Reminds me of the do school debate in the WSJ this morning

[Hatton]

https://www.wsj.com/articles/the-rise-and-fall-of-a-law-school-empire-fueled-by-federal-loans-1511544524

Just because you want to go to professional school someone will let you run up lots of debt.  No standards then young people are left with lots of debt and are working in a call center.  I think grades and MCAT/LSAT are protecting lots of people that do not realize it.

[Doc Spouse]

The quote that struck me was that Sterling saw "Surplus Demand" for lawyers in 2004.

That and..

"In 2006, the year Charlotte opened, Congress approved a loan program known as Grad Plus. It allowed graduate students to borrow unlimited sums to cover tuition and living costs. Previously they were limited to $18,500 a year."

I mean.. What could go wrong?

Very interesting article.  Thanks for posting it.

[The White Coat Investor]

I don't think these are anywhere near equivalent. The vast majority of graduating DOs are matching into residencies, finishing those residencies, and getting jobs as physicians.

I would much rather have a DO degree and $400K in debt than a DDS and $400K in debt. I would rather have it than a DVM or DPT and $200K in debt. I would rather have it than a JD and $150K too.

They're going to have to open a lot more DO schools before this becomes an issue. Bear in mind there is a bit of a safety valve here- the FMG/IMGs. The match rate for a DO, even into MD residencies, is much closer to that of MDs than that of FMGs or IMGs. Open a DO school and your graduates don't yet have to compete with/displace other DOs (much less MDs) to get residency spots. They only have to displace FMGs/IMGs. I don't think that's a terrible position to be in.

http://www.nrmp.org/press-release-results-of-2016-nrmp-main-residency-match-largest-on-record-as-match-continues-to-grow/

MD Match Rates:

• MD 94%


• DO 80%


• USIMG/FMG 54%


• IMG 50%

And that ignores the fact that there is a completely separate DO match, with a 99.6% match rate. I mean, you could argue you're better off with a DO than an MD when it comes to matching somewhere that will allow you to eventually practice as a physician.

[Hatton]

I think the law school article is interesting because it shows the financial incentives in play to increase the number of law students paying tuition (student loans) and ignore that the student is not capable of passing the bar.  This is not really helping these students in any way.  It is just putting them into debt.  It shows the moral hazard of increasing the amounts of money available for graduate education such that it attract private equity is not necessarily a good thing.  Are all these DO schools doing this same thing?  I don't know but I thought this article is interesting.

[ajm184]

I believe there are differences between a DO program and a Law program.  For law it is a one time exam (the Bar).  In my wife's case (a DO) she took exams (I believe 3) at the end of her 2, 3, and 4 year medical school.  This provides a natural check to keep students on course or in not so subtle terms tell them they need to consider another career.

The WSJ article demonstrates the conflict of interest between the school's original mission and that of the later financial owners.  It seems to me though a mission based approach to giving minorities who have a desire to pursue law is viable given the early results.  It is also useful to understand that scale would have to be done slowly and consume greater resources relative to a traditional Law school.  In my mind, the two points above are relevant new DO schools, though only time will tell of the students success.

About 12 years ago there was a front page article in the Chicago Tribune about a woman who had just earned an undergraduate degree from University of Chicago, taking on roughly 60K of student debt.  The tragedy in my mind is that her degree was in Social Work with an average starting salary of like $28k/year at the time.  If I were king, students could only borrow a total amount that is a percentage of the career's starting earnings based upon the program/degree in question of the first year earnings.  This issue is far worse imo in undergraduate programs, with administrations snowing students and family's of the cost/benefit's of a given degree program.

[The White Coat Investor]

Here's the other thing I can tell you from my experience on an admissions committee. There is no shortage of people smart enough to get through medical school and residency and practice medicine in a competent manner. It was easy to find 400 of those people for a class of 100. So I think the fear that these new DO schools are suckering people who can't hack it into paying hundreds of thousand in tuition is completely overblown. It's going to have to expand a lot before that becomes an issue.

[AR]

The White Coat Investor wrote:

Here’s the other thing I can tell you from my experience on an admissions committee. There is no shortage of people smart enough to get through medical school and residency and practice medicine in a competent manner. It was easy to find 400 of those people for a class of 100. So I think the fear that these new DO schools are suckering people who can’t hack it into paying hundreds of thousand in tuition is completely overblown. It’s going to have to expand a lot before that becomes an issue.

Click to expand...

My speculation, and it's only speculation, is that a lot of the folks outside that top 100 basically have an MD or bust mentality.  They realize that DOs have fewer opportunities and many of them will just eschew medicine all together.  For example, it would be very easy for almost anyone who gets into any medical school (or is smart enough to) to get in to a top 20ish law school which virtually guarantees them a high paying job.

I can think of 3 people who I knew in college who didn't get into medical school, who were absolutely smart enough to become good docs.  One did a PhD first and then went to allopathic med school (and ultimately matched a an extremely prestigious residency). Another went to a top 10 law school.  The last went into management consulting and ultimately business school.  I'm sure they're all doing as well financially as most docs.   None of them considered DO school for even a second  This was a while ago, however.  Maybe things are different these days.

[Kamban]

The White Coat Investor wrote:

MD 94% DO 80% USIMG/FMG 54% IMG 50%

Click to expand...

These are raw numbers. Many IMG apply for internal medicine to try and get into one of the lucrative sub-specialties, or gen surgery or even the difficult to get into specialties, especially if they have had previous experience with it in their home countries. They apply for FP in much smaller numbers. Thus they have an overall lower match rate. Some IMG are just plain terrible in their medical knowledge and training.

For 2017 all positions in FP residencies were not fully matched.

As the number of US IMG, who have predominantly to Caribbean schools, decrease the slack will be filled by DO. But once this is reached there will be unmatched DO unless the residency slots increase.

Also, as the debt load of DO increases much more than MD they will try and get into higher paying specialties ( as you point out as one of the ways to build wealth and get out of debt). And there they will clash with US MD and highly trained FMG and will not get matched in those specialties. They may have to settle for primary care with low pay and competition from mid levels, and yet have $400-500K debt..

[ENT Doc]

I'm not sure where you're getting the 99.6% number but here are the numbers for the AOA match (the match for DOs specifically):

https://natmatch.com/aoairp/stats/AACOM-NMS-Apr4-14.pdf

Their match rates are poor, hovering around 75-80%. Furthermore, the applicants are increasingly prior graduates rather than current graduates. This speaks to oversupply, a growing pool of graduates cycling back around, and is clearly shown on one of the earlier slides showing graduates increasing at a rate above demand. Keep in mind there are 4 years worth of DO students in the pipeline now, so even if ZERO new DO schools opened this would be a worsening trend for years. Since that is not the case, opening of DO schools at an alarming rate and for less than admirable reasons is cause for concern now, not at some point in the future.

[orthodds]

I would rather have a DDS degree and equivalent debt than an MD or DO. Dentists generally spend significantly less time (if any at all) in residency training programs which gives them a head start. General dentists have earnings similar to family practice physicians while dental specialists have earnings equal to the average of physician specialists. I’m only making this point in the context of this discussion regarding debt and the finances of MDs, DOs and now DDSs. Whichever profession one chooses is a personal decision and it’s based on many factors. But I wouldn’t assume MD/DO will be a better choice financially than DDS.

[orthodds]

My comment is in response to WCI who said: “I would much rather have a DO degree and $400K in debt than a DDS and $400K in debt. I would rather have it than a DVM or DPT and $200K in debt. I would rather have it than a JD and $150K too.”

[MPMD]

ENT Doc wrote:

I’m not sure where you’re getting the 99.6% number but here are the numbers for the AOA match (the match for DOs specifically):

https://natmatch.com/aoairp/stats/AACOM-NMS-Apr4-14.pdf

Their match rates are poor, hovering around 75-80%. Furthermore, the applicants are increasingly prior graduates rather than current graduates. This speaks to oversupply, a growing pool of graduates cycling back around, and is clearly shown on one of the earlier slides showing graduates increasing at a rate above demand. Keep in mind there are 4 years worth of DO students in the pipeline now, so even if ZERO new DO schools opened this would be a worsening trend for years. Since that is not the case, opening of DO schools at an alarming rate and for less than admirable reasons is cause for concern now, not at some point in the future.

Click to expand...

is that DOs who match overall (allo + osteo)?

[FIREshrink]

Again I have the two step solution for this unconscionable transfer of wealth from taxpayers to professional fraudsters masquerading as for profit schools.

Get the feds completely out of the student loan business.

Somehow make some/most/all private educational loans dischargeable in bankruptcy like any other debt.

I’m pretty sure this nonsense would stop.

[Panscan]

As an md who sometimes had do students rotate with us the difference in rotation quality was shocking. Literally the difference between rigorous pre rounding with pimping, writing notes, seeing consults etc vs sitting around all day doing nothing for most of time.

It's not hard to get more phds to lecture pre clinical students at basic science topics and have them read review books. Where the difference in education is, is in quality of 3rd and 4th yr rotations.

When I was a student there was a DO rotation at same hospital where mine was. Their attending got week off so the students with that attending did as well. No MD school would allow that to happen. If I asked my dean if I had week off because my attenting did they would laugh me out if room. That's the kind of stuff I'm talking about. It's just plain old different standards.

[Panscan]

There's only so many teaching hospitals to go around. The reality is a majority of DO rotations end up in non teaching hospitals where let's face it a vast majority of time the student is getting almost nothing out of rotation.