MD vs DO vs Caribbean for Medical School

If you want to become a doctor in the U.S.,
there are 3 main medical school paths to choose from: MD, DO, or Caribbean. Unfortunately, there’s a terribly large
amount of misinformation regarding the pros and cons of each, and which you should ultimately
choose. In classic Med School Insiders fashion, we’ll
cut the fat, debunk the myths, and give it to you straight. Dr. Jubbal, No matter what you may have heard, it does
matter which medical school path you take. It frustrates me that people’s egos and
pride get in the way of providing sound advice to pre-meds who deserve to know the truth. First, understand that the default path to
become a doctor is attending a U.S. allopathic medical school. At an allopathic medical school, you earn
your MD. However, getting into one of these medical
schools is insanely competitive, the reasons for which I have explored in a previous video. Link in the description below. For almost every pre-med, going the U.S. allopathic
route is the default, and the best choice. It keeps the most options and doors open moving
forward, and it doesn’t have any major drawbacks compared to its alternatives. However, 60% of applicants each year don’t
get into a U.S. allopathic medical school. Luckily, there are alternatives if you still
want to become a doctor. Osteopathic medical schools are those where
you earn a DO. This degree is technically distinct from the
MD, but you’re still granted the same rights in practicing medicine, and you’re still
a physician at the end of the day. If you want to know more about the differences
between the MD and DO, I have compared the two paths in a previous video. If you haven’t already, I recommend you
watch that video as a supplement to this video to get the full picture. Now a quick disclaimer about my first MD vs DO
video. It’s my most controversial video yet because
of the subject matter. The video is 100% factual, accurate, and I
stand by it completely. That being said, I did make an apology video
as a follow up where I doubled down on the facts presented but apologized for not treating
the topic more gently, as it is admittedly a heated conversation. The second alternative is going Caribbean,
where you earn your MD but at a medical school on a Caribbean island rather than in the United
States. While tropical climates and beach weather
year round may sound great, there are significant drawbacks to this option, which I have explored
in great depth in my video titled The Truth About Caribbean Medical Schools. At U.S. allopathic medical schools, over 90%
of graduates successfully match into residency, and attrition, meaning students who don’t
finish, is quite low at 4%. In short, the odds of finishing medical school
and successfully matching into a U.S. residency is good if you go to a U.S. MD school. For DO medical schools, the good news is that
you don’t have to be as strong academically to get in. According to the most recent data, the average
GPA and MCAT of DO medical school matriculants is 3.5 and 503, respectively, compared to
3.7 and 511 for MD schools. The match rate is in the mid 80’s, compared
to mid 90’s for allopathic schools. More on the Match and residency merger shortly. For Caribbean schools, the data are very different. Caribbean schools are by far the most approachable
by students with weaker academic records, and you are bound to find a school in the
region that will take you. But according to the NRMP, the Match rate
for U.S. citizens who are graduates of international medical schools is only 50%. There is a very important caveat to this data,
which is that within the Caribbean there is a large range in school quality. The match rates amongst the big 4 Caribbean
medical schools, including St. George’s, AUC, Saba, and Ross are higher, but still
nowhere near the level of their U.S. MD and DO counterparts. Additionally, attrition rates are abysmal,
anywhere from 10 to 50% depending on the school. And remember, to even apply to residency,
to even begin paying off your study loans, you first need to finish medical school. There are several other worrisome trends about
Caribbean schools. For example, all medical schools in the Caribbean
are for-profit institutions, whereas less than 2% of U.S. based MD and DO schools are. Based on this data, it becomes clear that
U.S. allopathic medical schools should be your first option. The real question becomes what is the second
best option? If you’re unable to get into a U.S. MD school,
should you go DO or should you go Caribbean? The data suggests that DO schools are a clearly
superior option. These numbers may or may not be news to you,
but as we’ve been exploring on our Research Explained series, data is often misrepresented. It’s important to understand that statistics
apply to populations, not to individuals. We obviously cannot create randomized controlled
trials sending pre-meds randomly to MD, DO, or Caribbean medical schools. Therefore, there are certain biases we need
to take into consideration. First, student caliber matters. On average, the strongest students go to U.S.
MD schools, followed by DO schools, and finally Caribbean schools. Again, this is on average. Congrats to your mom’s friend’s cousin
who got a 520 on the MCAT and a 3.9 GPA and went to a DO school, but that doesn’t change
this fact. Therefore, some of the variation in the data
we see is due to the average caliber of the students rather than to the institutions themselves. It’s impossible to determine the exact magnitude
of this effect, but it is present. In other words, your individual efforts and
performance are factored into the equation, not just the school you go to. While MD vs DO vs Caribbean is a very important
decision, we may not be accounting for student contributions enough. Going back to your mom’s friend’s cousin
with the 520 and 3.9 would likely be fine at either DO or Caribbean programs, regardless
of the trends in the data. If you’re attending a DO or Caribbean program,
you can put your pitch forks down. I’m not saying you’re a weak student,
I’m just speaking to the population averages, as based on the data. Just reporting the facts. Plus, I fully believe that any student can
learn the right study techniques and tools to be a stellar student. That’s what this entire channel is about. Second, not all residency matches are created equal. Another point of oversimplification is the
Match rate. Match rate success as a percentage is only
part of the picture. Being able to go into your desired specialty
and at a strong program is also tremendously important. This is arguably the most frustrating part
of this entire conversation. I have heard others on social media, who I
will not name, telling pre-meds that going MD or DO does not matter. Shame on them. If you’re considering primary care, the
differences are present but they are diminished. However, it matters tremendously if you’re
considering a more competitive specialty. If you want to go into a hyper competitive
specialty like dermatology or plastic surgery, you’ll be far better off going to a U.S.
MD school over both DO and Caribbean medical schools. I’ve gone over the top competitive specialties
in a previous video so you can know for yourself where your specialty of interest ranks in
terms of competitiveness. Because of this, I’d still urge most students to
pursue U.S. MD options when possible, as it has been demonstrated that over 50% of medical
students change their specialty of choice during the course of medical school. For example, I entered medical school thinking
I would match into internal medicine, but I ended up falling in love with plastic surgery. The fact remains that if you go the DO route
and want to go into something hyper competitive, it’s going to be more challenging for you. It’s definitely not impossible. And again, congratulation to your dog’s
friend’s owner’s sister that went DO and matched into plastics, but that’s the exception,
not the rule. It doesn’t change the fact that it is much
tougher to go into hyper competitive specialties if you graduate from a DO or Caribbean program. Now you may be throwing your arms up in protest because won’t the residency merger solve all these problems? I’m glad you asked. Previously, MD students would apply for residency
in the MD Match, and DO students would often apply to both the MD and DO Matches. But beginning in 2020, there will no longer be
two separate Matches. Now, both MD and DO students will be applying
to residency under the same Match. I’ll start with a disclaimer. No one knows for certain what effects this
merger will have, unless you have a crystal ball. That being said, I have spoken with several
DO colleagues and admissions experts very familiar with the matter, and here’s what
they had to say. Some argue that the residency merger will
eliminate the problem altogether. After all, everyone will be applying to the
same residency programs, and we can all hold hands and sing kumbaya. Others argue the opposite, that it will make
it even more difficult for DO students to match into competitive specialties. For example, some orthopedics or dermatology
DO programs have not made the cut when re-certifying by ACGME standards. As a result, there would be fewer spots for
a similar number of applicants. Equally important, those spots wouldn’t
be open to just DO applicants, but MD applicants as well. And MD applicants on average, again emphasis on average, have higher Step
1 and Step 2CK scores, due in part to their stronger average academic history, and also
because DO schools don’t generally focus their curricula around high-yield USMLE topics. Additionally, ACGME program directors don’t
trust COMLEX scores – the USMLE is preferred. Some argue that the COMLEX should even be
abolished and replaced by all DO students taking the USMLE with an addition of a smaller
supplemental exam to test them on osteopathic manipulative medicine, or OMM for short. Regardless, these are just two separate sides of the argument, no one knows for certain, and
only time will tell how the merger will effect the Match. It’s important to dispel some toxic misconceptions
I’ve heard thrown around. You may hear osteopathic medical students
or physicians suggest they prefer the DO degree because they want to treat their patients
holistically, implying the MD route isn’t holistic. This is an idiotic and toxic mindset that
only further divides DO’s and MD’s. You can be a phenomenal physician and treat
patients holistically regardless of your degree. Good doctors are good doctors, whether DO
or MD. The DO is still, unfortunately, subject to
a stigma that the MD is not. I mentioned this in my previous video and
got a few highly agitated comments. I don’t agree with the stigma, and MD and
DO physicians deserve equal respect. Again, the degree has little to do with one’s
abilities, merit, or skill as a physician. That being said, pretending the world is all
sunshine and rainbows to make you feel better doesn’t actually fix the problem. It’s dishonest and harmful to pre-med students
to deny these realities. Don’t shoot the messenger. This stigma is ultimately detrimental and
we should continue to actively work to reduce harmful misconceptions, but we need to in
a mature and ethical way. Lying to pre-meds is neither. Also, if you’re a DO and you never experienced
this stigma yourself, that’s awesome, and that likely points to progress being made
in this area, but I know dozens of DO medical student and physician colleagues who would
beg to differ. Lastly, after my DO physician colleague reviewed
this video script, she asked me to include one last thing: when going Caribbean, you
would earn your MD, and therefore wouldn’t have to deal with any stigma of the DO or
constantly explain to patients what the DO degree is. While a relatively minor point, this was factored
into her own decision and I’m including it here for you to assess yourself. Now to be honest, the reception to my first MD
vs DO video made me second guess myself. I feel so privileged and honored to have each
of you viewing my videos, and I take this YouTube channel very seriously. I want to provide sound advice and ultimately
help you all. As much as I derive joy, entertainment, and
even inspiration from the haters, the messages I received from that first video made me seriously consider
if I had misled you. So I reached out to almost a dozen DO medical
student and resident friends and colleagues, I rewatched the video multiple times, I double
checked the data, and all of that reassured me that the first video was valid. I have a feeling this video, despite my multiple
disclaimers, will rustle some feathers as well. But I remain committed to providing you with factual,
effective, and accurate information to help you in your journey to becoming the best possible
doctor. And as much as I love social media, it has the
side effect of augmenting the already problematic snowflake mentality. Outrage porn is a growing issue – many people
believe they have the right to not be offended, that their feelings are more important than
facts, and they should be able to silence those that make them uncomfortable, even if those people are speaking the truth. I don’t subscribe to this notion and I’d
rather cut through the noise and tell you the honest truth that you deserve to know,
even if it is unpopular for me to do so. I’m always open to being wrong and being
corrected. If you have data or logical arguments against
anything that I raised in this video, by all means let’s have a discussion down in the comments. But if you’d rather tell me how angry this
video makes you or how your cousin’s goldfish’s twin’s father went DO and matched plastics,
then perhaps we’ll just agree to disagree. If you’d like to learn more about either
DO or Caribbean medical school options, I have a video on each – link in the description
below. Thank you for watching. Seriously, it means a lot to me and please
leave any feedback or suggestions you may have down below. Much love to you all.

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