Will Changes to the Student Loan System Worsen Physician Shortages?

WayOutWestMom
Fri, 27 Jun 2025 01:38:27 +0000

Western isn’t a random DO school. It’s one of the most competitive-for-admission DO schools in the US. It’s located in Pomona, CA and largely draws its students from the CA pool of med student hopefuls. Many CA pre meds choose to attend a DO program rather than attend an OOS med school. Its students have admission stats that are comparable with those of many MD programs. Western had a 2.3% admission rate, average GPA 3.76, average MCAT 507. (Full disclosure: my daughter used to supervise/teach Western’s med students and residents rotating thru her hospital when she lived in CA.)

Now here comes the question: why do 56% of their students go into primary care?

Is it because they chose a osteopathic med school because DO programs have a reputation of sending a large percentage of their students into primary care?

Is because of the DO “stigma”?

Is it because their board scores aren’t high enough to get serious consideration for the more competitive specialties?

Is it because as an osteopathic med school, Western has limited facilities and opportunities for the students to engage in basic research and gain publications that are a de facto requirement to enter the most competitive specialties?

Is it because osteopathic med schools often require students to find and arrange their own rotation sites for electives thus leading to weaker or less hands on exposure to surgical and highly competitive specialties?

Is because many DO students don’t take the USMLE boards that competitive specialties require for consideration? (Osteopathic med schools require their students to take COMLEX exams instead of USMLEs. DOs need to take both the COMLEX and the USMLE if they want to be considered for certain programs/specialties. The overlap is between the 2 exams is pretty high, but the each exam covers topics not included on the other. Also the scoring system for each exam is completely different.)

Is it that most of the students chose to accept a rural primary care residency in order to remain in California, near family instead of pursuing an OOS post in more competitive specialty?

Many of the primary care matches are at formerly DO-only programs. Why is that?

Are the students choosing programs they’ve rotated thru previously and thus have an advantage when it comes to Matching? (Partial answer: yes, one of the programs that has multiple primary care matches is a rotation site for Western. Its students have an advantage there because the program already knows them and how well they fit into their program.)

Some or all of the above?

You really can’t infer anything from a single year’s Match List.

The NRMP has Match data goin back to the 1980s that is publicly available. All you need to do is google it. However, the data is not comparable because older data does not include USDO seniors and grads because DO programs held their own separate Match until 2020. Older NRMP data also does not include information about US IMGs or non-US IMGs. Also in 2021, the NRMP instituted an “all in” policy that mandates if a hospital/clinic uses the NRMP for any specialty match, that program MUST use the NRMP Match for all of it specialties. Prior to this, a residency site could opt to privately hire some or all of their residents and not report their results to the NRMP. There are still a few programs that don’t use the NRMP match to hire residents.

I don’t have the time or energy right now to do a deep dive into the data, but a quick look at the aggregate 2000-2005 and 2006-2010 data showed that FM had a 3% decline in the number of USMD seniors applying to it between 2004 and 2005. That decline was maintained in 2006. (So not a 1 year fluke.)