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DO Residency Talk

19 min



Elite Medical Prep recently hosted a roundtable event dedicated to the intricate aspects of residency applications, providing participants with insights into the application cycle. This session was hosted by Dr. Janet Tam and Dr. Jim Devanney. The discussion spanned topics ranging from exam preferences to specialty considerations, encompassing vital factors like interviews and beyond. Watch the full session above, or read on for the blog version!


For those who prefer written content or wish to supplement the recorded session, we’ve condensed the discussed points into this blog post. However, if you prefer, the session video is available above. Furthermore, a collection of informative residency roundtable discussions and Q&A sessions can be accessed here.


In 2020 the DO and MD residency match was merged into one. This raised a lot of questions as to what this means for DO applicants, and the available positions. Did this even the playing field for DO applicants?  We will review the challenges you may face when applying to residency as a DO, and how you can overcome them.


Exam Choices for DOs Applying for Residency


While either COMLEX or USMLE meet the minimum requirements to apply to residency, allopathic programs have historically been more comfortable with USMLE. This caused some hesitation for programs to accept DO applicants into their residency programs. For this reason, many DO applicants choose to take the USMLE in addition to COMLEX. This allows for a more competitive ERAS application, especially for more competitive specialties.


How Important is it for DOs to Have a USMLE Step 2 Score When Applying for Residency?


Both COMLEX Level 1 and USMLE Step 1 have become pass/fail exams in 2022. Because of this, programs rely more heavily on Level 2 and Step 2 scores to assess applicants.


Do DOs Have to Take Step 1 in Order to Sit for Step 2?


No! There is no requirement to take Step 1 before Step 2. For this reason, DO residency applicants may choose to take COMLEX Level 1 and 2, as well as Step 2 to help them match into a more competitive program. This allows DO applicants to save time and money by bypassing the Step 1 exam.


Should DOs Still Take Step 1 to Boost Their Residency Application?


While you still have to take COMLEX level 1, as it is required for licensing, taking Step 1 as a DO residency applicant is absolutely not necessary since it is a pass/fail exam.


That being said, there are still some benefits to taking Step 1 anyway. Preparing and taking Step 1 will help you be better prepared for your rotations and Step 2 exam. On the other hand, having a Step 1 failure on your application can add an unnecessary red flag to your residency application. It also adds stress and fatigue and will take away from the time you have available to study for your other exams. This is a highly individualized decision, and we recommend weighing the pros and cons. Consider consulting with friends, mentors, a tutor, or a residency advisor to decide what will make the most sense for you.


How Much Time Should You Spend Studying for Each Exam?


The truth is, you should really be spending as much time as you possibly can. During your dedicated, which is typically an 8-week period, you should spend at least 8-10 hours a day studying. Make sure you are employing active learning techniques as much as possible. If you are able to get some studying in before your dedicated starts, we highly recommend starting early.


Use practice questions as your main study resource to work on your active recall.


When Should You Take the Exams?


Is there a sweet spot for when to get started, and when to take COMELX vs. USMLE?


For COMLEX Level 1, ideally, you would have taken it between the summer of your second and third year of medical school. Although some schools require students to take it earlier.


When it comes to Level 2 and Step 2, specifically if you are planning on taking both, we recommend timing the two exams a week or two apart. Students typically take Step 2 first and spend the week in between focusing on OMM topics. However, this depends on your comfort level with the specifics of each exam. You can read our blog post dedicated to this topic for more information.


However, whatever order you choose to take the exams in, it’s important to have both scores available by the time ERAS applications open for programs to review. This is typically around mid-late September, check our updated residency timeline for the most updated dates. While you can update your scores later in the match cycle, most programs will download the applications as soon as they become available to them. For this reason, it’s important to have the scores ready as soon as the applications open for review.


Specialty Considerations for DOs Applying for Residency


How Should I Choose My Residency Specialty as a DO?


First and foremost you should be true to yourself. Consider what areas interest you most, and speak to people who have started their training within the specialties you are considering. Consider what you would like to see yourself doing in 10 years.


Is It Possible to Pursue a Competitive Specialty as a DO?


Absolutely! We are all competing for limited available positions, and there are objective measures in place that programs use to assess applicants. This is partly why so many DOs choose to take the USMLE, to offer programs an easy comparison to their MD counterparts. Being a DO candidate does not bar you from competitive specialties or programs.


How Can I Make Myself a More Competitive Applicant?


The best thing you can do is start early. Get involved in clubs, volunteer work, research opportunities, etc. Of course, getting good grades in medical school and your exams provides programs with those objective measures that help them decide which applications they will take a closer look at.


Should I Apply for a Backup Specialty?


There is no cookie-cutter answer here, this is something that each applicant will need to consider for themselves. Some people could only see themselves pursuing one specialty. Some applicants can see themselves being happy in multiple specialties. Having a backup specialty can definitely raise your chances of being matched. The downside, however, is that you have to split your efforts to craft an application for two separate specialties. There is some difficulty and complexity added in that you have to keep your options organized, make sure you are associating your correct documents for each specialty, etc. This may also mean applying for more programs, which can inflate the overall cost and time associated with applying to more programs.


Auditions Rotations for DO Residency Applicants


Is It Necessary to Do Audition Rotations as a DO Applying to Residency?


Yes. It’s one of those things that’s very important, and generally expected. It is very important to showing your interest in the field. Especially with more and more programs opting for virtual interviews, it’s becoming more important to seek out those opportunities to allow you to get face time with decision-makers in your desired program.


When you are auditioning, it gives you a chance to put your best foot forward. This is especially important for DOs as many DO medical schools and programs don’t offer home rotations in some specialties which would allow you to gain some experience in your field of choice. In that sense, an audition rotation would not only help your chances at a certain program but would also provide you with some experience and clarity on what working in your chosen specialty could look like.


How Many Audition Rotations Should I Do?


DOs generally tend to do more audition rotations than their MD counterparts. This is because of some of the things we have already discussed and will vary depending on each individual, and specialty. If you are applying to a very competitive program, getting in some face time will help you stand out and be remembered when programs are reviewing your application. It can also be another form of program signaling, showing your genuine interest in the program.


On the other hand, if you are applying to programs that you feel very confident you will match to, you may be better off spending more of your time and efforts elsewhere.


How Do I Choose Where to Audition?


As mentioned before, auditioning at a program signals to them that you are serious and interested. We recommend spending your time auditioning at programs that you can see yourself working at. Consider your geographic preferences, programs that are a bit more reach for you, etc.


You can also take the opportunity to determine what aspects of a program are important to you. For instance, do you want more of an academic or clinical residency? Getting exposure to different types of programs will help you prioritize better.


Where Can I Find Audition Rotations? Any DO-Friendly Ones?


We recommend taking a look at the VSLO (Visiting Student Learning Opportunities). VSLO is a program run by the AAMC that fosters elective audition rotations. That’s the primary way that students use to find their audition rotations. You can also email program directors specifically to let them know that you are interested in an audition rotation.


To determine whether a program is DO-friendly, you can look up NRMP match data and the director’s survey to see which programs were more DO-friendly in previous years. You can also look at their website to see how many of their current residents or recent graduates are DOs. If they have matched a good amount of DO applicants in the past, they are likely to do so again.


What Are Some of the Differences Between Regular Clinical Rotations and Auditions? What Can I Expect to Do on an Audition Rotation?


You are being more closely watched on audition rotations than on clinical rotations. This can be both a positive and a negative. One positive is that if you demonstrate that you are capable and likely to add value to the program, your efforts are not likely to go unnoticed. It’s important to make a good impression and show that you are interested and engaged. This is also a great opportunity to show how you can be a great team player who will seamlessly integrate into the program.


You want to treat yourself as a potential resident. You won’t have the same responsibilities as a resident, however, you will have more responsibilities than a med school student on clinical rotations.


Keep in mind that, while audition rotations are a great way to put your best foot forward and show programs what a great resident you will be, they are also a great learning opportunity for you. Take the time to get to know the specific programs and really consider if it’s the right choice for you.


For tailored assistance with your application, consider a one-on-one meeting with an Elite Medical Prep residency advisor. Book your consultation today to learn more about how Elite Medical Prep can help you succeed!

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