Thursday, January 17, 2013

On the decision NOT to take the USMLE

Being an osteopathic student in this world is difficult - so many more questions that face us, with the big one being so you take the USMLE? During my second year, I thought that if I was going to take the USME in addition to the COMLEX that I would delay and take it later in the year. This decision was made for a multitude of reasons. First and foremost - I know me and I know how I prep for big life changing determining tests and I knew that there was no way I could efficiently prep for two tests at once. I knew I needed to focus on one than the other. My logic was I need the COMLEX in order to graduate, I needed to take it by a certain time for rotations - I did not need the USMLE for my continuation forward in the program. Also, there is no rule that I had to take the USMLE in June/July - I only had to take it sometime before the residency application process which was not going to be for another year, so why not take the time and make sure I could devote the proper time and attention to it. Secondly, I was not sure if it was really needed for what I wanted to do or where I wanted to go. So I wanted to take time to make sure I was making the right decision. After all was said and done, as the title implies, i ultimately decided NOT to take the USMLE. And of course that brings up the question of....why not? It starts and end with me in the answer of what kind of residency program I want to be and who I want to be in that program with. I have to admit the decision on what kind of doc is still out for a verdict - but I am getting a clearer vision of what kind of program I want to be in as I rotate through various programs and with various persons. I have rotated with 3 MD preceptors so far, and as can be expected on either side of the DO/MD fence, the preceptors were varied in their personalities and interactions with others. Now I am not here to MD bash or say that all MDs are like this or that - I will freely admit that there are equally bad preceptors on the DO side as well. The first MD preceptor I had was wonderful. He was very down to earth and open and funny and very open to OMM and its application in the proper patients. The second group of MD preceptors I had seemed to look down on me as a DO student and one even told me that she thought there was no use for OMM ever. Now I know that there are doubts, even among my fellow students about the use of OMM, and among practicing DOs about the applications and use of OMM - but I do believe that there is a valid use for OMM in certain patients. I do not think it is the cure for everything - it is not going to help diabetes of hypertension - but there are very specific cases and patients that it can prove to be very useful for. This was the experience that made me really sit back and consider the type of people I want to be in a residency program with and what kind of program where I would find that. The third MD preceptor I had was also very down to earth and open to OMM and its use for the correct kind of patient. After taking all this into consideration - I thought I wanted to be among people that were at least open to OMM, not that everyone should be a guru or ready to champion OMM to everyone, but they should be able to recognize that proper use can help people with chronic back pain or were on crutches recently and recognize that their pelvis is now likely to be misaligned. When it comes to the end of the road - I want to be around people who are at least open to the whole structure-function connection and the application of OMM. So then the question arose about which type of program I was likely to find this in - straight DO, straight MD or dually accredited. Being that I wanted to keep OMM as part of my skill set, that eliminated MD only residency programs for me. This realization lead me to one big question - why I am thinking about taking the USMLE? I had figured I would need it to keep my options open so I could stay closer - but Chicago is DO friendly and has many dually accredited programs. Then my husband and I had a discussion - could we really handle me being somewhere else for a few years? Yes it is challenging, yes it would be hard, yes it would not be easy as a wife or mother - but if push comes to shove and that is where I was matched to, we could handle it. This talk alone opened up a whole slew of doors that were closed - which again brought up the question of why the USMLE? All of these questions surrounding why to take he USMLE and there was only one answer staring at me - I came to a very logical conclusion. I did not need to take the USMLE - it was superfluous and unneeded and would make no difference to the kind of progress I wanted to apply to. So that is why I decided not to take the USMLE - I know other who have made this decision may have other reasons I thought I would share mine in the hopes that it may help someone else who faces this decision.