What factors to consider before becoming an osteopathic physician?
December 21, 2009 8:08 PM   Subscribe

What factors to consider before becoming an osteopathic physician?

My numbers are not competitive enough to get into allopathic medical school. However, I am a more competitive candidate for osteopathic medical school. I have searched on the studentdoctor.net forums on the debate/discussion between MD vs. DO. I wanted to know for any mefites who has gone through/or is going through/completed osteopathic medical school, what factors do I need to consider in making this career-life decision in becoming an osteopathic physician?

I have shadowed a DO, and know of several individuals in DO school whom I respect. I’m not looking to start a controversial debate. I’m aware that DOs once board certified, have the same legal power and abilities as MDs, but I have my concerns. In a way, it should not matter whether I’m a DO or MD, a great doctor is a great doctor no matter what. But I want to know on the practical and not theoretical level, how that pans out in the real world. It’s hard enough being a physician as is. It’s a tough job with long hours and lots of work, liability and problems to deal with on its own. Adding to the mix that most of the public is not informed of what an osteopathic physician is. Even reading, talking to others, and shadowing a DO has really not really made any great progress about how to deal with some of the bias that comes along with becoming a DO and some of the professional hurdles I would have to overcome. Nobody is going to make this decision for me but me, but I want to be well-informed.

Other info: I’m female, in my mid-twenties, living on the east coast. I have a science degree, graduate work, volunteered many hours in community service, in a clinic, at a hospital, and in the health related settings. I feel so shallow to want to only have an MD in my degree, but to a certain point, I feel that for all that work and effort having a MD is better in my opinion because of the clinical training. And having to deal with being looked down by MD (some, but I know not all) is something I just don’t know if I want to put up with for the rest of my career. Note too, that I do not plan on re-applying again for medical school. I don’t have money to spend another year with this expensive process of applying to allopathic/osteopathic medical school, submitting secondaries and the costs associated with attending interviews.

A part of me has thought that if I’ve wanted to become a physician, then it shouldn’t matter if I become a DO. But there are just so many concerns, hesitations I have. And I feel like there is an uncertainty in dealing with being perceived as second-rate to the public bias/ignorance that exists (even though the medical education is the same, with the inclusion of OMM).

Here are my concerns:

1. Most lay people do not know what a DO is. How have DOs dealt with this issue?

2. How difficult is it to pass the COMPLEX and USMLE during school? Since DO schools are not geared towards USMLE and allopathic residency training programs, would there be more obstacles for me to overcome in studying for both exams? I don't know for certain if I would want to go into family practice or internal medicine. Would I be limiting my options by going to a DO school?

3. What other things do I need to understand perhaps in the climb career wise in obtaining a residency and future career prospects?

Please, only constructive discussion/thoughts/perspectives would be very much appreciated. I'm not putting down osteopathic physicians at all. The DO I shadowed completed a fellowship and was very successful in their practice. But I'm sure that those who have gone this route have voiced similar concerns/questions and I'm just asking for more balanced opinions other than starting a controversial debate on studentdoctor.net. I’m asking what I need to consider in the osteopathic physician route and how to deal with my concerns. There just hasn't been much progress in my thought process. School is expensive, time consuming and emotionally draining. To spend four years in medical school and not get into my desired training program would be financially and emotionally devastating. Where I would want to end up living too is on the east coast where DOs are not very well known.

Thanks in advance,
Frustrated (Argh)
posted by anonymous to Education (13 answers total) 4 users marked this as a favorite
While you wait for people with the specific experience you prefer to reply, Anon OP, let me offer two data points.

The primary physician for a close family member undergoing complicated cancer (transplant) treatment at a top-rated university medical center is a DO who subsequently did a fellowship from Hopkins. From a patient's perspective he seems to fit in with and be treated as any other physician (including by MDs as well as by the RNs, Nurse Practitioners, and Physician's Assistants) but of course there must be things we do not see.

On the other hand, when my uncle (a DO practicing in Connecticut) moved to Wisconsin in the early 1960s he was unable to obtain a license due to restrictions he saw as unfairly favoring MDs. But I think things have changed. In any case that experience made me happy to see a DO now a full member of a medical team in our current circumstance.

As personal encouragement -- I have a couple of friends who were not initially admitted to medical school who persevered and have gone on to very satisying careers as physicians in a variety of settings, whether clinical or research centered.
posted by Rain Man at 8:43 PM on December 21, 2009

I'm an allopathic MD in primary care. At my level, out of residency and practicing for a number of years in a major urban area, DOs are treated pretty much the same as MDs. I have worked with DOs in several different fields: primary care as well as specialties. I have this sense (which is probably based on nothing, really) that DOs are imbued with a more holistic sensibility than MDs and as such osteopathic training seems much more in line with the values of primary care medicine than allopathic training. I have also worked with many DOs in specialties such as orthopedics and dermatology, including here at the University. I have never felt that these people were in any way inferior doctors.

That having been said, there's always been this sort of unconscious reaction when I work with a great DO physician, as in "Why is that person a DO, they're a great clinician?" I'm sure this isn't uncommon. On a very material level, this probably will never affect the kind of job you get or the way people treat you, but medical training is very long and hard and if, at the end of all of it, people having this kind of unconscious reaction to the letters after your name is going to bother you, think very carefully about it now. We all have this bias that most people who go to osteopathic schools didn't have the grades for "regular" medical school. I have a really good friend, a *great* doctor in fact, who decided to go to a Caribbean medical school just to avoid this stigma.

In the end, it is completely obvious to everyone in medicine that the kind of student you were in undergrad actually has very little to do with the kind of doctor you might become. There are as many bad MDs as there are DOs and what really matters is what you get out of med school and residency. A stellar DO will be treated the same as a stellar MD. A mediocre DO might be viewed with a little less sympathy as a mediocre MD.
posted by Slarty Bartfast at 9:37 PM on December 21, 2009 [1 favorite]

Several of my mentors are DO's. They are able to obtain academic positions, do research, get fellowships, and appear to do just fine.

Still, I'm applying for residency now, and will tell you that being a DO will all but close doors for you at certain places, in certain specialties. That doesn't mean you won't be able to train at some very excellent places, it just means you probably won't be matching at Brigham (if that matters to you), and will have an uphill climb in some subspecialties.

If that matters.

I think that I'd go to a DO school before I went to a Caribbean school. The board pass rates are much lower for Caribbean schools than for the osteo/allopathic schools in the States.
posted by archofatlas at 10:35 PM on December 21, 2009

The disparity is diminishing yet remains. Have you explored the options of foreign medical schools? I would rather be an MD from a medical school in Spain, than a DO from a school in the US. That being said, I know some excellent doctors who are DOs.
posted by caddis at 10:35 PM on December 21, 2009

As a health care consumer, I would prefer you personally not go to DO school.

This isn't because I consider DO inferior to MD; actually I attempt to visit DOs instead of MDs.

From your question, it doesn't feel you have the mindset I would like in my DO.

Good luck with your decisions and your schooling.
posted by GregorWill at 3:05 AM on December 22, 2009

My primary care physician is a DO and I don't notice any difference in her level of or approach to care as my previous MD physician. Both are in their mid to late 30s.
posted by gjc at 4:29 AM on December 22, 2009

Whether you believe medicine is a science or not, for a start.
posted by fourcheesemac at 4:53 AM on December 22, 2009

fourcheesemac: That's either flamebait or very misinformed. A DO is a science-trained medical doctor, who attends the same number of years of schooling, passes the same exams, and generally is equivalent to a MD. The historical difference -- the inclusion of body manipulation -- is less important in modern training, and many DOs do not engage in it at all.
posted by ellF at 5:35 AM on December 22, 2009

fourmancheese: Well, according to the American Academy of Osteopaths, it's both!

"The mission of the American Academy of Osteopathy is to teach, advocate, and research the science, art and philosophy of osteopathic medicine, emphasizing the integration of osteopathic principles, practice and manipulative treatment in patient care."

posted by fatfrank at 5:59 AM on December 22, 2009

Just wanted to chime in with: I thought the conventional wisdom these days was American DO is "better" than Foreign MD, if you want to practice in the US?

I suppose I should not be surprised if the SDN forums have led me wrong.
posted by quirks at 6:21 AM on December 22, 2009

fourcheesemac, I think you're confusing osteopathy with some other school of medicine.

DOs are exactly as eligible for licensure and board certifications in the US as MDs. The clinic my dad goes to is about 2/3 MDs and 1/3 DOs.

OP, if you want an MD, you're better off taking a year off and making yourself a better candidate for a school that awards an MD. A year is nothing. A lifetime with a degree that isn't the one you want is something.
posted by Sidhedevil at 8:59 AM on December 22, 2009

Yes, DO =/ chiropracter. Osteopathic med school is 4 years of biochemistry and cutting up cadavers and looking through microscopes and all that.

And I don't know specifically at Brigham, but there are in fact DOs in competitive training programs at top 10 medical centers, including mine.
posted by Slarty Bartfast at 2:21 PM on December 22, 2009

I'll note, fwiw, that in my experience DOs are generally speaking better primary care physicians and I regularly get referred to them over MDs for condition management. They still have all of the same knowledge/power, but they also are generally more willing to consider holistic (and by this I mean behavioral changes/etc. NOT homeopathy) medicine. All of the truly great doctors I've had who have been truly helpful were DO trained (including one who became a specialist).
posted by eleanna at 4:00 PM on December 22, 2009

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