By Alexandra Taffany From Times Union

I’m returning today to New York from what was my “last hurrah” before med school starts on Monday (side note: AHHHHHH!!!!!!!). I was lucky enough to spend a week on a Caribbean island, relaxing and soaking in as much free time as I could before the insanity of school takes over.  While I expect the weather in Buffalo to be sub-par compared to the Caribbean islands, I also know that students who attend medical school in the Caribbean face a far more difficult path than I will as a US student.

As much as I love it, I think the beach would not be the best environment for studying.

For a variety of reasons, students from different types of medical students are often “classified” based on where or what type of school they attend. It’s an unspoken opinion, but many medical students are aware of this bias. USA allopathic (meaning the degree earned is an MD) students are often viewed at the top of the caste, followed by US osteopathic (meaning the degree earned is a D.O., or Doctor of Osteopathy) students. Following the DOs are the International Medical Graduates (IMGs), who often are Americans who attend Caribbean or other international medical schools. But if everyone earns a medical degree, what accounts for this bias?

A lot has to do with statistics, tradition and (mainly) ego. MDs were the first medical degrees awarded in the US, and the average GPA and MCAT scores are the highest for US allopathic students. Due to this legacy and higher statistics, I think a lot of US graduates think of US allopathic schools as “the best option.”

DO degrees were created as an enhancement to the MD degrees. Andrew Still, an MD, thought that the MD curriculum was not properly treating ailments. He founded the first Doctor of Osteopathy school in the US. Additionally, the osteopathic philosophy seems to be more holistic than its allopathic alternative.

DO students learn an interesting technique known as Osteopathic Manipulation to treat medical conditions. Using bone and joint manipulations, DOs can use physical maneuvers to treat patient’s complaints without medication. Aside from this technique of physical manipulation, which MD students do not learn, DO students learn the exact same information as MD students.

While many DOs choose to apply solely to DO schools based on the philosophy alone, sometimes DO students are viewed only as students rejected from allopathic schools. While many osteopathic schools have a slightly lower GPA and MCAT average compared to US allopathic schools, it is an unfair stigma to assume DO students are less competent than MD students.

Caribbean and other international medical students also encounter significant bias. International students are often viewed as students who were rejected from US medical schools. They have a much more difficult time arranging clinical rotations in the US, and they may have to move all over the country in order to complete the required rotations (US students have a guaranteed slot in a hospital close to their medical campus). IMGs encounter a much more difficult time matching into a residency program, as program directors generally favor US graduates over international graduates. Again, it is unreasonable to think international students are less capable than US grads. In fact, IMGs may be better doctors because they had to work even harder to accomplish their goals.

In the end, once matched into a residency program, everyone is considered an equal. It’s disappointing that some portions of medicine are so resistant to change. However, considering the competitive nature of doctors, it’s not surprising to see that some doctors self-impose a hierarchy to fuel their egos. Really, if a doctor is competent, compassionate, and ultimately doing what is best for the patient, does it really matter where he or she attended school?

For more on this story go to:

http://blog.timesunion.com/mdtobe/the-unspoken-hierarchy-of-med-schools/3809/

PHOTO: St Matthews University, Grand Cayman, Cayman Islands