Tag: DO

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DO Or Foreign MD- Which One Is Better For Radiology?

foreign md

Each specialty looks for different skill sets and activities when selecting candidates for residency. As part of an admissions committee, institutions scour dean’s letters, recommendations, board scores, volunteer activities, and more to ensure that the candidate makes it through rigorous residencies. However, one of the most “in-your-face” factors that most residencies cannot overlook is the degree applicants have completed. Yes, it is a soft criterion because a suitable candidate can graduate from most foreign MD programs or DO institutions in the United States. Nevertheless, it can become an issue, especially when the committee is not sure of the quality of the medical school.

So, for radiology residency specifically, which degree stands out as the best for applicants? And, which one gives them the best chance of getting into a radiology residency program? I will break down the different degrees into Caribbean MD, Other Foreign MD, and DO schools to accomplish this feat. For each, I will give you the insider advantages and disadvantages. Then, I will provide you with my opinion of the rank order based on the objective facts of each degree.

Top Tier Caribbean MD Schools

Within the Caribbean MD schools, there are undoubtedly several tiers. First of all, we know the quality of St George’s institution since we have had a relationship with them in the past. And, we know that a top student from this school performs at the level of most United States medical schools as we see in our program. Moreover, many other program directors feel the same way from what I have heard. Unfortunately, many medical schools nowadays are biased against Caribbean graduates, even St. George. Many large prestigious academic institutions won’t even touch one of these applications unless the applicant is an exception to the rule.

Furthermore, with the AOA (American Osteopathic Association) combination with the ACGME (Accreditation College For Graduate Medical Education), having a DO degree is no longer a disadvantage for getting a residency. DO residents no longer have to complete separate osteopathic internships and osteopathic accredited residencies. So, Caribbean residents have more competition than ever before to get into ACGME accredited residencies. But, at least, the Caribbean schools with a known reputation can help these applicants secure a spot.

And then finally, the new Step I board pass/fail non-scoring criteria will prevent radiology residency programs from assessing incoming students’ test-taking acumen, which correlates with passing the radiology boards. Therefore, residencies will be more wary of accepting a Caribbean student, even from a top-tier program, especially without knowing if they are a good test taker.

Other Foreign MD Schools

For other foreign MD programs, residencies have the same problems. It’s a problem of familiarity. What does a degree from a Taiwanese, Indian, or Iranian institution mean? This problem is even more complicated than the top-tier Caribbean schools (where we are more familiar). How do we know how students compare to United States schools that graduate? Perhaps, a few institutions do break this mold. But for the most part, we cannot figure out where a candidate stands. Nor do we have the time and energy to tease that out. Primarily, we don’t need to when programs have so many excellent United States candidates to choose from nowadays.

Additionally, the ACGME combining the AOA and the new Step I board pass-fail criteria will make it much more difficult for these students to secure a radiology residency slot due to the increased competition.

DO Schools

Today, many MD radiology residency programs still have a bias against DO candidates, especially at larger academic institutions. Nevertheless, all DO schools must meet the same criteria as MD schools since the AOA and the ACGME have combined into one organization. Therefore, even at the most questionable United States DO institution, theoretically, we should know the baseline training of the medical student applicant. We cannot receive this same assurance from a foreign graduate school.

Moreover, getting rid of the Step I board scores will have a negligible effect on these applicants. Why? Because we have an idea of the baseline quality of these US accredited schools.

So, What’s The Final Ranking Of DO AND Foreign MD Degrees For 2022?

From best to worst chance of securing a radiology residency spot:

  1. DO Schools
  2. Top Tier Caribbean MD Schools
  3. Other Foreign MD Schools

 Just a few words of advice, because you may have graduated from a lesser-known foreign medical school does not mean you have no shot of acquiring a radiology residency. And, if you are coming from a top-tier United States medical school, it does not mean you are guaranteed a spot. But, the type of program you are coming from influences the chances of getting in. You were wondering about probabilities, right?

 

 

 

 

 

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Postponed COMLEX Due To Covid: What Do I Do?

postponed COMLEX

Question About Postponed COMLEX:

Hello, I am DO third year medical student interested in radiology. However, I worry about the current situation that I put myself in. During this COVID summer, exam dates got thoroughly messed up to the point where my COMLEX was pushed back two times, leaving me with the decision to delay the beginning of my third year to take Step I or to leave it and focus on COMLEX 1. I chose the latter decision because I was thoroughly exhausted from studying due to my postponed COMLEX. Unfortunately, I received a low score and have dug a relatively large hole for myself.

I know that trying to take Steps I, II, and COMLEX 2 is not an option in my third year. But I wanted to ask you if I had to take a year off, would it be worth taking Step 1 since by then it would be a pass/fail exam? And if I did not take Step I and significantly improved on Step 2 and COMLEX 2, what would my chances be for matching into DR after 4th year? What are other things that I can do to optimize my chances of matching right away or, if not, matching after taking a year off?
Best

Answer:

For most programs, the COMLEX exam holds much less weight than the USMLE. If you score well on the USMLE and don’t score so well on the COMLEX, it does not matter as much. That said, if you decide to take the new pass/fail USMLE Step I, the scores for the USMLE Step II become much more important, especially coming from a DO school. So, it will become a much more critical exam to do well on. I would go as far as to say that a good USMLE Step II score will become a requirement for you to get in since programs will most likely use this score as a screening criterion for interviews. (in the past, you only needed Step I.)

Taking a year off to take an exam is a red flag from a program director’s perspective. Why? Because it shows that you may not be able to multitask well. And, radiology residencies involve lots of multitasking. So, if you are taking off an entire year to take exams, it raises lots of questions from a program director’s view. If you decide to take that route, you need to do something else that will add to your CV for getting into a radiology program, such as a relevant radiology research year/fellowship. Taking off a year just to retake the exams would be a disaster for your application.

My two cents,
Barry Julius, MD

 

 

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DO Friendly Programs- Should I Bother To Apply?

do friendly

Question About DO Friendly Programs!

 

Hello! Thank you so much for this website; it has helped me out immensely. What is your take on small community programs with lots of DO residents? They seem to have a pretty good fellowship match (IR in some top programs, a pretty good mix of fellowships overall).

 

Thanks a bunch,

Low Tier

 

Answer:

 

I am somewhat biased as our program has welcomed both DO and Caribbean medical school graduates for years. And, yes, folks consider us a “community” program. (although that will change with our impeding merger)

 

My philosophy on radiology education is that a residency is only as good as what you put into it. Regardless of the name, if you work hard and read a lot, you will come out of your residency as a great radiologist. The big difference some of the more popular programs afford is additional subspecialty work that you might not get elsewhere and hardcore research that you may or may not want. However, all is not lost if your residency does not fit this category. Indeed, you can get some of these experiences during your fellowship. And, most residents complete a fellowship after residency.

 

In terms of being a DO friendly program, I have no problem with that. As long as education is of high quality and the program’s resources are adequate, it should not matter if the residents are Caribbean, foreign, or DO. In our residency, some of our best residents tend to be Caribbean grads, for one reason or another. That should not dissuade you from applying to a program if you know that the program’s quality is high, and you will receive the training you want. We have had excellent residents from American, Caribbean, and DO residencies alike.

 

Hope that helps,

Barry Julius, MD

 

 

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Didn’t Take The USMLE And Still Want To Apply To Radiology Residency!

USMLE

Question About Applying Without The USMLE

Hello,

Currently, I am starting the intern year as a categorical surgery resident. I know I would be happier as a radiologist, but now I am in a tricky situation. I am a D.O. with decent scores. Unfortunately, I did not take the USMLE (I entered medical school thinking of pediatrics, and my advisor told me to focus on just one examination). Even though I have not taken the USMLE, I have published research from undergrad in pediatrics from an excellent medical school. Moreover, I was a part of the medical honor society, a tutor during medical school, had prior work experiences, and plenty of volunteering/club involvement. I know the radiologist I worked with would be willing to write me a persuasive letter of recommendation.

As a student, I initially applied for general surgery due to a passion for anatomy, and because I enjoyed working with breast cancer patients. I thought I wanted to be a breast surgeon. However, I had the pleasure of working with a radiologist working in breast/women’s imaging. I loved it. Being able to detect subtle changes in breast tissue was fascinating. From the mammograms, stereotactic biopsies, and needle localizations, the days would seem to fly by. I couldn’t get enough of it. Never did I think I would be so interested in radiology, but without any prior exposure in the field, I would have never known. 

I guess at this point I am unsure what to do. The current hospital I am at does not offer a radiology residency but is a part of a healthcare system that is about an hour away. What is the best advice you have for someone in my position? Any help would be much appreciated.

Thank you for your time!

What To Do?

 

Answer

Dear Applicant,

As an intern in surgery, you are well within the window to change specialties from the standpoint of government medicare funding. But, if you make your decision to enter radiology too late, that may no longer be the case. Applying later will reduce the number of residencies that will give you an interview. So, there is no better time than now to apply for radiology, as that is your area of interest.

Also, you may not want to hear this. The best way to ensure that you will get a spot in radiology would be to take the USMLE Step I and II exams. Many residencies disregard the COMLEX scores. Now that the AOA has merged with the ACGME, the USMLE tests are the standard throughout the country. A good score on the USMLE Step I would go a long way to giving your application some more “street cred.” (Eventually, in 2022 the USMLE Step II will be more critical exam since Step I will be a pass/fail test only). 

If you only have the COMLEX exam, you will be limiting the number of residencies that will seriously examine your application. I would try to take these exams as soon as possible so that the residency programs will have your scores. (Not sure if you can fit it in before this application cycle ends, but if you can, that would be great!)

All the other stuff that you have done, such as research, tutoring, and volunteering, is excellent. But, everyone else applying for radiology residency has done the same. So, although you need to add it to your ERAS application, it’s not going to differentiate you.

A recommendation from a radiologist within a health care system that has a residency can still support your application. Even if there are no other residency programs within the healthcare system, it will still help a little bit (but not as much).

The bottom line is that all is not lost. It will take a bit of work to study for the USMLE Step I and start your application soon. If you can’t get those USMLE scores before the application cycle, you can try to apply regardless. However, the chances of getting into radiology residency will be a little bit less. I think it is still worth a shot because you don’t want to lose out on government funding. Alternatively, you can take off a year of residency and find a job in research. That would potentially postpone the medicare funding issue and allow more time to study for the USMLE. When there’s a will, there is a way!

Good luck,

Barry Julius, MD