find one at virtually every US hospital: just go to the website and click "find a PHYSICIAN".
      And if Fizzy uses Wikipedia, so can I. There are citations there, do some research yourself, maybe you'll learn a bit.

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    7. Considering that when I was a registration person in the ED that at least 50% of the patients called me their doctor, I think that you put too much merit into the whole "people won't know what a DO is". The majority of the public could give a crap about the letters in front of your name, they just want you to fix them.

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    8. behind your name*

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    9. This is a mistake. DO > Caribbean in terms of ability to match.
      -MD med student who has respect for DOs, but recognize a stigma still exists so would rather have an MD

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  13. hi dr. fizzy, thanks for this post. i'm starting at a DO school next year, and your words actually made me feel a little better b/c you didn't try to sugarcoat things by saying 'oh yeah do discrimination isn't that bad' which i've been told many times but suspected wasn't the case. your candor is really appreciated, and while it's true that my premed grades did suck, it's good to know that those won't doom me to be a bad doctor.

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  14. I'm a DO Physiatrist. Scored 34 on my MCAT and got A and A+ grades at a well-respected undergraduate institution to earn a degree in Biochemistry. Later scored high (99 -- 2-digit score) on my USMLE step 1 and did very well on all the DO board exams.

    During college, my advisor told me DO school was for those with worse grades and test scores. I didn't know anything else about DOs. I later learned about osteopathic manipulation and wanted to start developing the skill during med school, so I chose the DO route.

    I met some brilliant classmates as well as a few who should never have been admitted. Most of these folks failed out, but a few squeaked through. The average test scores/GPA climb each year, although I believe it is easier to get into the newly established schools since they don't yet have the reputation to warrant being more selective.

    Osteopathic manipulation is a great adjunctive treatment for a subset of patients, although it does take extra time. It cured my thoracic outlet syndrome in 3-4 sessions when nothing else worked. I'm so grateful to the DO who took time to treat me and try to remember that during the busy days when I see someone who I think would benefit from manipulation.

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    1. Thank you for your respectful comment. I am happy to hear that you were effectively assisted by a DO. I hope you are still doing well.

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  15. As an organic chemistry lecturer I have never understood the emphasis on the organic chemistry grade by medical schools. I suppose though the requirement helps keep me employed. I heard an admissions guy at a DO school say that the organic grade is the 1st one he looks at when evaluating an applicant, so I don't know if DO schools necessarily emphasize different things in applications or if they have just slightly lower standards overall.

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    1. my guess is it's a tough course and shows what the student can do in a difficult course?

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    2. I recall my undergrad orgo prof saying that organic chemistry teaches problem solving skills that weeds out pre-meds.

      "Instead of memorizing the steps of a process can you propose a synthesis of molecule B from molecule A using proper reagents and conditions? And can you do that in 10 minutes, 10 times during an exam?"

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  16. As a DO student who is about to apply for residencies this year, it was only mentioned in one other post that as DO students, we are able to apply to both DO and MD residencies. So while it may close some doors to go to an osteopathic residency, you can still be an ENT or neurosurgeon if you choose.

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  17. Oh well, why not. One more comment from a DO student, lol.

    I think you're spot on with what you said, Fizzy. Discrimination is there. Grades generally are lower. But you also brought up a great point (uh...orgo doesn't = medicine). You also mentioned in your comments that it's the residency that matters most. I agree.

    If I had to split hairs with you I'd say that your "bullshit" reference is probably more directed towards OMM than Osteopathic Medicine. I mean that's basically the part that makes it "osteopathic." There are good parts of OMM and then there's cranial (lol).

    All in all, good no-nonsense, straight shooting post; I respect that.

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  18. I think there are some DOs who think that OMM is bullshit and that's fine. They were also probably the ones who went to DO school after getting rejected from MD and then blew off OMM in medical school, didn't practice it, and now don't use it because they didn't practice it enough in school.

    Other DOs really like OMM and use it with patients because they believe in it, have seen good results from it in the past, and are confident with their skills in it.

    Like the student above, I believe that to blanket the term "OMM" and call it bullshit or not is short-sighted. It depends on the TECHNIQUE being performed as well as the PRACTITIONER...can't emphasize that enough. OMM ain't easy, and not everyone can do it correctly.

    Also, the discrimination is slowly changing and I believe that one day it will no longer exist... as long as more and more docs think more like Fuzzy, and the anti-DO MD's and anti-MD DO's slowly die off... lol. But the only reason any doors as far as residency goes are closed to DO's is based mostly on prejudice of the program director or precedence.

    - Another DO student

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    1. Are you a DO?

      LOL, "Fuzzy"??

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    2. Someone linked to this post off SDN so a bunch of people came here who don't ordinarily read this blog.

      I think OMM may be similar to acupuncture in that it's a technique that may potentially be very effective, except that many people who do it are inadequately trained and not doing it correctly.

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  19. There's noticeable tension between the MD and DO crowds, which I think is rather detrimental to the education and training of physicians, and possibly for patients, too. What I have a difficult time wrapping my head around is that DO students can apply to and get into MD residencies, but, however, MD students cannot get into DO residencies because of the lack of Osteopathic Manipulative Medicine (OMM) training. As an MD student I can wholeheartedly respect the appropriate use of OMM if it means helping patients. I would absolutely be interested in learning OMM. But, I don't believe that having OMM training through DO education or not having OMM training through MD school should limit choices for further medical training or make it more difficult to pursue good training. We all work hard to become trained physicians through undergrad, med school, and life; we all make sacrifices; we all (hopefully) care about and for our patients; we all want the best opportunities for ourselves to become as well trained in a field of medicine.

    Since DO and MD physicians are essentially indistinguishable in terms of responsibilities and capabilities, why can't we just consolidate medical education and training into just one type doctorate degree and training? Doing so would diffuse discrimination toward either crowd and patients would just simply go see physicians, not have to think about DOs or MDs. If you want to train with Osteopathic Manipulative Medicine, then more power to you and that training can be an added credential with some more initials embroidered to your white coat. There is value in OMM, no doubt, but can it really justify a complete separation in this day and age?

    Historically, I can understand why there was a rift between the two fields, but as medicine advances with possibly a growing demand for medical care, all this bickering between MDs and DOs seem childish and antiquated in past egos and traditions. There are people fervently defending either side, but I see inadequate sharing, collaboration, and support. I think it boils down to would you rather be a fantastic physician or a fantastic MD or DO. I'd rather be a fantastic physician.

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    1. That's a good point. I think while there may be some valid uses, I'd wager the *vast* majority of DOs don't practice it enough to do it well. And are probably MDs who might be interested to learn OMM and don't get that opportunity. Considering I suspect OMM is just a small part of the training that DOs get, this seems very unreasonable. I feel like it would make more sense to consolidate the degrees and offer extra training in OMM for those who might be interested (an elective?). Also, I think the MD/DO distinction is most confusing for *patients*, since most doctors do know that they're both pretty much the same. I bet a lot of patients who might benefit from an osteopathic manipulation have no idea what a DO is or that they do this. (And truth be told, most of them don't do it.)

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    2. Fizzy, we get about 3 hours a week of OMM (1 hr lecture, 2 lab) so do with that what you will. I actually think it's a fantastic anatomy and MSK course, if nothing else. Plus, certain techniques (usually muscular ones) do actually work, and work well. I think it would serve MDs well to be open to taking a course in those techniques.

      However, I personally don't think it justifies an entirely different degree. It's the Old Guard who are preventing any type of "merger." I wouldn't be surprised if a merger happened in our lifetime after they retire.

      The differences between the degrees and training might have been drastic a hundred years ago but they've really come together since modern science became a large part of modern medicine so one degree, in my mind, is more appropriate.

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    3. The extra stuff is great for you, but the core of what DOs learn is the same. So it doesn't really make sense (in my opinion) for it to be an entirely different degree. Maybe schools should have an option to do the extra OMM stuff and have a second degree on top of the MD (like you can be an MD, DO). I'd hazard a guess though that if the OMM part were optional, a lot of the current DO students probably wouldn't bother. I suspect, for example, the DO cardiologist who works with me doesn't get much use out of his OMM training.

      In PM&R though, it would be a bonus.

      Delete
    4. I love this reply!!! As a wee undergrad, I chose the MD route because I had more contacts with MDs for shadowing. MDs were simply more accessible (to me). But there was also that bias, which drifted down from advisers and peers to my impressionable mind, that doing the DO route would be considered "settling." But it's not settling for less and no one should think that way about a career where a he/she is responsible for a patient's well-being. I'm more open-minded about it now, but that is how I remember feeling at the time because that was how I was told to feel.

      I ain't proud of it. Also, I love my DO ophthalmologist. She is so cute and funny (and also very good at her job).

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    5. I think having an AMA and an AOA-two different medical school/licensing governing bodies has its benefits (and its down sides) DO schools are growing, which should help with the projected primary care physician shortage and the already rural primary care physician shortage. 50% of my DO class will go into primary care. I'm pretty sure that the prestigious MD medical schools don't do this. Additionally, DO schools can pick students with poorer stats who are absolutely committed to going back to their rural hometown practice despite having a 22 on their MCAT. The valedictorian of small town USA doesn't have the education chances as the straight A not valedictorian rich businessmen's kid from Big City USA. However the small town kid, still has the intellectual capacity to be a great primary care/gen surgeon/etc in their hometown.

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    6. I am an MD and attended a residency in primary care populated with both MDs and DOs... and we were all educated through lecture in some of the more effective OMM maneuvers. I considered it really interesting, and I still use many of the techniques in my practice now.

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    7. Okay, I'm a little late with my response and no one will probably read it, but here it is. Some people have made mention of different licensing bodies for MD and DO. I know each state is different, but here in Mass, MD and DO are licensed exactly the same way, are accountable to the same Medical Board, and have to follow the same regulations, etc. I also know of several DOs who are board-certified through the ABMS in their chosen specialty, the same as MDs are. Without looking specifically for the initials after the name, no one would be the wiser. Tricia

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  20. Something else to throw out there... DO versus MD doesn't matter to me. Most of my doctor appointments are with a NP. (I'm talking about family medicine/internist). I think NP's are great for routine care.

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    1. "Routine care", you said it.

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    2. I think NPs are great too, but they are entirely different from MD/DOs.

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  21. I think there is some regionality involved in this too. I grew up near a very respected DO school and every doctor I ever saw was a DO and even some of the specialists my family saw occasionally were DOs. I shadowed a radiologist a few days ago who went to a DO school. They are awesome doctors and to be honest I didn't really know that there was a difference until I starting taking some interest in pre-med.

    That being said, I didn't even apply to this school, but instead chose to go to the MD school in the state. EVERYONE from back home (with the exception of people who are doctors or have children interested int he field) question why I didn't go to this school.
    Why didn't I apply?
    1. Even though this DO school is well regarded, the caliber of the MD schools that I applied to (and knew I would probably get into) was much much higher. (Not because its "MD", just because its all around a stronger program)
    2. Applying for medical school really sucks and I didn't want to have to go through an entirely separate application process. I'm serious.

    I should mention I've never had OMM performed on me and I think my doctor mentioned that he basically never used it.

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  22. oh i loved what Fizzy said in here. No sugarcoating. Just straight to the point. Oh yeah I'm a DO student. Personally I'm proud of my degree after my last name. Because it gives me a chance to practice medicine. It give me an chance to become a great doctor if I try hard. It doesn't define who I am.

    I think lots of people are missing a point. Dr.Fizzy said he has respects for D.Os right? It probably means that We D.O.s are doing something right in terms of physical examination training. i'm glad to hear that. haha

    M.D....D.O.... who cares? And who cares about the international recognition (unless academic research purposes)? Most economical-strong countries do NOT need U.S. doctors to come in and practice there. They already have a great medical program of their own. The countries in Africa won't care if you are MD or DO. They are looking for help from anyone w/ right mind and warm hearts.

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  23. My mother and I both see a DO for our GP. I have seen lots of MDs (including my psychiatrist of 20 years) and have left practices for generally poor patient handling including:

    - not informing me that I wasn't getting a standard tetanus booster but a Tdap shot until after I had received the injection. I had a reaction to it and was in bed for a week. Had they told me beforehand, I would have asked for a regular tetanus shot.

    - using a dirty syringe to get the wax out of my ear with a middle ear infection, which (according to an ENT) probably caused the concurrent outer ear infection that was MUCH more painful!

    - coming into the exam room and saying "boy are you FAT!" (I'm 5'8" and weighed about 205 at the time. I have also struggled with food and eating disorders my whole life).

    When I first went to see my DO, she clearly views medicine as a whole. She asked if this was a good weight for ME, and after tests said that even though I'm on the heavy side, all of my numbers are good so I'm at no extra risk for problems. She asked questions about my psych drugs but did think that it was best that my psychiatrist continue to handle them. Most importantly, she took the time to get to know me as a person and not just as a set of systems and parts, which makes a huge difference to me.

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    1. Years ago, I went to an ob/gyn practice, and the MD I saw there was so horrible, I cried after my visit ended. I was reassigned to a DO and she was absolutely lovely. Fantastic doctor.

      More recently, in a new ob/gyn practice, I saw a DO who spent the whole visit staring at her computer screen (I hate that). I was then reassigned to an MD who was just the sweetest woman ever.

      As Grumpy said above, there are a good DOs and bad DOs, just like there are good MDs and bad MDs.

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    2. Throw a Nurse Midwife into the mix, they are usually very patient friendly. They do women's health also.

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  24. Nail...hit on the head...as hard and as square as possible.

    I'm in D.O. school. Why? Couldn't get into MD. Got in on my 2nd cycle with a 3.3 GPA and a 37 MCAT. Just couldn't get the time of day from MD schools.

    Should've studies Sociology in ugrad instead of Biochem and I probably would've been good to go.

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  25. "Let's face it, most of the people who go to DO school do it because they don't have the grades for an MD school."


    You should probably clarify by saying US MD school. The admissions standards for Caribbean MD schools are a joke.

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    1. I agree entirely! The problem is pretty much everyone who doesn't know about this disparity is under the presumption that all MD schools are equal.
      My cousin was accepted to a Caribbean MD school after completing his undergrad. This school only 'required' a high school diploma for entrance. No MCAT, and at minimum a 2.0 GPA if you want to go from undergrad. And oh boy did he play it up as if he got into Harvard Med. Parties, prayer services for his education, and bragging parents. The problem is that 'everyday people' don't know the difference that he's taking the easy way out towards a degree, while I look like a failure getting rejected after my first time applying to Canadian MD schools.

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  26. As a medical student finishing his first year in a DO school, I must say that I totally agree with everything you have said in your post. I also think you were very respectful and informed. Thank you for that.

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  27. Thank you for this post Fizzy!! This is a controversial topic that definitely needs to be discussed and debated - for the sake of both MDs and DOs. I'm a current DO student to. I actually did well in O-chem and in undergrad in general (3.7, Bio Sci Major), but I didn't study as much for the MCAT and didn't do well on that. However, I do have friends that did well on both the MCAT and in undergrad and decided to go to DO school.

    From what I observe, you post is pretty dang accurate, but here's my attempt to explain the reasons behind the bias. The DO discrimination is a result of antiquated thinking from both the DO and MD world. Some old MDs still don't think DOs are equal to MDs regardless of how well they perform in the field, and a good amount old administrators in the DO world still believe that OMM is still the "next hot thing" and believe that DOs are "special." I find it absurd that some DO administrators still cling to antiquated, non-scientific theories - especially cranial OMM/craniosacral theory. However, this bias is starting to disappear - albeit slowly. MD residencies are starting to open doors to DOs (a residency director from a top MD program - not primary care - just visited my school to promote it's program). Also, DO schools are starting to emphasize evidence based medicine heavily, and some administrators are encouraging dually accredited (AOA/ACGME) residencies over pure AOA residencies. My old workplace - a top ACGME surgery program in the west coast - now has a number of DO anesthesiology and surgery residents (a recent trend). Hopefully, in the future, science will settle the OMM debate, the whole MD vs. DO debacle will disappear, the AOA will merge with the ACGME, and we can just practice medicine. (I recognize that this is extremely wishful thinking).

    If you want to go into a super competitive specialty, like ENT or Derm, getting accepted is nearly impossible (it's not impossible, but it's an excruciating uphill battle). However, it's not impossible. The chief resident of orthopedic surgery at Mayo Clinic (Minnesota) this past year was a DO. Yes, he worked his ass off for that position.

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  28. while i think it inappropriate to perpetuate the stereotypes that DOs are MD-wannabees and no one takes osteopathic manual medicine seriously, i appreciate your candor and recognition that discrimination is present and not a good thing.

    of course, i can speak from nothing but my own experience and opinions, and i must acknowledge the bias in these -- my exposure to the DO world (as an osteopathic med student) has occurred in a bubble of the west coast very wellness-conscious and open to various perspectives and modalities, and the demographics of my classmates reflect that, with a vast number having chosen DO over MD, or having selected this particular school because of its mandate to train primary care physicians. still, i know that that is not the case everywhere, and there definitely are classmates who simply could not get in elsewhere.

    as others have said, i think the best physicians are those with whom patients are able to develop the relationship they desire and will respect (whatever that looks like in various circumstances and specialties). which pair of letters follows the name is not so important.

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  29. So, I'll be honest and say I didn't read the other seventy something comments before me because I have a musculoskeletal midterm tomorrow that I can only procrastinate studying for another ten minutes or so.
    I just wanted to share my rainbow and unicorns premed stats to help fizzy squish the bias even further (you go fizzy!). I applied to MD and DO by the way, and was an alternate at 2 ivy league MD schools (was accepted to others). I chose DO not because of the extra class, but because of the awesome people that happened to be at the school I chose. Being in an Ivy league environment would be my sarcastic, laid back ass' hell.
    That being said, I graduated from undergrad with a 3.78 overall, a 3.6 science GPA and scored a 33 on the MCAT (not stellar in any area, but competitive, yes?)
    I went on to get my MPH with a 4.0 (both from a large state university)
    I also worked as a medical assistant in private practice for two years, shadowed for over 80 hours, volunteered at a local free homeless clinic, worked for a year as a research assistant in a cardiovascular genetics lab, and did a stint in an organic chemistry lab for a year. Oh and I was the PI on my own clinical study with 200 neonatal participants. I did other stuff too, but I forgot because it really doesn't matter... (it wasn't so bad all spaced out over 4 years).
    I'm not trying to make myself sound super awesome (which is why I will post this anonymously), because honestly I'm not, I'm the kid that sits in the back of the class and reads humerus blogs the day before a midterm.
    Just wanted to share that kiddos with good grades and MCATs choose DO schools, and some kids with good grades and MCATs don't get into DO schools either. We aren't the "MD wanna-bes" (okay, like 10% are, but not all of us).
    One definite perk to DO school- we can soft tissue rock your world and adjust each others backs/necks for free.
    Thanks for bringing up the issue, I want to be a neurosurgeon so I have some LARGE "boys club"/MD doors to knock down

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  30. To say we are the same is to say we don't have a reason to exist. The AOA can't have that now can they..?

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  31. There's a thread on SDN that is discussing this post (http://forums.studentdoctor.net/showthread.php?t=919141) and there's been some supportive and not-so-supportive comments there. I've been criticized for being passive aggressive here... not sure why and someone said I don't know what passive aggressive means, and that's probably true if this post is an example of passive aggressive because I can't conceive of how.

    Other things that were questioned is the suspicious "timing" of the post (???????). And it was pointed out that this is a "dead" or "old" issue, although that doesn't explain how it attracted 70 comments.

    Also criticized was my use of the word "rampant" to describe DO discrimination. Maybe that's the wrong choice of words but maybe not. There certainly is discrimination out there against DOs, but if you're going into a primary care path, you may not notice it or care. But if you change your mind and want something different (I have firsthand experience with this), you may start to experience the discrimination firsthand. For example, I know until recently, DOs were barred from doing neurology fellowships. What a kick in the teeth, right? Very unfair, but this is an example of how the discrimination still exists. An MD school gives you more and easier options.

    And to say that patients don't know the difference.... well, that's a matter of debate. Some patients just parse all men as doctors and all women as nurses, so who cares what degree you have? But I certainly know of individuals who look up all their providers on the internet prior to a visit and they do care about stupid things like that.

    I'm not going to fight on SDN, but suffice to say, I stand by my post.

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    1. Good post, but I want to clarify something. As far as I know, DOs ARE ALLOWED in Neurology fellowships, as long as they attend an ACGME internship and residency. If they go through an AOA internship, DOs can't attend an ACGME fellowship. This isn't a knock against you personally Fizzy. I just didn't want anybody out there - especially aspiring DO Neurologists - to have the wrong idea about DOs in Neurology.

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  32. DO or MD, it's all about what you make of your time.

    Thanks for writing about this, I'm tired of explaining to people that DOs can do all the same things as MDs.

    "You mean you can do surgeries?"
    "Yes"
    "And you can specialize?"
    "Yes"
    "I thought you could only do Family medicine"
    "No"

    I'm a DO student getting ready to take both the COMLEX and USMLE (to keep my options open, roll eyes). That's the other fun DO student doctors get: we not only have to take our board (COMLEX), but to be strong candidates we need to take the MD (USMLE) one as well if we want to get into a competitive field. And the two tests are as different as can be. Not one being easier; they aren't. The focuses are just totally opposite.

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  33. I think it is good that someone is addressing this issue, and I appreciate the positive remarks. I do think you are generalizing though. You are essentially saying that all DOs went into the field because they could not get into an allopathic school, but most of them turned out OK anyway. That is a bit offensive. You are also downplaying the philosophy of osteopathic medicine, which I don't think you completely understand. It is not all about manipulation. Manipulation is beneficial in some situations as an adjunct to other treatments. The emphasis of osteopathic medical training is on prevention and overall physical and psychological wellness- which may include proper body mechanics- so that the body can heal itself. This combined with appropriate medical treatment can optimize health. This is not an obscure idea, and most MDs I know agree with it. Some of my physicians growing up were DOs so I did not realize this was an issue until I finished medical school. It has been pretty annoying dealing with the DO/MD issue but I am very sub-specialized right now- I don't think choosing osteopathic medicine has hurt me. Like anything, success in medicine depends on the individual.

    To Heather- I also took both tests. The COMLEX was harder because it was longer and I did better on the USMLE. I wish I had not taken both. I don't think it made a bit of difference and was a waste of money.

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  34. Thanks for this post. I agree with everything you said. I applied late in the application cycle, I was geographically limited, but I think my grades and MCAT score would have gotten me in an MD school if I applied earlier and more widely. There was a DO school 20 minutes from my house.

    I didn't match, even with a 99 on my Step 2 USMLE. I strongly suspect being a DO had no small part in this. I will be applying for MD residency again, because there are no DO o/gyn residencies anywhere near where I need to live. Not by several states.

    I personally think it is time to merge the two tracts into one.

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  35. It is not entirely true that students choose the DO route because they did not have the grades to attend an MD college. I know people who got into great MD schools but decided to go for the DO route because they found that it matches their thinking. Personally, I plan on going the DO route because my role model(whom I worship) is a DO and not because I can't get into a MD university.

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  36. I know this is old, but I live in Philly and it seems that at my hospital we have an equal mix of MDs and DOs. I was in a serious trauma and my Pain Doc is an MD and I love him because of his approach. On the other hand, my OB is a DO and she delivered my daughter and she is the most amazing OB I have ever seen, she even let me labor for over 48 hours without pushing me into a c section (pretty much unheard of) and even though I had the epi she did help with manipulation throughout labor. I think it really doesn't matter in the end as long as they are competent and fit your needs.

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  37. "Do I think osteopathic medicine is a little bullshit? Uh, yeah."

    A little arrogant, especially since you really don't know anything about it.

    "So do most DOs. Most of them will admit to you they think it's bullshit."

    Nope.

    "On my peds rotation in med school, most of the residents were DOs, and I remember there was some patient who was having a pain issue, and the chief (a DO) joked, "Hey, maybe we should do an osteopathic manipulation on him?" And everybody laughed and laughed."

    Yes. We have a sense of humor about ourselves, unlike some MDs. We ALL had that one or two OMM professor(s) who acted like we were going to cure cancer with OMM. THAT is why we laugh and laugh. And we have stupid OMM questions on COMLEX (DO boards), which I wish would go away so we could just take USMLE, which is what we are taught toward. But we have also ALL seen it work in appropriate circumstances. Just like you aren't going to cure cancer with an antibiotic, but you will most likely effectively treat an infection with an appropriate antibiotic. Also, our dopey associations come up with things that make our eyes roll, like doing an osteopathic structural exam (that depends on feedback from the patient as well as cooperation) on EVERY patient, including obtunded/uncooperative ones, or ones we would NEVER do OMM on. That's like doing a funduscopic exam on everyone. So yeah, we make fun of THAT. Then we usually put some BS like: increased lordosis, increased kyphosis, no scoliosis, no tenderness, no abnormal range of motion, no tissue texture changes. Sound familiar? Stuff that goes under musculoskeletal exam findings! Except you wouldn't do an in depth MS exam on just everyone. Hence we laugh because we wouldn't do a funduscopic exam on everyone either.

    The other problem is, OMM is time consuming. That's why we usually refer such patients to an OMM/NMM specialist, unless we can do it fast with one of the faster, usually HVLA (popping, similar to chiropractic, although not as violently) techniques. We are NOT going to do such techniques on anyone under the age of about 10, give or take depending on physical maturity. If we're in a hospital without an OMM specialist on staff, then whatcha gonna do?

    But OMM is useful beyond treatment. It is sometimes an effective diagnostic tool. I doubt many DOs realize that they are doing things slightly different than you guys, since that's the only way they have known. That said, I'm not knocking you guys. We both use the skills we have effectively and achieve the same results usually.

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  38. "Let's face it, most of the people who go to DO school do it because they don't have the grades for an MD school."

    Nope. This is one of those VERY antiquated beliefs out there, and YOU are helping to perpetuate it. All the "I think DOs are good doctors" doesn't make up for you perpetuating a myth. Sure, this was true decades ago when a DO couldn't get a medical license. Why would someone who could get a medical license go a route that wouldn't get them one? But when the majority of states began licensing DOs, that tipped the scales toward ending this little bit of trivial history.

    "That said, I think many DOs are fantastic doctors, perhaps because your abilities in organic chemistry don't actually predict what kind of doctor you'll be. In general, I've found DOs to have a great bedside manner. And in my field, I think they come to residency with better physical exam skills. Some of the best doctors I've known have been DOs."

    Yeah, as a student, and now as a DO, MDs have been good to me for the most part, and many DOs have been jerks to me. Through my interactions with MDs as attendings, I have noticed that the difference between an MD and a DO is that MDs know osteopathy, they just don't realize it. You guys know the anatomy, physiology, and the principles, it just isn't brought to your attention in a systematic way. When it is, you guys catch on FAST. That is, when you don't have a chip on your shoulder like you seem to have a bit of. And believe me, being as skeptical as a person can be, I can appreciate skepticism, except when it's selective skepticism.

    One of my best OMM professors in med school was an MD. I've talked to MDs about OMM and the more experienced they are, the more they realize that it is useful. In fact, I had one who said, "You know, when my neck has a kink in it, and it isn't moving right, I find one of my DO colleagues." Unfortunately, much of the discrimination these days is by DOs discriminating against MDs. We don't let you into our residencies or fellowships because we (well, not me) deem OMM to be above your heads. If you do go through OMM training and certification, we let you practice it, but we don't let you hold official positions beyond professor in our organizations or our schools' OMM departments. We (again, not me) often turn our noses up at you when you do something foolish, as though we couldn't make a mistake too. In a few states, such as the one in which I reside, we refuse to join your medical licensing board. Even though you welcome us and would like to collaborate, we refuse, instead insisting on being separate. This brings a little backlash on us, too, unfortunately.

    Oh, and the sensitivity about osteopath/doctor of osteopathy vs osteopathic physician/doctor of osteopathic medicine also stems from all the idiots that distinguish us from you guys by calling us osteopathic doctors or physicians, and you guys medical doctors or physicians. We're BOTH medical doctors. Even some state licensing boards such as in my home state of Missouri are that dopey. It makes us sound like chiropractors, who are always trying to grab the physician title with none of the physician training. BTW, chiropractors stole their "art" from osteopathy.

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    1. "It makes us sound like chiropractors, who are always trying to grab the physician title with none of the physician training. BTW, chiropractors stole their "art" from osteopathy".

      I loved your post until this last sentence. Your whole reply was about how Fizzy shouldn't make broad, sweeping statements against a profession she doesn't know that much about (as in the training). So why would you just do the same thing yourself about chiropractors?

      I am both an DC and a DO, and that last sentence is complete BS. Chiro school was every bit as hard as DO school (actually for me I thought it was harder because it was what I learned first, the majority of my DO classes were repeats of classes I had in DC school). So they do have SOME of the physician training. No chiros don't have to do residencies, so that is not comparable. However it is still a doctorate level degree in a specialized area of training, no different than becoming a dentist or an optometrist. Manipulation of any form is an "art", DO's who perform OMM routinely will say that too. Both philosophies are very similiar, they were both developed in the same part of the country at around the same time. Honestly I believe AT Still and DD Palmer probably trained and learned from each other. And I can promise you, since I have been through both DC and DO school, that the manipulations are pretty much the same. The two professions should support each other, since they are both promoting the same philosophy, not argue over who created it.

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    2. Just ran into this thread again, and hadn't seen your reply. First, I have to say LOL! You're pretty offended by facts.

      Second, in response to this: "Honestly I believe AT Still and DD Palmer probably trained and learned from each other."

      I have to laugh even harder. I guess you didn't know? Palmer was a snake oil salesman and an opportunist who happened to be a patient of Dr Still. Later, he somehow magically "discovered" manipulation.

      I have known a few DC to DO docs over the years. None of them would agree with your defensive response.

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  39. Yes, you've obviously shown that you respect our profession by calling it "a little bit bullshit," and reminiscing on the great old time when your department laughed about performing a totally plausible pain treatment on a pediatric patient. There is nothing funny about people like you whose crass rhetoric and condescending tone make it that much more difficult for us to feel fully accepted in our profession. Some of us became DOs because we understand the depth of their connection to the patient, their ability to use their hands and contact to treat pain (look at the research!), and their vision to treat multiple aspects of the body at once. I hope you attempt not to post such senseless comments in the future.

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    1. Instead of pointing the finger at me, point it at the vast majority of your colleagues, who don't ever practice OMM and likely don't even know how to do it anymore. It was a group of DOs who laughed at the idea of performing the OMM, not me. It's your own kind that's betraying you. If you guys don't respect your own practices, how do you expect others to?

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  40. I like this blog, it's funny, sarcastic, and a whole lot of fun :) Keep doing what you are doing. I can't believe that this post was so visible it was discussed on the SDN. I guess students like flame wars, I'm no exception.

    For disclosure purposes, I was admitted to UNE College of Osteopathic Medicine (fall 2013). I agree with some of your comments, disagree with others. Either way, you've heard them all.

    I'll keep checking in for new posts as they come. Please visit my website, if you have time and comment.

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  41. I know this was from a while ago, but I'm so glad you brought this up. Personally, I love DOs. I've always had the best luck with them as doctors maybe because they are often discriminated against so they don't have the chance to stick their heads up their asses like some MDs do (sorry). It's silly that people really think that your ability to handle a few select courses in undergrad at 18 dictates if you can heal people at 30. I've met some MDs who were brilliant and great at putting on a show for interviewers and higher ups but down right cruel with nurses, staff and patients. MD in too many ways is still the ol' boys school. I hope DOs will grow in popularity soon so they can give them a run for their money.

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  42. Thomas Sullivan Magnum IV, D.O., M.B.A., D.D.S., PharmD, D.P.T., P.A., J.D., M.B.A., B.A.February 28, 2013 at 7:43 AM

    "Let's face it, most of the people who go to DO school do it because they don't have the grades for an MD school."

    DAMN YOU! why don't you try sticking your head up your ass, and see if it fits

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  43. I heard a radio commercial this week for Ross University, a Caribbean medical school which issues MD degrees and is owned as a subsidiary of the DeVry Institute, no kidding. I found that very telling. What serious, high caliber academic environment solicits applications on KHOT FM? Maybe the private loan companies split the cost of the ads with DeVry.

    So I agree, as an MD I hold DOs in much higher regard than these type of "foreign School" graduates. But the only people I knew who became DOs did so after being rejected from the MD schools (such as my lab partner in physics, who squeaked out a C where I made an A...he is not an idiot, but he was just not as good as student as me. Inherent academic talent or study skills, who knows? But today he is a DO emergency room doctor and is very good at his job, so does it really matter?)

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  44. The correct name for a D.O. is Doctor of Osteopathic Medicine, not Doctor of Osteopathy. Just saying.

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  45. It is time for the damn DOs to change their inititials to MD, DO already. The DO degree is archaic & this AT Still, MD guy would want this change now in this modern area.
    - from a patient who sees an MD, a DO, & a DNP. (honestly, I get confused when I see the DO & DNP now. If I saw the MD behind this DO,s name, though, I wouldn't anymore!) :-(

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    1. DNP, doctor of nursing practice. I am a registered nurse and do not think a DNP should be on the same level as an MD/DO. DNP has no major science requirements. After taking Physics and Organic and all the other required courses for med school a DNP should not be on the same level as a MD/DO. They have not earned the privileges that come along with the title physician.

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  46. Being a DO ophthalmologist is even more trouble- I am asked repeatedly why I, as an optometrist (OD), I can do surgery. The explanation about what a DO is takes about 3 minutes as the patient (or more often, their family) stares suspiciously at my degree on the wall. Unfortunately, the degree does not use the word "doctor". The degree says Diplomate of Osteopathy. I went to the mothership... eh... mother school of osteopathy, Kirksville. If only California were again letting us pay to change a DO to an MD degree... saving 3 minutes per patient encounter is worth it, even if I only have to do this 10 times a day.
    What is also scary to me is the number that think I'm an optometrist and were still okay with me performing major eye surgery on them. I've had too many optometrists ask questions that showed blatant lack of understanding of basic concepts in glaucoma even as they talk about certifying to treat it. And then there's the patient that almost died due to their optometrist's eyedrop prescription (which was written under the absentee vigilance of their "supervising" MD)because they didn't realize that eyedrops have systemic effects and timolol Q1 hour really can cause a fatal degree of bradycardia.

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  47. I'm a pre-med student applying for med school. I'm hoping that I get into a U.S. MD med school or Carribean med school. If not, my backup plan is applying to DO schools as well to make sure I get into med school.
    My hope is that if I do get into a DO med school, that the Old Guard of stubborn stawart old fary DOs will retire from the AOA board & the new modern DOs rising will take over the AOA board & change the damn poor DO degree to a prestigious MD, DO or MD title. Keeping my fingers crossed.

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  48. Good idea...Go to a Caribbean medical school over a US one. Getting a Caribbean MD is going to serve you better in both board prep and residency options over having a US DO degree. I would like to hear you expert opinion in 4 years.

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  49. Excellent post, Fizzy. I have a lot of respect for you, after seeing your posts on this blog. You can't see me right now, but I'm making the little jerk off motion.

    I guess if I had to pick my favorite part of your post, it would be the part where you tell us all that you have so much respect for DOs. I mean, let's face it, you said you respect the profession multiple times, so it must be true.

    That said, you're a little more transparent than you would like to think. Could it have been the part where you said you think osteopathic medicine is a little bullshit? Uh, yeah.

    I remember in my PGY4 year, I worked with a medical student who was really amazing. I mean, really, he was the best medical student anyone had ever seen. If I had to give him a title, it would have to be 'God's Gift to Medicine'.

    I think he ended up being another self-righteous ego-maniac who couldn't restrain his own insecurities long enough to withhold making a blog on the internet to give himself a sense of accomplishment.

    By writing this, I suppose I'm putting myself at risk for seeming like I'm calling you out on your bullshit.

    But if you read my entire post, you should realize that I have a tremendous amount of respect for you, because somewhere in there I said that I did. I mean, everyone has to get along with that socially inept elitist in their workplace, right?

    I'm sure you can relate.

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  50. *blinks*
    Hi, newcomer to reading this blog. I do not actually get the American system though... Personally, I think we should remember doctors are doctors no matter if they are MD, DO or MBBS. But I guess you don't get as many MBBS's over the pond do you?
    Opinions?

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  51. Like on last comment.
    A quote from CuriousCarib: 03-07-2013, 03:35 PM
    http://forums.studentdoctor.net/archive/index.php/t-986229.html

    I don't understand this.

    I have a 245-250 on Step I, a 255-260 on Step II, and happen to go to a Caribbean school. I applied to almost 100 programs and received only 9 interviews. I have good letters, research, no red flags, etc.

    And I'm not alone. I know a handful of people, all with >240s on their Step I and >250s on their Step II who are in the same boat with between 7-13 interviews on ~100 applications each.

    How on earth is it possible that you and your friends, as DO applicants, are faring that much better? Neither of our groups are composed of US allopathic grads, and it would stand to reason that's the only real differentiating factor in our applications as independent applicants. It makes little sense to me. Any insight from someone who has actually been a part of the selection process would be welcome.

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  52. Old post is old, but I thought I'd weigh in.

    There is certainly a prevailing attitude of OMM being bullshit. I certainly see it in my classmates and even my professors. I think these are largely the students and doctors who, as you point out, wanted to go to an MD school but couldn't get in.

    There is still a sizable contingent, however, of students and docs who are passionate about the hands-on medicine. There are so many patients with problems (pain or otherwise) that are unresponsive to conventional medicine. OMM offers a tool that may be beneficial for many of these patients, and I really wish there were more DOs graduating who practiced it.

    They say that when you're a hammer, the whole world looks like nails. That's the problem I have with naturopaths, chiropractors, etc., and even allopaths to a degree: everyone's problem is that they need manipulation, or nutrition, or a pill. I think being a real, well-rounded DO means having a hammer, a screwdriver, a wrench and a saw, and knowing who's going to respond well to what. I really hope that breed of doc makes a comeback.

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  53. So, you just proved that stats/application to get into med have little correlation to whether or not you will be a good physician. In essence there is no difference between MDs and DOs. But, DOs have to put in more hours studying an art they most likely won't use and work harder to get a fraction of respect an MD doesn't really deserve.

    A better post might be to look into why a few DOs back in the 80s tarnished the DO name for all of them and how the AMA assisted in doing it.

    Then maybe, you can side be compare the atrocities MDs have done to the public at large and compare that to crimes DOs have done to the public at large, adjust for numbers and see who the real monster is. I'm sure you'll be proud of your MD degree after that.

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  54. I went to a DO for several years as my primary doctor. He was alright until he nearly killed me by essentially hiding the results of an CT scan, telling me to wait one year and have the test redone, and dismissing my concerns. Of course, I didn't take no for an answer, got the hard copy of the results, saw immediately that something was very wrong with me, and went to a nephrologist MD who steered me to some great surgeon MDs. I will never forget sitting in my car outside the DO's office with my hands shaking as I read the CT scan results that he did not deem important enough to share with me until I insisted upon it.

    I ended up having a nephrectomy because of a rare and large renal arterial aneurysm and AVM.

    Let me just say that you couldn't get me near another DO if you paid me one million dollars every time I had to go to his or her office. The confidence is not there. Believe me, I have been to MDs who should never have been allowed into the profession but the letters DO will always carry an immediate stigma, at least for me.

    Anonymous in AZ

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    Replies
    1. Another simple mind, drawing conclusions with broad strokes. Tell me how do you take a sample size of one and apply it to an entire population of physicians?

      Sorry, for your loss. But, you are still an ignoramus.

      Delete
    2. Was that doctor Caucasian? Asian? African American? Near-Eastern? Latino? If they they were White, then maybe you should never see another White doctor again...seems to be consistent with your logic.

      There are awful doctors, whether MD or DO--just do a google search.

      Delete
  55. Just to counter the anecdote above...

    My freshman year of college, my roommate took me to the ER because I passed out after having severe stomach pains. The MD I saw thought I was drug-seeking and dismissed me right away (without doing any tests other than palpitation to see if it was appendicitis). I then went to my school's health center and saw a DO who saved my life. She listened to me, did the necessary tests, and found that I had a GI bleed.

    To reiterate: There are good MDs and bad MDs, and good DOs and bad DOs.

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  56. This is all nonsense...only 1st & 2nd year medical students and lay people worry about the medical school you attended. If a physician has attended medical school in the USA, the same curriculum/education was imbued upon the student, regardless of allopathic (MD) or osteopathic (DO) concentration. Slight changes in preceptorship schedules and the optional OMM are prevalent, of course... but these are just as prominently independent within their own respective MD or DO subgroups, as these small things vary from school to school, creating this supposed aura of "uniqueness."

    Residency Matters! Short and simple!

    For all the non-physicians out there, Residency, officially known as GME (Graduate Medical Education) is the single most important piece of information you need to make an informed decision about your physician's capabilities; it is also one of the litmus tests, we physicians, use to evaluate one-another.

    I'm a DO who graduated from PCOM. I loved my school and was more than adequately prepared. I'm a 2nd year resident at Johns Hopkins, in the Emergency Medicine program - undoubtedly the best in the nation. Yes, it's an allopathic institutions. GASP! And no, I'm not an anomaly...countless residents past and present, are DO's who've practiced and studied alongside their MD counterparts at this school and many top institutions like it. For God's sake, we take the same licensing boards,(USMLE) ... they literally are the same tests!

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  57. Yeah... Pretty much everything the last guy said... I'm a first year DO. Had a 32 MCAT and a 3.93 sGPA, but my prerequisites were lacking, and I had next to zero clinical experience. I worked 40-50 hours a week at a restaurant for 8 years (I'm 30), so there wasn't much time. I have two undergraduate degrees (Music, Biochemistry), and started on a masters in organic chemistry when I decided to go to medical school. I know plenty of people with lower scores who were accepted to MD schools. Most had followed a doctor for 4 or 5 months, so their overall package was more attractive. The point. Its inaccurate to say, in an absolute way, that DOs have lower grades.

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  58. what you said is absolutely right. I think the bottom line is that it really depends on what kind of doctor you want to be come. When I started doing pre-med in college, I aimed for M.D grating schools only because I did not know there were D.O schools as well. But I always believe that the illness people may come to have is also related to other things in their life and it's better for the doctors to get to know those things than not. So personally I prefer the DO philosophy than MD. but they are both excellent degrees, and as for now the society recognize MD more.

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  59. I am a current DO student and chose to go this route over the MD (I was accepted to both DO and MD schools). I think it's a little ignorant to suggest that people who chose to go the DO route have lower pre-med grades. My GPA was well over a 3.85. My MCAT score was in the high 30's. I find that a lot of my classmates have similar stats... Clearly my stats were good enough to get offers of admission from MD schools, so your argument is flawed.

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  60. I'm late to the conversation, but also wanted to chime in. I am a third year DO student and as many others in this thread have written, I too chose osteopathic medical school over allopathic.

    I was accepted into both, but the OMM and holistic philosophy of osteopathic medicine drew me in. Just to dispel any myths that DO students go to DO school because they "don't have the grades" to go to MD school, I'd like to also share that my MCAT was a 33, and undergrad GPA was a 3.99. I did years of research, tutored organic chemistry and physics, had many extracurriculars, and lots of shadowing hours. My USMLE is a 259. COMLEX is a 715.

    I will admit that there are students in my class that very openly admit that the only reason they cam to DO school was because they couldn't make it into MD school. But I've also found that the students with that attitude and bias are the ones that think "osteopathic medicine is a little bullshit." They don't bother to learn it and they half-ass all the OMM labs. I think the stronger students in my class are the ones who came to DO school because they want to be a DO. My classmates who wanted to be MD's are the ones that have a bit of an attitude problem, and I'm confident they will be the DO's that give OMM a bad name. I'm sure they'll succeed in their respective specialties, but they will also be the ones that laugh about performing OMM. All because they don't want to highlight anything that shows they are different than an MD. OMM is legitimate IF you know how to use it. The problem is that most of my classmates don't know how to use it because they don't care to practice or use their full efforts during labs.

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