Kansas City university – Page 9

Premed Series: MD versus DO?

Hello hello!

Now, I wasn’t sure what ya’ll really wanted to know from this. By the time you are applying to medical school you likely have a good grasp on the differences between MD and DO. It will be a bit more DO heavy, and will obviously be based on how I’ve experienced this at KCU. But just in case you are still deciding and this is the beginning of your journey, OR you want some more clarification, keep reading!

What does MD and DO stand for?

Ah, I’m so glad you asked.

MD stands for Medicinae doctor, which is a fancy way of saying Doctor of Medicine. It is the allopathic branch of medicine here in the United States. It is one of the main forms of Western medicine that we recognize today. According to thenewmedicine.org, allopathic medicine became more official after creating the American Medical Association in 1848.

DO came around much later than MD, so we aren’t as fancy in the Latin naming department. But DO stands for Doctor of Osteopathic medicine. I can give you way more information about DO simply because I’m studying it. But long story short, a guy in Missouri by the name of A.T. Still created this branch of medicine in 1874. Better yet, he is quoted stating “On June 22nd 1874, I flung to the breeze the banner of Osteopathy“. I have a whole blog post on Osteopathy here.

What differentiates them now?

So, because osteopathy turned osteopathic medicine was seen as voodoo and witchcraft if you will for awhile by allopathic doctors, there was a period of time where they offered DO’s to get their MD license for a certain fee. I don’t remember the year. It’s somewhere in my notes and I’m too lazy to go hunt for it. Just take my word.

However, the DO’s fought strongly if you will, and eventually became accepted (to a degree). There is still some backlash by certain MD’s, particularly of the almost retired age. But, we literally do the same things MD’s do in every aspect except we use OMT (osteopathic manipulative medicine). In layman’s terms it means that “bone popping” stuff, but we do so much more than that. Popping, or as we call it HVLA (high velocity low amplitude) is a very small portion of OMT. And in all reality, just because you want something popped doesn’t mean you need it.

So, if you decide to pursue the osteopathic route, you do a bit extra. We call it “an extra tool in our toolbox” to treat patients. Not all DO’s once they graduate incorporate it as not every specialty may call for it. On the flip side, many DO’s still incorporate some techniques into their practices.

What does this mean as a DO student?

When you first start out in your first 2 years (or didactics), you learn your coursework for your systems, you start learning how to be a doctor such as physical exam skills, learning to interview, and using that shiny new stethoscope. You also start learning how to do OMT! At the very beginning of learning OMT, you have absolutely no idea what you are doing. To be frank, there are somethings I’m really good at and others I absolutely suck at. Sometimes you just can’t feel it.

So you start learning how to try to “train” your hands and you start learning a bunch of ways to diagnose someone along with a bunch of techniques. You get tested both on written exams on these principles and how to do these techniques. You will also be tested on if your hands can produce the diagnosis and treatment as well. Our school calls them CPA’s, and they are a big chunk of our grade. The downside to when you first start is on one task, they ask you to diagnose your patient. But on the second task, they ask for a completely different treatment (unrelated to your diagnosis) to show them. This plainly is because you haven’t learned enough and they want to make sure you know how to do the treatments that they have been teaching you.

The further in you get, you will be asked to diagnose and then treat either the problem you found with a treatment of your choice OR they will give you a modality to use, and it is up to you to use it correctly for the problem at hand.

What are these treatment modalities you keep throwing around?

Basically, they are the different ways I can treat you for the problem that I find. Sometimes, depending on if you’ve injured yourself, you are sick, or your body just doesn’t like certain treatments, we may pick an indirect technique. Usually more healthy patients can tolerate direct techniques. But every patient and body is different. I won’t necessarily delve too much into this. That’s what going to osteopathic medical school is for!

Modalities are as follows:

Soft tissue (ST) which is direct
Myofascial release (MFR) which is direct or indirect
Articulatory (ART) is direct
Facilitated positional release (FPR) which is indirect
Balanced ligamentous tension (BLT) is also indirect
Still’s (named after the original bone wizard A.T. Still!) can be either
Muscle energy (ME) is direct
High velocity low amplitude (HVLA) is direct
Counterstrain (CS) is indirect
Chapman’s points and Viscerosomatics typically fall under direct.
Craniosacral can be direct or indirect.

What is the difference in schooling?

Well, we mostly covered that above. DO students spend extra time learning OMT and there is a large focus on treating the patient as a whole, not just a specific problem. But other than that, we learn the same things.

However, different schools (even within MD and DO) go about teaching in different ways. This is why going to the school’s site you are interested in is important. The gist of your questions are the same no matter what type of school you are looking at though.

So what does that look like?

Does your school go by a traditional grading system (like KCU) or do they do a P/F system?
Do they go by systems or subject?
Are your courses longitudinal or block? Are they mixed? For example, KCU is taught by systems in a block schedule. So we do one main subject for x amount of weeks before we move onto the next one. Then we have a handful of longitudinal courses that go all year round. So, I may only have 3 or 4 classes total, with one main one. Another school may have 7 classes that go all year round.
Do you have cadavers or is it virtual? Personally, I really enjoyed having a cadaver. Made things more realistic. Turns out main structures can be tough to get too, yet oh so delicate at the same time.
What type of services do they offer students?
Is the campus more student friendly or more traditional in the sense that it is faculty based?
How much exposure and practice does the school integrate when it comes to practicing my exam and patient interviewing skills?
How does the school prepare you for boards? How well has the school ranked with board scores?
If you are interested in research, are there opportunities for this?

You get the idea. All of these things are important when looking at schools to apply at. Not only do you need to look at the specific schools website for some of this, but you may need to scour additional sites to get a better idea per the students.

Just remember, med students can get pretty salty so take it with a grain of salt. Ha, hahaha.

What are the differences for getting into medical school?

Honestly, they are pretty much the same. You need to have the basic pre-med/science courses down. Each school may require slightly different “required” courses versus “recommended” courses. Check out my “Pre-Med Courses: What to Take Before Medical School” post for more information.

Before you get too far into undergrad, make sure you’ve looked at some medical school sites to see what those courses are. You want to have enough time to incorporate any additional courses that aren’t in your required major, but that schools you are interested in going to require/favor so you don’t have to spend money on postbac courses.

What you need for your application:

Required and recommended science courses (which do slightly vary from school to school).
A good GPA. High overall GPA is always good, but you need to make sure your science only GPA is also high.
MCAT. You aren’t really getting out of this unless you do one of those fancy programs from high school to medical school. Honestly, I think taking the MCAT (even if it is a beast) is a necessary step to growing as an individual. You need to learn failure and hardworking at some point in life. The current average MCAT score is 500. Most schools won’t look at you if you are below this unless you have a super compelling application outside of that. Some schools don’t give you the time of day unless you meet their average. Such as the top 10 schools, coastal schools, etc want a higher MCAT score.
Volunteering. You need a good mix of medical and what you are personally interested in. By the time you get to applying, they mostly look at what you did in undergrad. Unless you did something for all 4 years of high school, they likely won’t care. They want to know that you could balance extra things in undergrad while prepping for medical school. There is no set number, But the more you are able to incorporate with different experiences the better. And honestly, pick a few things or one thing that you are really passionate about outside of medicine. Passion shines brighter than mediocre requirements.
Shadowing. A must. You need to show you’ve seen what the field is like. For DO students/applicants, it is highly recommended that you’ve shadowed a DO. Find out with each specific schools if this is required or recommended. Why? No clue. They literally do the same things. But, that’s what DO schools like to see.
Even better than shadowing is patient care experience. Get in there and get your hands dirty! You are also more apt to get a good letter of rec this way.
Speaking of Letter of Rec’s, you need these. Usually 3 is good, sometimes up to 5 is fine. Anything else and they won’t look. Make sure they are strong though. Don’t just ask someone that doesn’t know you well. And for DO schools, you need at least 1 DO to write you a letter of rec. Again, most of the time DO schools prefer a letter of rec be from a DO, but it is not necessary for all DO schools. In general, make sure you are making strong connections so they have positive things to write about you. You usually need 1-2 science professors and a physician. Each school has separate requirements for this as well, so make sure to peruse the sites so you have what they want. Otherwise, they will just toss your application out.
Research. I honestly didn’t really do this, but for MD schools they look very favorably on this. But in general, the more you are able to immerse yourself into the science and medical fields before-hand, the better.
Have a list of meaningful experiences and why. These will be your highlighted achievements when filling out your application. They can be from the above categories, but you need to make sure you have a compelling reason as to why they were meaningful to you and how they will help you in medical school OR how they have helped you grow as a person, which makes you ready for medical school.
And lastly, that darn personal statement. I hated this. There is no great way for you to go about this. Just start writing why you want to go into medicine. Throw in some main meaningful experiences, or one main one that helped guide you to your choice of medicine. You are going to rewrite this thing a million times. And if you have to reapply for the following cycle, you will probably completely re-edit it. My advice? Make sure someone else reads it. Preferably someone in the field, but you need to make sure it is a strong piece of literature written about yourself that sells you well.

What are the differences in boards?

Same thing as previous honestly. The COMLEX which is what DO’s take has OMM (osteopathic manipulative medicine) woven in. MD’s take USMLE. Everyone takes a step 1, step 2, and step 3. You don’t get out of it either way. DO’s can take both the COMLEX and USMLE, however MD’s can only take the USMLE.

You will mostly use the same resources to study for both. First Aid is still the biggest tool, along with U world questions and pathoma. Other favorites include things like Sketchy, Boards and Beyond, Doctors In training, Kaplan, and other question banks.

When taking the exam, the style is a little different. However they just revamped the test in early 2019, as the amount of answer options varied between the two exams. I will let you know more about them once I take them this summer!

What are the differences in residencies between the two?

Previously, the match for residencies was separate. So if you wanted to go to a more MD focused residency as a DO, you’d have a harder time getting in. Vice versa for MD students. They did take students with outstanding applications though (or so I’ve heard).

In 2020, the residencies for both MD and DO will merge as one. So technically, each site should take either COMLEX or USMLE and they are supposed to be seen as equal. However, there are still some MD specific places that are not as friendly towards DO applicants and do not see the COMLEX as equal as the USMLE. I’m assuming the same if it is vice versa with some DO residencies and MD applicants.

If you are interested in a more MD oriented-type of residency in the future, you will be looking to see how many DO’s they tend to take. Most DO residencies don’t restrict on MD students unless they are very focused on integrating OMM. The hope with the merger is that they are seen as equals (because they literally are outside of OMM?) and to incorporate a more diverse set of doctors.

Hopefully with the merger in years to come, there won’t be a difference in the types of residencies.

I have also learned that regardless of those “average” board scores that you see in some of those charts *cough cough*, the main takeaway is you need to interview at a certain number of residencies to get placed. A lot of times, if you interview at enough places, your board scores and that fact that you are a DO who didn’t take USMLE doesn’t really matter.

However, if you wish to go to a more academic institution for residency REGARDLESS of what degree you have or residency you are looking for, you do need to have research on your CV. They don’t tend to take students who haven’t done research. They also tend to have you do research while in your residency as well. And if you are considering a surgical specialty, it is always a better plus that you have some research on your CV as surgical specialties tend to do more research as well.

Do MD’s and DO’s practice differently?

Not really, no. Again, some DO’s don’t use OMT at all while some do. Medical procedures and the art of taking a history, doing a physical exam, and treating patients is exactly the same. However, if a DO does use OMT, they can bill it as a procedure. Just like if you were to get a knee injection, or get your dislocated shoulder back into place, or get an IUD placed. Other than that, they practice in the same capacity.

I hope this was helpful! Let me know if there are other aspects of MD vs DO that you would like me to talk about. Cheers!

Kenya Series! Medical Mission Trips & How To Get Started

Jambo! (Hello in Swahili).

At KCU, we have a couple of options to partake in a medical mission trip. You can be a part of the global health track (which you have to apply for and be chosen to for), you can fill out the applications that are sent out, OR you can find one on your own.

I recommend researching any mission fairly in depth. Including the ones that are offered at KCU or at your school. You should know some basic things such as:

How much does it cost?
How long will I be traveling?
What sort of experience do I want out of this?
Are there scholarships available?
What guidance is available to me?
What to I need to obtain before traveling out of the country?

For this particularly mission, I had emailed the head professor in charge of the global health track. I was curious if KCU would take students outside of the track at the time, and wanted to know some more information on the Kenya trip. A few months later, an email was sent out to all students for applying. The summer Kenya Mission took 9 students this year (more students were taken this year than in previous years). It was a total of 18 days, but our total clinic days weren’t set in stone. We personally had a great mix of clinic and additional touristy things to do. Looking back, I wanted slightly more clinic time, but the weather and other factors this past year just didn’t allow for it.

Applying

You need to make sure you have researched all potential places before applying. I emailed a lot of companies/sites before deciding to actually apply. Please be mindful with travel companies, they may try to spin a few things or sell pretty hard because they want you to pay to go with them instead of to another country with another company.

You will also need a valid passport. Depending on the time of year, it could take several months to get a passport if you’ve never gotten one before. Renewing a passport takes less time, but still takes time. If you are thinking of doing a trip, I suggest you try to tackle this way ahead of time. You can’t leave the country without a valid passport. End of story. You also likely won’t get picked for a school trip if you don’t have one either.

The KCU trip, like I stated, was an email sent out to every student with the information for how much it would cost and the application. For all other applications through specific companies, they usually have their application on their website. Most will ask you why you are interested in going and if you have any previous experience. That way if you do have some medial experience they will be more open to allowing you to use your skills.

Obviously, KCU knows how much experience you have because they have access to your profile. For KCU, you need to be in good academic standing. If you need to repeat a course that summer or you have lower than a 2.5 GPA (required GPA for any clubs or leadership positions), then you likely won’t get it.

Other than that, I don’t think KCU had too many requirements. If you do the MBA program in medical school, you won’t be able to do the summer mission trip. At least the year that I went the schedules collided. I’m not sure if the bioethics one overlaps as well with this trip. But be cognizant that you can’t do everything. And some of your previous scholastic engagements may overlap when you are wanting to do a summer trip.

After acceptance:

Filling out the application was easy. Especially if your passport is ready. It is all the additional things you need to get done to go that take up time, effort, and obviously cost $$$. Most of the vaccinations you need will be done or had to have been updated in order to be enrolled at KCU. Some will not. Here are the things that were expected of us to complete, and we were given some additional information on:

vaccinations
visa
specific cost breakdown
packing list
some information about your travel/specifics of what you will be doing

Majority of your vaccines should be up to date as you needed them for medical school. Unfortunately for me I needed a bunch of boosters because I hit that sweet spot of still young but my original immunity was waning. Le sigh….

So I did have to get boosters plus the additional traveling vaccinations as Kenya is endemic to many diseases that are eradicated in the United States.

-make sure you are paying adequately for the amount of time you will be gone… and if there are any additional services/experiences included. Some places are extremely unreasonable with the amount of money asked…

Vaccinations

Typhoid Capsules (the oral vaccination lasts 5 years and is recommended over the injection which lasts 1-2 years).
Malaria prophylaxis (not really a vaccine, but you do need this).
Yellow Fever Vaccine
Meningitis
Polio (Kenya has an endemic. You must get this prior to going. If you are going to be there longer than 28 days, you need to have it boosted right before leaving).
Tdap
Hepatitis A & B

Fun fact: if you were born before 1995 the Hepatitis A vaccine was not created yet. So even though it is now part of the mandatory vaccination routine for children, I never got it. And that shit hurts.

Yellow Fever vaccine is EXTREMELY hard to get. It is very costly, and there are limited clinics which are now able to give this out. Apparently, there were 2 factories who made this vaccine; one in France and one in the US. Well the US one shut down and has not reopened (yet). Thus, France is the only supplier for the entire world of this vaccine. Hence the hefty price tag and difficulty obtaining it. There is one clinic in KC Overland Park that has it, but call ahead of time. St. Louis, Nebraska, etc tend to have month(s) long waiting periods. As soon as you know you are going on this trip, call ahead and book an appointment with one of these places. It will be less stressful for you if you have it on the books, and will be awful if you have to cancel your trip because you couldn’t get it.

Visa

In general, the company or school you are booking your trip through should walk you through how to fill out that country’s visa. But it never hurts to make sure you have guidance if you need it. I could easily visit Kenya’s government website and had to pay $50 for my visa to be processed.

Cost Breakdown

KCU’s total cost was $4300 for the trip. This included most things: flights, lodging, transportation, food, safari, and groceries. If you wanted extra money to spend or needed more groceries/water then the allotted allowance, you would need to bring more money.

KCU also recommended you bring about $300 extra in case you wanted trinkets or if we ran across any additional touristy things. We ended up going out a few times as well; sometimes we had to pay and other times our tab was covered for us. I did not end up spending all of this money. In fact, I barely spent any of this extra money I brought. But it was good to have on hand just in case I needed it in Kenya to do something extra or in case I needed it when I got back to the States.

The last thing you need to know is you may have to spend a bit more prior to your trip on things such as your vaccinations, visa, and extra stuff when packing.

Sure, you could probably figure out how to get to your country and back for much cheaper. But if you are traveling with your school, they have to ensure all of you are on the same flights and usually are seated near one another. Because of this, flights can be a bit more.

In general your flight should be the most expensive part. But look at flights, lodging, if food is paid for or provided (and if not, how much are you expected to find for yourself), transportation, and touristy attractions. You will also need to know if the company you are with can help you exchange your money or where you can go to do that. You will want to bring extra money in case: tourist attractions that may pop up, getting trinkets and gifts to take back, tipping, etc.

Make sure that when you are looking at these costs there is a good ratio for you. If you want to only be in clinic, pick a company that only goes to clinics. If you want more touristy events and less clinic, find a company that does that.

If you feel you are being gypped, do your research on other companies to see if it is a fair price.

During my school trip we were given about 1000 Kenyan Shillings a week each. My roommate and I pooled our expenses together since we were buying water and snacks together anyways. This money was part of what we had already paid for in our trip as well. And if we needed more, we had access to exchanging American dollars for Kenyan Shillings.

Emergency Contacts

This goes without saying, but make sure you have phone numbers or a way to get a hold of the company if an emergency happens. Send your visa to the nearest embassy and have copies of your passports/visas stowed away from your originals as a just in case. If you are going with your school, they likely will have already done this for you. Make sure your school/company has contact information for your emergency contacts in case something happens to you and they have to phone home. And as always, ask about if they carry medicine on them or have a reliable hospital to take you to if need be.

Global Health Trips

Here were a few places that students have gone or where I looked into:

IVHQ. They have have many locations and have volunteer needs for much more than just medical. I had two classmates go with this company this past summer and they thoroughly enjoyed it.

Power of a Nickel. Another two of my classmates also went on this. I looked into this one, but the one place I wanted to go was a bit more expensive than I preferred and not as long as I would have liked. However, my classmates seemed to have had a blast.

DOCARE International. Here you can apply to a range of international trips. However with this, if it is through a specific school they may advertise it on the website but most spots will go with to their own student population. But it is a good place to look and see what is available and try!

Health Corps Haiti. It looks like trips last about 1 week and they take both pre-med/pre-dental and medical/dental students. They also seem to have multiple trips throughout the year. This was suggested by a upper classmate but I’m not sure how many students have previously gone with this one.

Rad-Aid. Does something with medical imaging. I’m not sure what is with this one, but it was suggested by an upper classmate.

Plan my Gap Year. This was the company I was going to go through if I didn’t get into KCU’s global health program. I found many reliable prior volunteer accounts. The only downside seemed to have been that if you didn’t know any skills they weren’t willing to teach you… makes sense. But overall there were many different places you could go at reasonable prices.

Your school! If your school has a global health tract OR has professors that are involved in global health trips, you can get in with them and tag along or apply.

Lastly…

I’m not sure how many times I have written this in this post, BUT DO YOUR RESEARCH. There were a few companies that I was completely sold on, but until I did a deep dive realized they were money scamming or were not great experiences per other travelers/students. Do your research. Reach out to other students or previous volunteers. Ask all those questions. And make sure you go with a place where you feel you will get the most out of your experience!

I hope this helps. Cheers!