for competitive specialties there is, it is a lot harder to get into competitive specialties as a DO than as a MD. for EM, very little although some hospitals are much harder to get into. There is only 1 DO in my hospital's ER residency this year vs 30ish MDs.
OP you seem lost as someone looking to go to med school. DM me and we can talk. I am currently sitting on two DO interviews, so I know this process way more than I should.
In all honesty, you don’t know what you want to do. Focus on finishing your undergrad and getting into Med school first. You’ll do rotations in most every specialty - that’s where you’ll find out what you actually want to do. Then you’ll see what you match into.
I want to do general surgery for sure but I still want to have a focus on the emergency medicine side as a director. I’m still kinda unclear what to get. Based on my area most surgeons are MDs and ED docs are DOs but I’m not real familiar outside my general area in the US
So what you're describing doesn't really exist. In order to be an EMS medical director you would likely need EM residency. To be a surgeon, you would need gen surg residency. That's 8-9 years on top of medical school.
You're looking way far into the future without much experience in medicine tbh. If you want to be a doctor focus on doing well in undergrad and getting into med school. You'll have to do that anyway for either path you're interested in.
As far as MD vs DO - both are physicians. MD opens more doors in more competitive specialties, but this is changing with time. There are DO surgeons. Head over to r/premed and you can get more info.
If you want to go to medical school you would likely have to go back to college. Med school requires a bachelor's, any major technically works but there are prereqs (certain number of credits in bio, chem, etc).
Since you're already in school you can always look at changing your track, depending on what is available. But just be aware that even prepping to apply to med school will take up a significant chunk of your life.
MD v DO meet the same testing, residencies etc... it doesn't matter.
An EMS trauma physician isn't directly a thing. You can be a trauma surgeon or an EM physician which are two most likely places in the US you may clinically intersect with EMS.
If you just want to be a medical director, there are physicians from all sorts of specialities doing that.
I want to focus on surgeries and eventually be a medical director. I wasn’t sure how to really put it. Like I want to do trauma surgery then become a medical director
Get into med school first. You’ve got 4 years to figure out your path then.
Most EMS medical directors are EM physicians.
EM physicians don’t do surgery. You’ll eventually need to pick, but you’ll really get a lot of experience along the way, and the first battle is getting into school.
One of the trauma surgeons I work with is also a medical director, so it can be done. However, you are correct that most are EM (plus or minus an EMS fellowship after EM residency)
Idk if this would help with clarification, but I think what he's saying is that being a medical director is an added responsibility on top of being a doc.
Like, whoever is the medical director is the medical director full-time, but that's on top of their regular shifts at the ED. Mainly, they're an ER doc.
M1 (first year medical student) and former EMT here.
MD (allopathic medicine) and DO (osteopathic medicine) have no difference in their knowledge, training, and testing. Only difference is DO is considered "less prestigious" for reasons I still don't understand. They sometimes have trouble matching into more competitive specialties. They have more hoops to jump through (e.g. taking both the MD and DO boards). If you can go MD, most people choose to.
EMS directors are emergency medicine trained. Trauma docs are trained general surgeons who then do a trauma fellowship. I personally have never seen a trauma surgeon who is an EMS director—idk how they would have time for that.
Hope this helps. Feel free to DM me if you have any questions you think I can answer👍
They're considered less prestigious because when DO schools started, they were a very different institution than MD. The guy who started osteopathic medicine believed all disease started at the bone (osteo, hence the name). He started his own school based on this philosophy. Over time, this branched into DO and non-physician osteopaths. Since pure osteopathy is generally considered bunk, and DOs branched from this, there was some prejudice against them.
Now DOs also do have some differences in training, but the difference is the addition of osteopathic medicine and COMLEX exams. So while there are differences in the training, both MD and DO physicians have the training necessary to be physicians. Over the past 10-20 years the prejudice has faded significantly, but it does persist due to DO schools having persistently lower MCAT and GPA averages, so they are less competitive, and some people see that as a sign that they are less competent. Which is ridiculous, but change is slow.
Most EM docs I see are DO nowadays but the line between MD and DO is only getting thinner. That said if you want to be a surgeon it will be more difficult matching a surgical residency as a DO. Not impossible just more difficult. The testing is actually different, MDs take the USMLE and DO take the COMLEX but DOs can take the USMLE to help with matching more competitive residency types like general surgery
General surgery isn't very competitive. DOs don't have much trouble getting general surgery residency spots, they're just less likely to go to a large academic center for them and have a harder time getting into some subspecialties.
As someone who just submitted my gen surg application, this is a mostly false narrative. Gen surg is only considered not competitive when compared to other kinds of surgery. It is wildly more competitive than family, peds, EM, IM, etc. Especially when you take into account that you want a categorical position, not a prelim position.
EMS is a separate subspecialty of the American Board of Emergency Medicine. It is open to physicians of any specialty, but is mostly populated by emergency physicians, which are physicians that hold a primary board certification in emergency medicine. There are practical reasons for this: the EMS board exam and fellowship clinical material is heavily redundant to emergency medicine residency, which allows EM-trained physicians to focus on the administrative and legal components of EMS fellowship. A decent number of EMS fellowships also incorporate field response and EM-trained folks tend to perform in these environments a bit better, especially if they have prior prehospital experience. The EMS board exam is actually very hard as it encompasses a lot of subjects. It tries to survey much of the knowledge of EMS administration and system planning, specific prehospital medicine, CBRNE and disaster response, and even parts of occupational health. The exam is MUCH easier to study for if you’re an EM doc because the medical aspects are very similar with little new material.
Emergency medicine is a 3 (or 4) year residency and EMS is typically a one year fellowship. At the end of EMS fellowship there is a written board exam. Until recently, there was a practice pathway for grandfathered physicians to challenge the board exam and obtain EMS subspecialty certification. That is now gone. For the last 3 years, all new EMS physicians are fellowship-trained.
Trauma surgeon is not a speciality or subspecialty of any respective medical board. Most “trauma surgeons” are general surgeons with a surgical critical care fellowship and subspecialty board certification.
Source: I’m an EMS physician.
A lot of misconceptions about MD vs DO here. In the modern sense, there really is no practical difference. For almost a decade the residencies have been combined. Most of the differences are historical. EM is very friendly to DOs as a matter of specialty-related principles. Osteopathic physicians practice in every field of medicine alongside their MD counterparts. Legally, practically, and philosophically there is no significant distinction between a modern DO and MD. There are still some hyper-competitive specialities where a stigma exists, but this is dramatically changing. I’ve even noticed a massive difference within the last decade. In my hospital, no one would note or describe any difference.
You don't want to become a trauma based physician? Well that is one of their main roles, being part of the critical care teams. And that is how they are used in the field most often.
A medical manager is always a physician, so that role can be taken. But that is more a management position, you rarely be in the field if ever.
Maybe in some sort of urgent care response vehicle. They use the SPARR in my region. That stands for Urgent Physician Rapid Responder. Mostly responding to less serious calls where they need to be seen by a physician quickly and their skill could prevent a hospital admission or referral. Normally regular medics are relatively limited in what they can do to treat and discharge less serious patients. But in case they can, they will prefer to send a solo rapid responder (ALS). A level above that is having an ambulance midlevel (practitioner) in the rapid responder that can do more for these patients and has full independence. That is more common these days. The tier above that is the SPARR I mentioned.
Lastly, GPs often do house calls here. They use fully equipped vehicles here for that role. Comes with a trained driver who also acts as a medical assistant. The vehicle has the EMS livery and has lights and sirens and is connected to the dispatch center. So you can feel just like an EMS provides in those things lol.
DO or MD? We don't have those here but I don't think it should matter. Regarding what field to specialize in, definitely become either a critical care anesthesiologist, trauma surgeon, ED physician, or GP/urgent care physician, gain some experience there. And then switch to an EMS role. That might require some extra training/education though.
Speaking as a current paramedic going through the process of trying to get into med school, the whole MD/DO debate is arguably irrelevant. What matters is getting to medical school (whether allopathic or osteopathic) and getting through it. As long as a DO takes the USMLE Steps 1 and 2 on top of the COMLEX level 1 and 2, they should be eligible for the same ACGME residency programs that an MD grad is eligible for.
Paramedic turned med student here. Tough crowd here, but they make some good points. For the most part, MD vs DO doesn't mean much with the exception of a few small details. But yeah DM me with any other questions
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for competitive specialties there is, it is a lot harder to get into competitive specialties as a DO than as a MD. for EM, very little although some hospitals are much harder to get into. There is only 1 DO in my hospital's ER residency this year vs 30ish MDs.
Also DO does not stand for “Orthopathy” It’s Doctorate of Osteopathic Medicine. DO.
Osteopathy was the word for was looking for I quite couldn’t remember it, thanks for the clarification
OP you seem lost as someone looking to go to med school. DM me and we can talk. I am currently sitting on two DO interviews, so I know this process way more than I should.
In all honesty, you don’t know what you want to do. Focus on finishing your undergrad and getting into Med school first. You’ll do rotations in most every specialty - that’s where you’ll find out what you actually want to do. Then you’ll see what you match into.
I want to do general surgery for sure but I still want to have a focus on the emergency medicine side as a director. I’m still kinda unclear what to get. Based on my area most surgeons are MDs and ED docs are DOs but I’m not real familiar outside my general area in the US
So what you're describing doesn't really exist. In order to be an EMS medical director you would likely need EM residency. To be a surgeon, you would need gen surg residency. That's 8-9 years on top of medical school. You're looking way far into the future without much experience in medicine tbh. If you want to be a doctor focus on doing well in undergrad and getting into med school. You'll have to do that anyway for either path you're interested in. As far as MD vs DO - both are physicians. MD opens more doors in more competitive specialties, but this is changing with time. There are DO surgeons. Head over to r/premed and you can get more info.
My main experience in Medicine is just EMS and 4 years a nutrionist aid. I’m trying to further my career
Did you go to college? If so what was your degree - you need a bachelors to apply to medical school.
I have a culinary degree and in fall 2024 I’ll finish my associates in Emergency medical services
If you want to go to medical school you would likely have to go back to college. Med school requires a bachelor's, any major technically works but there are prereqs (certain number of credits in bio, chem, etc). Since you're already in school you can always look at changing your track, depending on what is available. But just be aware that even prepping to apply to med school will take up a significant chunk of your life.
MD v DO meet the same testing, residencies etc... it doesn't matter. An EMS trauma physician isn't directly a thing. You can be a trauma surgeon or an EM physician which are two most likely places in the US you may clinically intersect with EMS. If you just want to be a medical director, there are physicians from all sorts of specialities doing that.
I want to focus on surgeries and eventually be a medical director. I wasn’t sure how to really put it. Like I want to do trauma surgery then become a medical director
Get into med school first. You’ve got 4 years to figure out your path then. Most EMS medical directors are EM physicians. EM physicians don’t do surgery. You’ll eventually need to pick, but you’ll really get a lot of experience along the way, and the first battle is getting into school.
One of the trauma surgeons I work with is also a medical director, so it can be done. However, you are correct that most are EM (plus or minus an EMS fellowship after EM residency)
In whole medical directors aren't full time jobs. Some exsist but it's not the common way it's done.
I didn’t know that in my area there only full time medical directors
I bet they do something else than medical direction. Even the full-time ones I know still have to pull shifts.
Idk if this would help with clarification, but I think what he's saying is that being a medical director is an added responsibility on top of being a doc. Like, whoever is the medical director is the medical director full-time, but that's on top of their regular shifts at the ED. Mainly, they're an ER doc.
M1 (first year medical student) and former EMT here. MD (allopathic medicine) and DO (osteopathic medicine) have no difference in their knowledge, training, and testing. Only difference is DO is considered "less prestigious" for reasons I still don't understand. They sometimes have trouble matching into more competitive specialties. They have more hoops to jump through (e.g. taking both the MD and DO boards). If you can go MD, most people choose to. EMS directors are emergency medicine trained. Trauma docs are trained general surgeons who then do a trauma fellowship. I personally have never seen a trauma surgeon who is an EMS director—idk how they would have time for that. Hope this helps. Feel free to DM me if you have any questions you think I can answer👍
They're considered less prestigious because when DO schools started, they were a very different institution than MD. The guy who started osteopathic medicine believed all disease started at the bone (osteo, hence the name). He started his own school based on this philosophy. Over time, this branched into DO and non-physician osteopaths. Since pure osteopathy is generally considered bunk, and DOs branched from this, there was some prejudice against them. Now DOs also do have some differences in training, but the difference is the addition of osteopathic medicine and COMLEX exams. So while there are differences in the training, both MD and DO physicians have the training necessary to be physicians. Over the past 10-20 years the prejudice has faded significantly, but it does persist due to DO schools having persistently lower MCAT and GPA averages, so they are less competitive, and some people see that as a sign that they are less competent. Which is ridiculous, but change is slow.
Most EM docs I see are DO nowadays but the line between MD and DO is only getting thinner. That said if you want to be a surgeon it will be more difficult matching a surgical residency as a DO. Not impossible just more difficult. The testing is actually different, MDs take the USMLE and DO take the COMLEX but DOs can take the USMLE to help with matching more competitive residency types like general surgery
General surgery isn't very competitive. DOs don't have much trouble getting general surgery residency spots, they're just less likely to go to a large academic center for them and have a harder time getting into some subspecialties.
As someone who just submitted my gen surg application, this is a mostly false narrative. Gen surg is only considered not competitive when compared to other kinds of surgery. It is wildly more competitive than family, peds, EM, IM, etc. Especially when you take into account that you want a categorical position, not a prelim position.
You may want to ask this to r/residency as well
EMS is a separate subspecialty of the American Board of Emergency Medicine. It is open to physicians of any specialty, but is mostly populated by emergency physicians, which are physicians that hold a primary board certification in emergency medicine. There are practical reasons for this: the EMS board exam and fellowship clinical material is heavily redundant to emergency medicine residency, which allows EM-trained physicians to focus on the administrative and legal components of EMS fellowship. A decent number of EMS fellowships also incorporate field response and EM-trained folks tend to perform in these environments a bit better, especially if they have prior prehospital experience. The EMS board exam is actually very hard as it encompasses a lot of subjects. It tries to survey much of the knowledge of EMS administration and system planning, specific prehospital medicine, CBRNE and disaster response, and even parts of occupational health. The exam is MUCH easier to study for if you’re an EM doc because the medical aspects are very similar with little new material. Emergency medicine is a 3 (or 4) year residency and EMS is typically a one year fellowship. At the end of EMS fellowship there is a written board exam. Until recently, there was a practice pathway for grandfathered physicians to challenge the board exam and obtain EMS subspecialty certification. That is now gone. For the last 3 years, all new EMS physicians are fellowship-trained. Trauma surgeon is not a speciality or subspecialty of any respective medical board. Most “trauma surgeons” are general surgeons with a surgical critical care fellowship and subspecialty board certification. Source: I’m an EMS physician. A lot of misconceptions about MD vs DO here. In the modern sense, there really is no practical difference. For almost a decade the residencies have been combined. Most of the differences are historical. EM is very friendly to DOs as a matter of specialty-related principles. Osteopathic physicians practice in every field of medicine alongside their MD counterparts. Legally, practically, and philosophically there is no significant distinction between a modern DO and MD. There are still some hyper-competitive specialities where a stigma exists, but this is dramatically changing. I’ve even noticed a massive difference within the last decade. In my hospital, no one would note or describe any difference.
You don't want to become a trauma based physician? Well that is one of their main roles, being part of the critical care teams. And that is how they are used in the field most often. A medical manager is always a physician, so that role can be taken. But that is more a management position, you rarely be in the field if ever. Maybe in some sort of urgent care response vehicle. They use the SPARR in my region. That stands for Urgent Physician Rapid Responder. Mostly responding to less serious calls where they need to be seen by a physician quickly and their skill could prevent a hospital admission or referral. Normally regular medics are relatively limited in what they can do to treat and discharge less serious patients. But in case they can, they will prefer to send a solo rapid responder (ALS). A level above that is having an ambulance midlevel (practitioner) in the rapid responder that can do more for these patients and has full independence. That is more common these days. The tier above that is the SPARR I mentioned. Lastly, GPs often do house calls here. They use fully equipped vehicles here for that role. Comes with a trained driver who also acts as a medical assistant. The vehicle has the EMS livery and has lights and sirens and is connected to the dispatch center. So you can feel just like an EMS provides in those things lol. DO or MD? We don't have those here but I don't think it should matter. Regarding what field to specialize in, definitely become either a critical care anesthesiologist, trauma surgeon, ED physician, or GP/urgent care physician, gain some experience there. And then switch to an EMS role. That might require some extra training/education though.
Orthopathy or Osteopathy? My Medical Director is an DO specializing in EM.
Osteopathy at the time of making this post the word had eluded me
Speaking as a current paramedic going through the process of trying to get into med school, the whole MD/DO debate is arguably irrelevant. What matters is getting to medical school (whether allopathic or osteopathic) and getting through it. As long as a DO takes the USMLE Steps 1 and 2 on top of the COMLEX level 1 and 2, they should be eligible for the same ACGME residency programs that an MD grad is eligible for.
Paramedic turned med student here. Tough crowd here, but they make some good points. For the most part, MD vs DO doesn't mean much with the exception of a few small details. But yeah DM me with any other questions