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A Six Year Head-to-Head Comparison of Osteopathic and Allopathic Applicants to a University-Based, Allopathic General Surgery Residency. Lisa L Schlitzkus MD, Christopher J Clark MD, Steven C Agle MPH, MD, P.J. Schenarts MD . Background. 250% increase in DO graduates, 1980 – 2005 - PowerPoint PPT Presentation
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East Carolina
UniversityDivision of
Surgical Education
Turning Knowledge into Action
A Six Year Head-to-Head Comparison of Osteopathic and
Allopathic Applicants to a University-Based, Allopathic General Surgery Residency
Lisa L Schlitzkus MD, Christopher J Clark MD,
Steven C Agle MPH, MD, P.J. Schenarts MD
East Carolina
UniversityDivision of
Surgical Education
Turning Knowledge into Action
Background
250% increase in DO graduates, 1980 – 2005
1/5 of medical school graduates DO
18,000 MD graduates annually, stable since 1980
East Carolina
UniversityDivision of
Surgical Education
Turning Knowledge into Action
Background
419% increase in DOs in allopathic residencies, 1985 - 2006
DOs entering allopathic general surgery residency 3%, up from 1.2% mid 1990s
Bias against DO applicants
East Carolina
UniversityDivision of
Surgical Education
Turning Knowledge into Action
Hypothesis
Applicant characteristics of osteopathic graduates to a university-based, allopathic general surgery residency are no different than those of allopathic graduates
East Carolina
UniversityDivision of
Surgical Education
Turning Knowledge into Action
Methods
IRB approval
Retrospective
US Graduates only
Electronic Residency Application Service (ERAS)
East Carolina
UniversityDivision of
Surgical Education
Turning Knowledge into Action
Methods Database of self-reported data
Demographics Years and Jobs after graduation Couples match Letters of Recommendation Volunteer experiences Scholarly works Advanced degree USMLE and COMLEX scores
Statistical Analysis Student t-test and chi-square Significance set at p<0.05
East Carolina
UniversityDivision of
Surgical Education
Turning Knowledge into Action
Results
1,155
East Carolina
UniversityDivision of
Surgical Education
Turning Knowledge into Action
Allopathic Osteopathic p-value
Age in Years 28.9 ± 3.6 29.3 ± 2.7 0.221
Male Gender 65.1% 63.0% 0.621
Caucasian 65.5% 78.5% 0.002
US Citizenship
96.5% 98.5% 0.220
Demographics
East Carolina
UniversityDivision of
Surgical Education
Turning Knowledge into Action
Allopathic Osteopathic p-value
Years after Graduation
0.3 ± 0.9 0.3 ± 0.8 0.884
Jobs after Graduation
0.2 ± 0.5 0.3 ± 0.6 0.061
Couples Match
3.6% 5.9% 0.192
Other Demographics
East Carolina
UniversityDivision of
Surgical Education
Turning Knowledge into Action
Allopathic Osteopathic p-value
Letters of Recommendation 3.5 ± 0.7 3.6 ± 0.8 0.065
Volunteer Activities 5.8 ± 4.8 6.0 ± 5.2 0.700
Scholarly Works 1.6 ± 3.5 1.5 ± 4.4 0.943
Advanced Degrees 15.1% 21.5% 0.057
Common Selection Variables
East Carolina
UniversityDivision of
Surgical Education
Turning Knowledge into Action
Allopathic Osteopathic p-value
Reported 99.0% 54.8% 0.0001
Score 207.7 ± 20.0 212.9 ± 14.7 0.030
Attempts at Passing
1.1 ± 0.5 1.0 ± 0.2 0.050
USMLE Step 1
East Carolina
UniversityDivision of
Surgical Education
Turning Knowledge into Action
Allopathic Osteopathic p-value
Score 217.4 ± 22.0 218.5 ± 18.0 0.699
Attempts at Passing
1.1 ± 0.3 1.0 ± 0.0 0.162
Reported 77.1% 43.0% 0.0001
USMLE Step 2
East Carolina
UniversityDivision of
Surgical Education
Turning Knowledge into Action
COMLEX 1 COMLEX 2
Score 512.5 ± 70.3 518.4 ± 91.8
Attempts at Passing
1.1 ± 0.3 1.1 ± 0.2
Reported 88.9% 77.8%
Reported USMLE equivalent
54.8% 43.0%
COMLEX Performance
East Carolina
UniversityDivision of
Surgical Education
Turning Knowledge into Action
Limitations
Retrospective
Self Reported Data
Unable to compare clerkship grades
Single Institution
Few osteopathic applicants
East Carolina
UniversityDivision of
Surgical Education
Turning Knowledge into Action
Discussion
Increased osteopathic graduates of which 9% enter general surgery residencies
Osteopathic residencies cannot accommodate thus more will enter allopathic
Screening variables not applicable to DOs Example: AOA membership
Unfamiliarity with specific medical schools
Race may reflect rural focus
Failure to report USMLE scores may be considered red flag
East Carolina
UniversityDivision of
Surgical Education
Turning Knowledge into Action
Conclusion
Essentially no difference exists between allopathic and osteopathic applicants, except for USMLE Step 1 scores, which may be due to self-reporting of favorable data.
East Carolina
UniversityDivision of
Surgical Education
Turning Knowledge into Action
