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m.d. or d.o?

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17 years 3 months ago #14132 by brown_eyed_girl
how did you decide which direction to go in?

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17 years 3 months ago #14133 by Cassie
I am still a pre-med, but I have never felt so certain about anything in my life. It is my understanding both M.D.'s and D.O.'s have the same medical education; however, D.O.'s have the advantage of malipulative medicine and they approach medicine from the perspective of patient care instead of disease treatment. There is also emphasis on maintaining a well body instead of waiting for disease to occur before problems are addressed. I think it is the person that makes a great physician and not the letters behind their name, but I would head for the school that most closely follows your own personal philosphy.

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17 years 3 months ago #14134 by MelissaGray
Good question, brown_eyed_girl!

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

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

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

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17 years 3 months ago #14135 by womansurgeon
I want to be a little (a lot) careful here to try to avoid offending anyone.

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

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

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

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

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

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

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

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

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

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

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

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

Womansurgeon

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17 years 3 months ago #14136 by efex101
I know that DO's versus MD is for some a matter of the last two letters, but for me I am not even considering the DO route period. Not because I think that they are lesser of a doctor but because many many people do not know what a DO is or does. I have worked way to hard to eventually gain acceptance to a medical school to then have someone ask "now what is a DO?" I do not want to explain not even once what the letters behind my name stand for.

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17 years 3 months ago #14137 by SpiritDoc2B_dup1
Hi,

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

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

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