18 Specialties For D.O.'s

Here's a list of the 18 Specialties that D.O.'s can become board certified in (not counting sub-specialties):

1. Anesthesiology

2. Emergency Medicine

3. Dermatology

4. Family

5. Internal (plus 11 sub-specialties - Cardio, Allergy, ID, GI, Oncology, etc.)

6. Neurology and Psychiatry

7.Neuromusculoskeletal

8. Nuclear Med

9. OB/GYN

10. Ophthalmology

11. Orthopedics

12.Pathology

13.Peds

14. PMnR

15. Preventative

16. Proctology

17. Radiology

18. Surgery

Not to mention, DO's can apply to allopathic residencies and then apply for board certification in those as well....

Doesn't seem so limiting now, eh?

Whoa.... psychiatrists and neurologists... relax. The AOA lists them that way. Don't shoot the messenger.

Well since we're on the subject....

I put my DO vs. MD link on the side, had a few comments, and others are posting about it again. Here's Ella's version of the straight dope.

Moment of truth: If I had to do this again. I would have gone to DO school.

GASP!

Not because I don't love my school or my program. I love where I'm at. But I could have gone to DO school years ago. I could have been a doctor by now, half way done with residency. I didn't do it out of pride. Pretty much pride only. Because I wanted to be an MD, and because I didn't want to "defend" my education to others. Which is a pretty BS reason to waste years of your life.

Additionally, I think I would have had a different peer group. More alternative routes to med school, more diverse backgrounds, and more older students. Which is something I do feel that I miss out on here.

I really don't think the education is any different. And while there is undeniable residual stigma associated with osteopathic schools... I think it's lessening. All the time I hear MDs say how cool the DO physical manipulation is. And how so-n-so is a DO and is amazingly good. And I promise... very soon osteopathic schools will have the exact same academic criteria for admission. Some of the best osteo schools are already there (like the Texas program). Others are building their reputations.

Consider it. Or don't... and spend however many extra years of your life stressing about how you can POSSIBLY become an MD.

To DO or not to DO

So here's the controversial subject of the hour. MD vs DO. Is one better than the other? The following are my opinion about DO school and the debate...

Here's a refresher: Osteopathic schools grant a D.O. which is a doctorate of osteopathy. Allopathic schools grant the traditional M.D. DO schools are a little newer, and a DO has all the same "doctor powers" as an MD. They can prescribe, treat, do surgery, etc. The cool thing about DO schools is that they teach physical manipulation techniques which are damn awesome. For example, they may learn to treat a condition with physical manipulation of lymph nodes to promote drainage before resorting to an antibiotic. It's like getting regular medical school plus something extra cool.

There are pros and cons to both schools I believe. The pros of DO school seem pretty obvious to me. You get to be part of a pretty progressive community and learn modern techniques in medicine. Unquestionably I think the education is equal if not better, and your skills will be just as strong as any MD program. DO schools are a little less competitive to get into (but probably not for long... they're catching on quickly!)... meaning that you still have to have all the pre-reqs completed and to take the MCAT, but you can get in with less competitive scores.

The cons of going to DO school are basically that you're going to have to work in a world full of dumb-ass MDs that think that you're inferior. And this can really limit you. First you have to consider the specialty that you want to enter. Most DOs train to do family medicine, pediatrics, internal medicine, etc. There are actually DO residency "slots" that you apply for as a DO based on the DO specific board exams. If you want to cross over an train in a traditionally allopathic residency, you'll ALSO have to take the USMLE boards which are for the MDs. This would grant you access to apply for some allopathic spots, which may include some more competitive specialties like anesthesiology, radiology and orthopedics.

All in all it sounds great, right? So you're probably wondering why I didn't just go to DO school instead of spending so many years waiting for an acceptance to an allopathic school. Well, looking back I probably should have just gone to DO school. But here's the reason I didn't. Basically, I didn't think that I had the strength (nor did I want to), spend the rest of my life defending my education and my credentials. Like it or not, there is a huge stigma from the majority (the MDs) towards the minority ( the DOs, the international graduates, the Caribbean grad, the foreign medical students). I figured I'd had a hard enough time getting here, and I didn't want to add to my problems.

Looking back, this was probably naive... but at the time that's what I felt. And since I'd been rejected by allopathic schools, I guess I felt that I had to prove something to myself by making it. Whatever. I definitely could have saved myself a lot of time and heartache if I'd been a little less proud. Because truthfully, I know a lot of MDs who wish they were DOs, but I don't know any DOs who wish they were MDs.

If I knew then....

This post is dedicated to who I used to be... and who I am now. I used to be one of "them". The pre-meds. The high (understatment of the year) anxiety, nervous breakdown before an exam, vomit after the MCAT, can't get a grip pre-meds. This, I believe, was due to several things.


1) I really really wanted to be a doctor and couldn't think of any other career that sounded more exciting than watching paint dry. I was terribly fearful that I would end up as a forever high school teacher, a nurse, or a state employee. All fine careers, but none for me. My personality is a little, say, unconventional. Almost no one agrees with my ideas... they usually just look at me like I'm from Mars, I am bored to the point of suicide in work meetings, and I need something new to do approximately every 40 minutes. Medicine changes constantly.... there is always something new to learn, a physician has a great deal of autonomy (depending where you work), and medicine is the most harmonic symbiosis of humanity and science. I knew it was perfect for me.

2) I was-dare I say-older than my peers. Damn if this didn't work I wasted a lot of time... and then what the hell would I do?

3) Uh, can you say debt? Let's just say that I have yet to meet another person with as much educational debt as I do. Here's a little breakdown for you. And NO my parents were not able to financially help me beyond saving my ass here and there with an occasional rent payment or electric bill.

So... (gulp) here goes... have I ever actually written this down before???

Undergrad approx $30,000.00 USD per year for tuition (I always worked for housing as an RA or whatever) times 4 years. Ouch

2 years Post-Bacc Pre-Med program (1 at Harvard ($35,000 USD and 1 at state school $12,000 USD)

1 Master's degree at a top tier University approx $65,000 USD

Total BEFORE medical school even starts??? Approximately $232,000 American dollars. Yup. damn right almost a quarter of a million dollars.

Now, it just so happens that although I applied to (many) cheap state schools, I was only accepted into one of the most expensive schools in the US. When you factor in housing costs, medical school will cost me $71,000.00 USD per year (x4)

So by the time I'm I physician, I'll be starting my career with $516,000.00 USD of educational debt. Over half a million dollars.

And thanks to President Bush's administration, residents in the US are no longer allowed to defer student loan payments accrued during medical school. The average resident gets about $43,000 salary per year... or about $3000.00 take home per month. My debt will be a payment of at least that. Clearly, I'm not the only one in this boat... so something has to give unless we are going to start issuing food stamps to physcians.

ANYWAY,

So the point of this posting as I originally alluded to but did not say... was to pass down my best advice for pre-med hopefuls. Here you go. In a nutshell.

1. Being a hard-charger is lame. You're wasting your young years. I was hard core for a while, but I'm so so glad I used my 20's to make damn sure I wanted to be a doctor. I lived in 5 cities, traveled, learned languages, had several other careers, got my Master's degree, dated, bought a house, and was very sure and ready when I applied to medical school.

2. Don't become a physician for the money. As you can see above, I am having to spend $500k to be a doctor. The road to becoming physician is too long and too difficult to do for money. If money is what you want, save yourself a lot of time and energy and spend 6 months getting your real estate license. You'll be a millionaire in no time.

3. Forget about trying to get to the best school. Go to your local state school, make the best out of it, study hard, and get good grades. Save the fancy institutions for med school. Nobody will care and you saved yourself a ton of money and stress. Plus, I think state universities build character. They are less homogenous... and the students have less of a sense of entitlement. I swear my education at a state school was just as strong as it was at Harvard. I do not however, think that the education at many (possibly most) junior and community colleges is appropriate for pre-med study. These colleges are great for somethings... but do your pre-med work at a University. I'm sure med ad-coms would agree with me.

4. Stay away from pre-med chat forums. Other hard-chargers just drag you down. I seriously felt like the biggest piece of crap everytime I allowed myself to even look at studentdoctor.net. Here's an example of the asinine things you could read "HELP! Please tell me what you think my chances are of getting into med school (as if studentdoctor.net was frequented by anyone other than other freaked out pre-meds)... I have a 3.95 GPA double major in immunology and anatomy, but my science GPA is only 3.92. I scored a 38S on the MCAT but I only got an 12 on the biology section. I single handedly coded the entire genome for the deer mouse (the white footed one only), and I speak eight languages (except my Mandarin is really lacking in written ability). Can anyone give me a SERIOUS evaluation of my application??? I'm so scared I won't get in to both Yale AND Cornell. I haven't made up my mind yet as to which one I prefer, so I'll just die if I don't get acceptances at both."

Nuff said.

In order to keep your eyes on the goal (which is difficult to do after bombing your O-chem exam), get involved in something (anything), that gives you that feeling. You know the feeling. The one that screams "THIS IS WHY YOU WANT TO BE A DOCTOR!!!" It might be volunteering in a hospital, it might be reading pre-med blogs (constructive ones like this one :)). Whatever it is... do it and do it all the time. Every time I would get disillusioned I would either volunteer on the mobile clinic or just wander the halls of whatever med school happened to be closest. It helps so much.

5. Figure out if you want to go to medical school, or if you want to be an MD. There are a lot of options and many paths to becoming a physician... and becoming an MD is only one of them. DO school is fabulous, and international schools have many perks too. Don't be limited by pompus American doctors who think that an MD is the only way. There are also Chiropractic schools, Naturopathic schools, and many other paths to becoming a healer. Check out the pro's and con's from people that are IN that field.

6. Spend a lot of time before medical school thinking about your own ethics and values. You'll change through medical school... but it's important to know yourself well before going into a homogeneous enviroment where many people largely think the same way. Figure out where you stand on things... why you feel that way... You don't want to lose sight of yourself and your priorities in a highly intense, competitive, political field such as medicine.

7. Don't let the MCAT win. No way around it, the MCAT sucks. It's basically a giant mind-fuck. Do it once, do it right. Once it's over you'll never have to look at that bullshit again.

8. Know in advance that every single person you know (except possibly your parents) will try to say as many bad things about medical school and being a doctor as they possibly can. I have never understood this. Maybe people think they are saving you from a life of doom, maybe they are repeating what they've heard, maybe they're just negative, maybe they think they're helping, or maybe there is some jealous component. I don't know, but it is really irritating and unhelpful. Ignore it.

9. Learn a second (or more) language. Communication is so key to being a great physician... and learning languages really broadens your horizons and makes you competitive for positions you didn't even know existed.

10. Learn how to study and show up. If you aren't doing well in your classes, chances are you either don't know how to properly study for your classes or you simply aren't present. Present in class, present for homework, present for practice sessions, present for exams. That whole thing about 90% of success is just about showing up? True dat.