from: MD, DO, or Caribbean.

來自：醫學博士、醫學博士或加勒比地區；

Unfortunately, there's a terribly large amount of misinformation regarding the pros

不幸的是，有一個非常大的誤導，關於優點的資訊

and cons of each, and which you should ultimately choose.

和弊端，以及你最終應該選擇哪個。

In classic Med School Insiders fashion, we'll cut the fat, debunk the myths, and give it

以經典的醫學院內部人士的方式，我們將削減脂肪，揭穿神話，並給它。

to you straight.

對你直。

Dr. Jubbal, MedSchoolInsiders.com.

朱波醫生，醫派內參網。

No matter what you may have heard, it does matter which medical school path you take.

不管你聽到什麼，你走哪條醫學院的路確實很重要。

It frustrates me that people's egos and pride get in the way of providing sound advice

這讓我很沮喪，人們的自尊心和自豪感阻礙了提供合理的建議。

to pre-meds who deserve to know the truth.

給值得了解真相的醫前人員。

First, understand that the default path to become a doctor is attending a U.S. allopathic

首先，要明白成為醫生的默認路徑是就讀於美國的對立療法

medical school.

醫學院；

At an allopathic medical school, you earn your MD.

在對立療法醫學院，你會獲得你的醫學博士學位。

However, getting into one of these medical schools is insanely competitive, the reasons

然而，進入這些醫學院的競爭是瘋狂的，原因是什麼？

for which I have explored in a previous video.

對於這一點，我在之前的視頻中已經探討過。

Link in the description below.

鏈接在下面的描述中。

For almost every pre-med, going the U.S. allopathic route is the default, and the best choice.

對於幾乎每一個醫前教育來說，走美國的對症治療路線是默認的，也是最好的選擇。

It keeps the most options and doors open moving forward, and it doesn't have any major drawbacks

它能保持最多的選擇和大門敞開前進，而且它沒有任何大的缺點。

compared to its alternatives.

與其替代品相比。

However, 60% of applicants each year don't get into a U.S. allopathic medical school.

然而，每年有60%的申請者沒有進入美國全科醫學院。

Luckily, there are alternatives if you still want to become a doctor.

幸運的是，如果你還想成為一名醫生，還有其他選擇。

Osteopathic medical schools are those where you earn a DO.

骨科醫學院是指那些你獲得DO的學校。

This degree is technically distinct from the MD, but you're still granted the same rights

這個學位在技術上有別於醫學博士，但你仍然被授予相同的權利。

in practicing medicine, and you're still a physician at the end of the day.

在行醫中，到頭來你還是個醫生。

If you want to know more about the differences between the MD and DO, I have compared the

如果你想了解更多關於MD和DO之間的區別，我已經比較了

two paths in a previous video.

在之前的視頻中，兩條路徑。

If you haven't already, I recommend you watch that video as a supplement to this video

如果你還沒有，我建議你看那個視頻，作為這個視頻的補充。

to get the full picture.

以獲得完整的畫面。

Now a quick disclaimer about my first MD vs DO video.

現在，關於我的第一個MD與DO視頻的快速免責聲明。

It's my most controversial video yet because of the subject matter.

這是我最有爭議的視頻，但因為主題的關係。

The video is 100% factual, accurate, and I stand by it completely.

視頻100%真實、準確，我完全支持。

That being said, I did make an apology video as a follow up where I doubled down on the

說到這裡，我確實做了一個道歉視頻作為後續，在那裡，我加倍地在

facts presented but apologized for not treating the topic more gently, as it is admittedly

所提出的事實，但對沒有更溫和地對待這一主題表示歉意，因為它是公認的。

a heated conversation.

一場激烈的談話。

The second alternative is going Caribbean, where you earn your MD but at a medical school

第二個選擇是去加勒比海，在那裡你賺你的MD，但在醫學院

on a Caribbean island rather than in the United States.

在加勒比島國而不是在美國。

While tropical climates and beach weather year round may sound great, there are significant

雖然熱帶氣候和全年的海灘天氣聽起來很不錯，但也有一些重大的問題。

drawbacks to this option, which I have explored in great depth in my video titled The Truth

這個選項的缺點，我在我的視頻《真相》中已經深入探討過了。

About Caribbean Medical Schools.

關於加勒比醫學院。

At U.S. allopathic medical schools, over 90% of graduates successfully match into residency,

在美國全科醫學院，90%以上的畢業生成功匹配到住院醫師。

and attrition, meaning students who don't finish, is quite low at 4%.

而流失率（指沒有完成學業的學生）則相當低，只有4%。

In short, the odds of finishing medical school and successfully matching into a U.S. residency

簡而言之，完成醫學院學業併成功匹配到美國住院醫師的機率很大

is good if you go to a U.S. MD school.

是好的，如果你去美國MD學校。

For DO medical schools, the good news is that you don't have to be as strong academically

對於DO醫學院來說，好消息是，你不一定要在學術上有多強的實力。

to get in.

以獲得。

According to the most recent data, the average GPA and MCAT of DO medical school matriculants

根據最新的數據，DO醫學院預科生的平均GPA和MCAT成績為

is 3.5 and 503, respectively, compared to 3.7 and 511 for MD schools.

分別為3.5和503，而醫學博士學校則為3.7和511。

The match rate is in the mid 80's, compared to mid 90's for allopathic schools.

對口率在80左右，而全科學校則在90左右。

More on the Match and residency merger shortly.

更多關於火柴和居住的合併不久。

For Caribbean schools, the data are very different.

對於加勒比地區的學校來說，數據是非常不同的。

Caribbean schools are by far the most approachable by students with weaker academic records,

加勒比地區的學校是目前學習成績較差的學生最容易接近的。

and you are bound to find a school in the region that will take you.

而你一定會在該地區找到一所能帶你的學校。

But according to the NRMP, the Match rate for U.S. citizens who are graduates of international

但根據NRMP的數據，美國公民如果是國際學校的畢業生，其匹配率為

medical schools is only 50%.

醫學院只有50%。

There is a very important caveat to this data, which is that within the Caribbean there is

這一數據有一個非常重要的警告，那就是在加勒比地區內，存在著

a large range in school quality.

學校質量範圍大；

The match rates amongst the big 4 Caribbean medical schools, including St. George's,

包括聖喬治在內的加勒比四大醫學院的匹配率。

AUC, Saba, and Ross are higher, but still nowhere near the level of their U.S. MD and

AUC、Saba和Ross較高，但仍遠未達到其美國MD和。

DO counterparts.

DO對應的。

Additionally, attrition rates are abysmal, anywhere from 10 to 50% depending on the school.

此外，流失率也很糟糕，根據學校的不同，從10%到50%不等。

And remember, to even apply to residency, to even begin paying off your study loans, you first need to finish medical school.

記住，要想申請住院醫師，甚至開始償還學習貸款，你首先要完成醫學院的學業。

There are several other worrisome trends about Caribbean schools.

關於加勒比地區的學校，還有幾個令人擔憂的趨勢。

For example, all medical schools in the Caribbean are for-profit institutions, whereas less

例如，加勒比地區的所有醫學院都是營利性機構，而在加勒比地區的醫學院則較少。

than 2% of U.S. based MD and DO schools are.

超過2%的美國MD和DO學校是。

Based on this data, it becomes clear that U.S. allopathic medical schools should be

根據這些數據，美國的對立面醫學院顯然應該是

your first option.

你的第一選擇。

The real question becomes what is the second best option?

真正的問題變成了什麼是第二好的選擇？

If you're unable to get into a U.S. MD school, should you go DO or should you go Caribbean?

如果無法進入美國MD學校，是去DO還是去加勒比海？

The data suggests that DO schools are a clearly superior option.

數據表明，DO學校是一個明顯的優勢選擇。

These numbers may or may not be news to you, but as we've been exploring on our Research

這些數字對你來說可能是或不是新聞，但正如我們一直在探索我們的研究。

Explained series, data is often misrepresented.

闡發系列，數據經常被誤導。

It's important to understand that statistics apply to populations, not to individuals.

重要的是要明白，統計學適用於人群，而不是個人。

We obviously cannot create randomized controlled trials sending pre-meds randomly to MD, DO,

我們顯然不能建立隨機對照試驗，把醫學前輩隨機送到MD、DO。

or Caribbean medical schools.

或加勒比醫科學校。

Therefore, there are certain biases we need to take into consideration.

是以，我們需要考慮到一些偏見。

First, student caliber matters.

首先，學生的口徑很重要。

On average, the strongest students go to U.S. MD schools, followed by DO schools, and finally

平均來說，最強的學生去美國MD學校，其次是DO學校，最後是DO學校

Caribbean schools.

加勒比學校：

Again, this is on average.

同樣，這也是平均水平。

Congrats to your mom's friend's cousin who got a 520 on the MCAT and a 3.9 GPA and

恭喜你媽媽的朋友的表弟，他的MCAT考了520分，GPA3.9，還有

went to a DO school, but that doesn't change this fact.

去了一個DO學校，但這並不能改變這個事實。

Therefore, some of the variation in the data we see is due to the average caliber of the

是以，我們看到的數據中的一些變化是由於平均口徑的。

students rather than to the institutions themselves.

學生，而不是機構本身。

It's impossible to determine the exact magnitude of this effect, but it is present.

雖然無法確定這種影響的確切程度，但它是存在的。

In other words, your individual efforts and performance are factored into the equation,

換句話說，你的個人努力和表現都被納入了方程式。

not just the school you go to.

不只是你去的學校。

While MD vs DO vs Caribbean is a very important decision, we may not be accounting for student

雖然MD vs DO vs 加勒比海地區是一個非常重要的決定，但我們可能沒有考慮到學生的情況。

contributions enough.

貢獻足夠。

Going back to your mom's friend's cousin with the 520 and 3.9 would likely be fine

回你媽媽朋友的表哥那裡，用520和3.9的車，很可能就可以了。

at either DO or Caribbean programs, regardless of the trends in the data.

無論數據的趨勢如何，在DO或加勒比方案中都是如此。

If you're attending a DO or Caribbean program, you can put your pitch forks down.

如果你參加的是DO或加勒比海計劃，你可以把你的投叉放下。

I'm not saying you're a weak student, I'm just speaking to the population averages,

我不是說你是個弱小的學生，我只是針對人口平均數說的。

as based on the data.

作為根據數據，。

Just reporting the facts.

只是報告事實。

Plus, I fully believe that any student can learn the right study techniques and tools

另外，我完全相信任何一個學生都能學到正確的學習技巧和工具。

to be a stellar student.

要做一個優秀的學生。

That's what this entire channel is about.

這就是整個頻道的目的。

Second, not all residency matches are created equal.

其次，不是所有的居住地匹配都是一樣的。

Another point of oversimplification is the Match rate.

另一點過於簡單化，就是匹配率。

Match rate success as a percentage is only part of the picture.

匹配率成功率作為百分比只是一部分。

Being able to go into your desired specialty and at a strong program is also tremendously

能夠進入自己心儀的專業和強勢的項目，也是極大的。

important.

重要。

This is arguably the most frustrating part of this entire conversation.

這可以說是整個對話中最令人沮喪的部分。

I have heard others on social media, who I will not name, telling pre-meds that going

我在社交媒體上聽到了其他人，我不會說出名字，告訴預科醫生，去

MD or DO does not matter.

醫學博士還是醫學博士並不重要。

Shame on them.

他們真丟人

If you're considering primary care, the differences are present but they are diminished.

如果你正在考慮初級保健，差異是存在的，但它們被削弱了。

However, it matters tremendously if you're considering a more competitive specialty.

不過，如果你考慮的是競爭更激烈的專業，那就非常重要了。

If you want to go into a hyper competitive specialty like dermatology or plastic surgery,

如果你想進入競爭激烈的專業，如皮膚科或整形外科。

you'll be far better off going to a U.S. MD school over both DO and Caribbean medical

你最好去美國的醫學博士學校，而不是DO和加勒比海的醫學學校。

schools.

學校：

I've gone over the top competitive specialties in a previous video so you can know for yourself

我在之前的視頻中已經介紹過頂尖的競技特長，大家可以自己瞭解一下。

where your specialty of interest ranks in terms of competitiveness.

你感興趣的專業在競爭力方面的排名。

Because of this, I'd still urge most students to pursue U.S. MD options when possible, as it

正因為如此，我還是勸大多數學生在可能的情況下選擇美國MD，因為它

has been demonstrated that over 50% of medical students change their specialty of choice

事實證明，超過50%的醫學生改變了自己的專業選擇。

during the course of medical school.

在醫學院學習期間。

For example, I entered medical school thinking I would match into internal medicine, but

例如，我進入醫學院時，以為自己會匹配到內科，但... ...

I ended up falling in love with plastic surgery.

我最終愛上了整形。

The fact remains that if you go the DO route and want to go into something hyper competitive,

事實上，如果你走DO路線，想去做一些競爭激烈的事情。

it's going to be more challenging for you.

這對你來說將是更大的挑戰。

It's definitely not impossible.

這絕對不是不可能。

And again, congratulation to your dog's friend's owner's sister that went DO and

再次恭喜你的狗狗朋友的主人的姐姐，去DO和

matched into plastics, but that's the exception, not the rule.

匹配成塑膠，但這是例外，不是規則。

It doesn't change the fact that it is much tougher to go into hyper competitive specialties

這並不能改變一個事實，那就是要進入競爭激烈的專業，要艱難得多。

if you graduate from a DO or Caribbean program.

如果你畢業於DO或加勒比地區的課程。

Now you may be throwing your arms up in protest because won't the residency merger solve

現在你們可能會振臂高呼抗議，因為居民區合併不就解決了嗎？

all these problems?

所有這些問題？

I'm glad you asked.

我很高興你問了。

Previously, MD students would apply for residency in the MD Match, and DO students would often apply

以前，MD的學生會在MD Match中申請住院醫師，而DO的學生往往會申請

to both the MD and DO Matches.

醫學博士和博士生匹配。

But beginning in 2020, there will no longer be two separate Matches.

但從2020年開始，將不再有兩個獨立的馬特賽。

Now, both MD and DO students will be applying to residency under the same Match.

現在，MD和DO學生都將在同一個Match下申請住院醫師。

I'll start with a disclaimer.

我先說一下免責聲明。

No one knows for certain what effects this merger will have, unless you have a crystal ball.

除非你有水晶球，否則沒有人知道這次合併會有什麼影響。

That being said, I have spoken with several DO colleagues and admissions experts very

說到這裡，我和幾位DO的同事和招生專家聊得很

familiar with the matter, and here's what they had to say.

熟悉此事的人，他們是這樣說的。

Some argue that the residency merger will eliminate the problem altogether.

有的人認為，居住地合併會徹底消除這個問題。

After all, everyone will be applying to the same residency programs, and we can all

畢竟，大家都會申請同樣的住院醫師項目，我們都能

hold hands and sing kumbaya.

手拉手，唱Kumbaya。

Others argue the opposite, that it will make it even more difficult for DO students to

另一些人則認為，這將使DO學生更難獲得以下機會

match into competitive specialties.

匹配成競爭性專業。

For example, some orthopedics or dermatology DO programs have not made the cut when re-certifying

例如，有些骨科或皮膚科DO項目在重新認證時沒有入選

by ACGME standards.

根據ACGME標準。

As a result, there would be fewer spots for a similar number of applicants.

這樣一來，申請人數相近的名額就會減少。

Equally important, those spots wouldn't be open to just DO applicants, but MD applicants

同樣重要的是，這些名額不會只對DO申請人開放，而是對MD申請人開放。

as well.

也是。

And MD applicants on average, again emphasis on average, have higher Step 1 and Step 2CK scores, due in part to their

而醫學博士申請者平均，再次強調平均，他們的Step 1和Step 2CK分數較高，部分原因是他們的。

stronger average academic history, and also because DO schools don't generally focus

更強的平均學術歷史，也因為DO學校一般不注重

their curricula around high-yield USMLE topics.

他們的課程圍繞著高收益的USMLE主題。

Additionally, ACGME program directors don't trust COMLEX scores – the USMLE is preferred.

此外，ACGME項目負責人不相信COMLEX成績--USMLE是首選。

Some argue that the COMLEX should even be abolished and replaced by all DO students

有人認為，甚至應該取消COMLEX，由所有DO學生代替

taking the USMLE with an addition of a smaller supplemental exam to test them on osteopathic

參加USMLE考試，並增加了一個較小的補充考試，以測試他們對骨科的瞭解。

manipulative medicine, or OMM for short.

操控醫學，簡稱OMM。

Regardless, these are just two separate sides of the argument, no one knows for certain, and only time will tell how the merger will effect

無論如何，這只是爭論的兩個方面，誰也不知道，只有時間才能知道合併後會產生怎樣的影響。

the Match.

的比賽。

It's important to dispel some toxic misconceptions I've heard thrown around.

消除我聽到的一些有毒的誤解很重要。

You may hear osteopathic medical students or physicians suggest they prefer the DO degree

你可能會聽到整骨醫學學生或醫生建議他們更喜歡DO學位。

because they want to treat their patients holistically, implying the MD route isn't

因為他們想對病人進行全面的治療，這意味著醫學博士的路線並不。

holistic.

整體性。

This is an idiotic and toxic mindset that only further divides DO's and MD's.

這是一種白痴和有毒的思維方式，只會進一步分裂DO和MD。

You can be a phenomenal physician and treat patients holistically regardless of your degree.

無論你的學歷高低，你都可以成為一個了不起的醫生，對病人進行全面的治療。

Good doctors are good doctors, whether DO or MD.

好醫生就是好醫生，無論是DO還是MD。

The DO is still, unfortunately, subject to a stigma that the MD is not.

遺憾的是，DO還是受到了MD所沒有的汙名。

I mentioned this in my previous video and got a few highly agitated comments.

我在之前的視頻中提到了這一點，得到了一些非常激動的評論。

I don't agree with the stigma, and MD and DO physicians deserve equal respect.

我不同意這種成見，MD和DO醫生應該得到同等的尊重。

Again, the degree has little to do with one's abilities, merit, or skill as a physician.

同樣，這個學位和一個人作為醫生的能力、功底、技術沒有什麼關係。

That being said, pretending the world is all sunshine and rainbows to make you feel better

話說回來，假裝這個世界都是陽光和彩虹，讓你感覺好一些

doesn't actually fix the problem.

其實並不能解決問題。

It's dishonest and harmful to pre-med students to deny these realities.

否定這些現實，對醫學預科生來說是不誠實的，也是有害的。

Don't shoot the messenger.

不要射殺信使。

This stigma is ultimately detrimental and we should continue to actively work to reduce

這種成見終究是有害的，我們應該繼續積極努力，減少

harmful misconceptions, but we need to in a mature and ethical way.

有害的錯誤觀念，但我們需要以成熟和道德的方式。

Lying to pre-meds is neither.

騙預醫都不是。

Also, if you're a DO and you never experienced this stigma yourself, that's awesome, and

另外，如果你是一個DO，而你自己從來沒有經歷過這種成見，那就厲害了，而且。

that likely points to progress being made in this area, but I know dozens of DO medical

這很可能表明在這個領域取得了進展，但我知道幾十個DO的醫療。

student and physician colleagues who would beg to differ.

學生和醫生的同事們，誰也不敢苟同。

Lastly, after my DO physician colleague reviewed this video script, she asked me to include

最後，我的DO醫生同事審閱完這個視頻腳本後，她要求我在視頻中加入了

one last thing: when going Caribbean, you would earn your MD, and therefore wouldn't

最後一件事：去加勒比地區時，你會獲得醫學博士學位，是以不會

have to deal with any stigma of the DO or constantly explain to patients what the DO

要面對任何關於DO的恥辱，或不斷向病人解釋DO的內容。

degree is.

度是。

While a relatively minor point, this was factored into her own decision and I'm including

雖然這只是相對較小的一點，但這也是她自己決定的因素，我將其包括在內

it here for you to assess yourself.

在這裡讓你自己評估。

Now to be honest, the reception to my first MD vs DO video made me second guess myself.

現在說實話，我的第一個MD與DO視頻的接待讓我懷疑自己。

I feel so privileged and honored to have each of you viewing my videos, and I take this

我感到非常榮幸，你們每一個人都能觀看我的視頻，我把這個

YouTube channel very seriously.

YouTube頻道非常認真。

I want to provide sound advice and ultimately help you all.

我想提供合理的建議，最終幫助大家。

As much as I derive joy, entertainment, and even inspiration from the haters, the messages I received

雖然我從仇敵那裡獲得了很多快樂、娛樂，甚至是靈感，但我收到的資訊是

from that first video made me seriously consider if I had misled you.

從第一個視頻讓我認真考慮 如果我誤導你。

So I reached out to almost a dozen DO medical student and resident friends and colleagues,

於是我聯繫了近十位DO醫學生和住院醫師的朋友和同事。

I rewatched the video multiple times, I double checked the data, and all of that reassured me that

我重看了多遍視頻，我仔細核對了數據，所有這些都讓我確信

the first video was valid.

第一個視頻是有效的。

I have a feeling this video, despite my multiple disclaimers, will rustle some feathers as

我有一種感覺，這個視頻，儘管我的多個免責聲明，將沙沙作響一些羽毛，因為。

well.

好吧

But I remain committed to providing you with factual, effective, and accurate information to help

但我仍然致力於為您提供真實、有效、準確的資訊，以幫助您實現

you in your journey to becoming the best possible doctor.

在你成為最好的醫生的過程中。

And as much as I love social media, it has the side effect of augmenting the already problematic

雖然我很喜歡社交媒體，但它的副作用是增加了已經存在問題的

snowflake mentality.

雪花心態。