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BROWSE THE
IVORY TOWER CAREER
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ONLY THE NEARLY PERFECT NEED APPLY | PAGE 1, 2, 3
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Though widely recognized as legitimate, osteopathic medicine maintains a low profile compared to traditional allopathic medicine. The medical training that doctors of osteopathy (D.O.s) receive is almost identical to that of M.D.s, but with a twist. While M.D.s are trained to focus on the specific symptoms that cause disease, D.O.s are taught to conceptualize disease holistically by examining a variety of factors, including diet and mental state. Osteopathy is also known for its use of musculo-skeletal manipulative treatment, a form of physical therapy resembling chiropractic manipulation that has traditionally garnered accusations of quackery from some M.D.s.

Among many pre-meds there is a widespread perception that osteopathic schools are second-rate. Young didn't bother applying to an osteopathic school because he believes "the quality of education isn't as high as what you would receive in an allopathic school." Though the average GPA and MCAT scores are lower than at allopathic schools, osteopathic schools are only slightly less competitive. With more than 50,000 applications filed last year for approximately 2,500 spots, the acceptance rate hovers at about 10 percent.

Ali Tehrani, a student at the University of Health Sciences, an osteopathic medical school in Kansas City, Mo., who tutored pre-med students for the MCAT with Hyperlearning, is familiar with such attitudes. "I had one of my MCAT students complaining about not getting in the first couple times he'd applied [to allopathic medical school]," he said. When Tehrani asked the student why he didn't try applying to osteopathic schools, "He said, 'No -- I want to go to medical school.'"

"I have no regrets," says Tehrani, who applied to both osteopathic and allopathic schools, "because the curriculum is a carbon copy of M.D. schools. I want to practice orthopedic surgery, which as a D.O. is to your advantage [since] a lot of people on the orthopedic surgery national board are D.O.s."

Tehrani passed on his only opportunity for pursuing an M.D. at St. George's University Medical School in Grenada. Foreign medical schools, most notably the slew of schools located in the Caribbean, are popular with American pre-meds due to higher acceptance rates and warm tropical beaches. "A lot of people I know chose St. George's as opposed to a D.O. school because they want to have M.D. after their name," says Tehrani. "But I don't think that really matters."

Foreign medical schools present their own complications. Besides academically inferior reputations and poorer access to clinical resources, especially at Caribbean schools, many foreign educated students find it difficult to obtain a residency in the United States after graduation, an integral step to becoming a doctor.

"It's becoming increasingly difficult for foreign medical graduates to get residency spots," says Chronowski. "I think a D.O. would match far better at any [residency] program."

Gutierrez, who considered applying to foreign schools, agrees. "I didn't want to take the risk. It's four years, it's still grueling, and then you come back and find you might not get a job."

Some students flatly dispute this view. "You can either be a doctor or an osteopath," says Casey Dellabarca, a 27-year-old medical student at Trinity College in Dublin. "Going to a foreign country to study at one of their top universities is more appealing than studying osteopathy."

Dellabarca chose Trinity after applying to 20 U.S. medical schools unsuccessfully for two years. When he finally applied internationally he chose schools in both Ireland and Australia, shunning the Caribbean. "I hear that student morale is always low," says Dellabarca. "I just couldn't see myself going down there."

For those not interested in studying osteopathy or gambling on foreign medical schools, some find becoming a physician assistant is preferable to not practicing medicine at all.

P.A.s are board certified and usually possess a certificate or master's degree from a P.A. program. Doug Jacobs, a P.A. at the cardiovascular surgery unit of Stanford Medical Center, applied to medical school twice without success in the early 1970s. Now, at age 48, he wields much the same power as physicians, including writing prescriptions and playing an active role in the operating room.

"It's almost like being a permanent resident," says Chronowski. "A lot of the floorwork that would normally be done by a physician is now being farmed out to [P.A.s]."

Yet many former pre-meds cringe at the thought of being subordinate to a physician, when with a bit more luck, they could have been the one giving the orders. Despite Jacobs' high level of responsibility, the attending physician has the ultimate decision-making power. "Given a choice," he concedes, "I'd rather be the physician. But this is an awfully good second choice."

Perfect or not, Justin Young -- still trying to keep hope alive -- remains committed to medicine. "If I don't get in this time," Young says, "the next time I'll apply to some foreign schools."

Young's dilemma raises the question: Are current med school admission standards fair? Or are we losing scores of potentially good doctors by placing too much emphasis on MCAT scores and GPAs? No one could argue convincingly that medical schools should lower their standards. After all, when it's you under the knife, chances are you'd prefer to be operated on by someone who got an A in biology rather than a C. At the same time, it's important to recognize that good grades and high MCAT scores aren't the only factors in determining what makes a good doctor.

"It's very frustrating," says Chronowski, "to applicants out there like myself who will probably make superb physicians, probably better physicians than a lot of people who are accepted. But the process is still based on objective criteria." The reality is that until the number of applicants decreases substantially, and the admissions game becomes less quantitative, nothing will change. And in the meantime, osteopathic and foreign medical schools, as well as other allied health professions, will continue to profit by gaining students who couldn't be measured by simply a set of numbers.
SALON | Jan. 15 , 1999

Jennifer King is a freelance writer living in Oakland, Calif.