In the ever-evolving landscape of healthcare, the debate over the equality of education and training between Doctors of Osteopathic Medicine (DOs) and Doctors of Medicine (MDs) has gained prominence. This blog post aims to shed light on the importance of recognizing the equality in education for DO physicians and MDs, while acknowledging the challenges that persist in achieving parity in the professional arena.
First, some background for the uninitated...
Firstly, it is crucial to understand that the education and training for DOs are inherently equivalent to that of their MD counterparts. Both types of physicians complete four years of medical school, followed by residency programs in their chosen specialties. DOs, however, undergo additional training in osteopathic manipulative medicine (OMM), a hands-on approach that focuses on the musculoskeletal system to promote holistic patient care.
This holistic approach, which emphasizes the interconnectedness of the body’s systems, adds value to the overall education of DOs. Far from being a disadvantage, this additional training equips DO physicians with a unique skill set that can contribute to a more comprehensive and patient-centered practice.
Implications on the Match
While the education between DOs and MDs may be comparable, the journey toward obtaining positions in the residency match has highlighted disparities. Historically, DO physicians have faced challenges in securing competitive residency positions, often encountering biases that favor their MD counterparts.
This ranges from silent lack of consideration to downright blatantly exclusionary behavior from certain programs and/or specialties. Per the NRMP data, in some specialties, osteopathic medical students produce on average, higher volumes of research and board scores, in order to secure positions in the same specialties compared to their MD counterparts.
How did we get here?
Initially, the AOA, the official governing body for the osteopathic profession, had its own residency programs reserved for DO students, and few, if any, matched into allopathic programs. In 2018, an event known as the merger converged the osteopathic and allopathic programs into one. This was done in hopes of promoting equality of the two degrees by recognizing each others eligibility in their respective programs.
However, some of the after-effects did not quite yield the intended results. Many traditionally osteopathic programs began to accept MD students, however, the converse did not occur at an equitable rate. This resulted in a greater proportion of DO students being displaced and running the risk of not matching or having to SOAP into 1 year positions and reapply.
The reason is likely that programs understand the biases that exist and want to harness the reputation of being a strong program. Unfortunately, given the current sociopolitical climate of this issue, programs with DOs are perceived as weaker, and thus it is sometimes in the programs best interest to limit the number of DO students they take in order to artificially inflate their reputation to future applicants.
As you can see, this is unfortunately a circular issue which self-perpetuates so long as the DO stigma exists.
The Issue, Summarized:
- Each year, more and more DO schools/campuses open without adding sufficient residency positions to accomadate the new volume of physicians they are producing, resulting in more DO students enter the match
- Many residency programs view having DOs as a negative for their optics/reputation, and they avoid interviewing these candidates to limit (or simply exclude) how many match there.
- Less DO students match into competitive specialties.
- More and more DO students match into their backup specialties or into 1 year positions via the SOAP
- The DO populace earns a poorer reputation as a result of not being able to produce similar match outcomes to their MD counterparts.
You Are A DO student. What Can You Do To Optimize Your Chances Despite These Circumstances?
- Educate yourself on the inherent limitations of your school/program.
- Take BOTH the USMLE and COMLEX (YES, part 1 and 2)
- Network within your future specialty EARLY in your medical school career. Mentorship from residents, attendings, and other faculty will be critical to support your academic success.
- Know when to ask for help.
- Work your butt off because ultimately, it is absolutely possible to do anything you set your mind to (as cliche as it sounds)
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