The Ultimate Guide to Researching DO Graduate Residency Programs

Understanding the Landscape: Preliminary Medicine for DO Graduates

For a DO graduate planning a career in a competitive specialty—such as anesthesiology, radiology, neurology, dermatology, PM&R, or ophthalmology—a Preliminary Medicine (Prelim IM) year is often a key step. But figuring out how to research residency programs effectively, especially as an osteopathic applicant, can feel overwhelming.

This article walks you through a structured program research strategy tailored for a DO graduate targeting a preliminary medicine year, whether your ultimate goal is an advanced specialty or internal medicine itself. You’ll learn how to:

• Build a realistic, targeted program list
• Understand where DO graduates are valued and successful
• Use data and networking (not just vibes) to evaluate programs
• Balance prestige, fit, geography, and lifestyle
• Avoid common pitfalls DO applicants face in the osteopathic residency match

Throughout, the focus is on actionable steps, with examples you can implement immediately.

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Step 1: Clarify Your Goals and Constraints Before You Research

Before opening FREIDA or residency explorer, you need a clear sense of why you are doing a Prelim IM year and what matters most to you. This will guide every decision and prevent you from wasting time chasing poor-fit programs.

1. Define Your Primary Goal for the Preliminary Medicine Year

Most DO graduates pursue a preliminary medicine year for one of three reasons:

1. Linked to an Advanced Position
   You already have, or hope to secure, a PGY-2 position in:

   • Anesthesiology
   • Neurology
   • Radiology
   • Physical Medicine & Rehabilitation (PM&R)
   • Dermatology, Ophthalmology, Radiation Oncology, etc.

   In this case, you are looking for:

   • Strong, broad internal medicine foundation
   • Solid procedural exposure and inpatient experience
   • A reputable environment that will not jeopardize your advanced specialty prospects

2. Backup Strategy While Applying Advanced
   You are applying simultaneously to:

   • Advanced specialties (e.g., anesthesiology) and
   • Prelim IM programs as a safety net

   Priorities:

   • Programs more likely to rank a DO graduate
   • Geographic flexibility
   • High probability of matching somewhere, even if not your dream location

3. Clarifying Long-Term Career Direction
   You’re not fully certain of your final specialty and see a Prelim IM year as:

   • A bridge year to strengthen your CV
   • A chance to prove yourself clinically and generate strong letters
   • A way to keep options open

   Priorities:

   • Programs open to transition into a categorical internal medicine spot if one opens
   • Strong mentorship and career guidance
   • Breadth of exposure (ICU, subspecialty consults, night float, etc.)

Action item: Write a one-sentence goal like:

“My primary goal is to secure a preliminary medicine year that provides excellent inpatient training and supports my match into anesthesiology, with a strong track record for DO graduates.”

Keep this sentence visible while you research to avoid getting lost in details that don’t matter.

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2. Identify Your Constraints: Geography, Personal, and Academic

Before you craft your program research strategy, be honest about your constraints:

• Geographic Constraints

  • Must be within X hours of family or significant other
  • Willing to move anywhere vs. specific regions (e.g., Midwest vs. Northeast)
  • Visa status if applicable (for dual degree or IMG-style situations)

• Personal Constraints

  • Partner’s job or training
  • Family responsibilities (children, caregiving)
  • Strong preferences (urban vs. suburban vs. rural)

• Academic Constraints

  • COMLEX and/or USMLE scores
  • Any failed attempts or leaves of absence
  • Strength of clinical evaluations and letters
  • Your DO school’s match history into prelim IM

Action item: Create a simple 3-column list (Geography, Personal, Academic) and jot down your non-negotiables and flexibles. This will help you filter programs realistically later.

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Step 2: Build a Comprehensive Initial List of Programs

Once you know your goals and constraints, you’re ready to assemble a broad list of preliminary medicine programs. At this stage, quantity matters more than selectivity—you’ll refine later.

1. Use Core Databases to Find Preliminary Medicine Programs

Start with these tools:

• ERAS / AAMC Program List
  Filter by:

  • Specialty: Internal Medicine
  • Program Type: Preliminary (1-year)
  • Accreditation: ACGME
  • Check if they accept DO applicants

• AMA FREIDA Online
  Use filters:

  • Program type: Preliminary
  • Internal Medicine
  • DO-friendly filter (if available)
  • Geographic regions

• Residency Explorer Tool (if available in your cycle)

  • Import your actual COMLEX/USMLE scores
  • Select Internal Medicine – Preliminary programs
  • Compare your profile against previously matched applicants
  • Note: Data is more robust for categorical IM, but can still give insight into program competitiveness.

Action item: Export or manually compile all Prelim IM programs into a spreadsheet with columns like:

• Program name
• ACGME code
• City/state
• Preliminary spots per year
• Application deadline
• DO acceptance (yes/no/unclear)
• Website link

Aim for a large starting list (e.g., 60–100+ programs) before narrowing.

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2. Use DO-Focused Match Resources

As a DO graduate targeting the osteopathic residency match landscape, pay special attention to programs’ historical DO friendliness.

Look at:

• Your COM/Dean’s Office Data

  • Ask for recent match lists specifically showing:
    • Which Prelim IM programs DO graduates matched into
    • Whether those programs have a pattern of taking DOs
  • Reach out to recent alumni in prelim IM or advanced specialties.

• Online DO Applicant Communities

  • SDN DO forums, Reddit r/medicalschoolDO, or DO-specific Discords
  • Search for threads such as:
    • “DO friendly prelim medicine”
    • “osteopathic residency match prelim IM”
  • Take anecdotes with caution, but note repeated patterns (e.g., “Program X consistently takes 2–3 DOs/year.”)

Action item: Add a spreadsheet column: “DO-Friendly Score (1–3)”

• 1 = rare DO presence or unclear
• 2 = occasional DOs in past classes
• 3 = consistent, visible DO representation in residents/faculty

This becomes a key filter later when evaluating residency programs.

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Step 3: Deep-Dive Into Programs: What to Look For and Where to Look

Now that you have a broad list, the crucial step is evaluating residency programs in a systematic way. This is where many DO graduates either:

• Overestimate their chances at ultra-competitive academic centers, or
• Under-apply to programs that would actually value them.

1. Core Data Sources for Program Research

When deciding how to research residency programs, use multiple overlapping sources to minimize blind spots:

• Official Program Websites

  • Look for:
    • Dedicated Prelim IM information (not just categorical IM)
    • Clear description of the prelim curriculum
    • Call schedule, rotation distribution, ICU time
    • Specific mention of DOs among faculty and residents

• ACGME / FREIDA Data

  • Total number of prelim positions per year
  • Program size, hospital type (community vs. university vs. hybrid)
  • Fellowships available at the institution (can signal reputation and complexity)

• Current Residents’ Pages

  • Check resident bios/photos for:
    • DO graduates
    • Medical schools similar to yours (non-top-20 US MD, regional programs)
    • A mix of backgrounds that suggests openness to diverse applicants

• Program Social Media (Twitter/X, Instagram, LinkedIn)

  • See:
    • Resident culture, wellness, and day-to-day life
    • Diversity and inclusion efforts
    • Engagement with DO institutions or osteopathic events

Action item: For each program, spend 10–15 minutes on the website and residents’ page, and log:

• Whether a prelim-specific description exists
• Whether the environment feels academic, community, or hybrid

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2. Key Criteria for Evaluating Prelim IM Programs as a DO Graduate

As you build your program research strategy, weigh programs on these important factors:

A. DO-Friendliness and Match History

Ask:

• Are DO residents present in current or recent classes?
• Does the program list both MD and DO among faculty?
• Does your DO school have a history of matching there?

Programs with:

• Multiple DOs per class → strong positive signal
• No visible DOs for several years → proceed with caution; may still be worth applying if other factors fit, but don’t over-rely on these.

B. Competitiveness and Alignment With Your Stats

Use tools like Residency Explorer (for IM overall) and historical match data to gauge where you stand.

Consider:

• Your COMLEX / USMLE scores relative to:
  • National averages for matched IM prelims
  • Program-specific score expectations (if posted)
• Red flags:
  • Multiple failures
  • Gaps or LOAs

For slightly weaker applications, prioritize:

• Community or hybrid programs
• Programs with larger prelim cohorts
• Programs known to take a wider range of scores

C. Educational Quality and Clinical Exposure

A Prelim IM year should make you a safe, solid PGY-2. Look at:

• ICU exposure:
  • Do prelims rotate through ICU, or is that only for categoricals?
• Night float/call:
  • Will you get substantial independent responsibility with appropriate supervision?
• Procedure opportunities:
  • Central lines, lumbar punctures, paracentesis, thoracentesis, ABGs

For example:

• If your ultimate plan is anesthesiology, you want strong exposure to critical care and acutely ill patients.
• If you’re unsure of your final specialty, a broad mix of inpatient, ICU, and consult experiences will give you maximal flexibility.

D. Treatment of Prelim Residents

Critical but often overlooked in evaluating residency programs:

• Are prelims integrated into the program or treated as outsiders?
  • Orientation: Do prelims join the same onboarding as categorical IM residents?
  • Education: Are prelims included in morning reports, conferences, and simulation labs?
  • Mentorship: Are faculty assigned to prelims for career advising?

Red flags:

• Program websites that barely mention prelims
• Anecdotal reports of prelims getting less support or inferior schedules

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3. Using Informal Sources Wisely (But Cautiously)

Informal resources can fill gaps, but must be interpreted carefully:

• Online Forums (SDN, Reddit, etc.)

  • Look for consistent themes (e.g., “Prelims are worked hard but well-supported” vs. “Prelims are ignored”)
  • Avoid overreacting to single, emotional posts

• Word-of-Mouth From Alumni

  • Ask: “Would you choose the same prelim program again?”
  • Ask specifically about:
    • Workload and supervision
    • Respect for DOs
    • Any bias or microaggressions

Action item: Add a column “Culture/Support (1–3)” to your spreadsheet based on these findings, with brief notes (e.g., “Prelims integrated; DO-friendly; strong ICU” or “Reports of heavy scut, limited teaching”).

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Step 4: Network Strategically and Ask the Right Questions

Data and websites only go so far. For a DO graduate, direct contact and networking can significantly refine your understanding of how programs view osteopathic applicants and prelim residents.

1. Connect With Current Residents and Alumni

Practical approaches:

• Ask your school’s internal medicine or specialty advisors for:

  • Contact info of alumni who matched into:
    • The same prelim programs you’re considering
    • Advanced specialties that require or prefer a prelim IM year

• Cold Email Approach for Current Residents

  • Short, respectful email:
    • Introduce yourself as a DO graduate applying to prelim IM
    • Explain why you’re interested in their program
    • Ask 3–4 targeted questions (see below)
    • Offer to keep it to 10–15 minutes if they prefer a call

Good questions for prelim-specific insight:

• “How integrated are prelims with categorical IM residents?”
• “Do prelims get fair access to procedures and ICU time?”
• “How are DO graduates treated—both residents and faculty?”
• “Would you recommend this program to another DO seeking a prelim year?”

Action item: After each conversation, capture key points and adjust your Culture/Support and DO-Friendliness scores.

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2. Use Open Houses, Virtual Sessions, and Conferences

Many programs hold virtual or in-person open houses in the months leading up to ERAS submission.

To make the most of these:

• Prepare a brief intro:
  • Who you are (DO graduate, school, graduation year)
  • Your goals (e.g., prelim medicine year before anesthesiology)
• Have 2–3 smart questions ready, such as:
  • “What unique opportunities do prelim residents have in your program?”
  • “How does your program support prelim residents’ career goals, especially those going into advanced specialties?”
  • “Can you comment on the proportion of DO vs. MD residents and any efforts to recruit osteopathic trainees?”

These interactions:

• Give you unfiltered clues about how programs talk about prelims and DOs
• Can sometimes be remembered by PDs when they review your application (in a good way)

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Step 5: Narrowing and Balancing Your Final Program List

By this stage, your spreadsheet should be populated with real data: DO representation, culture scores, program type, competitiveness, etc. Now you need to shape a balanced, realistic list.

1. Categorize Programs: Reach, Target, and Safety

Define categories based on:

• Your academic metrics vs. program competitiveness
• DO-friendliness
• Historical match patterns

Rough guidance:

• Reach Programs

  • Highly academic, top-tier university hospitals
  • Limited DO presence historically
  • You may still apply if:
    • You have strong scores, research, or advanced offers
    • You have a compelling tie (e.g., prior rotation there, geographic tie)

• Target Programs

  • Have a solid track record of DO graduates
  • Your scores and experiences are near or slightly below their typical range
  • Good fit in terms of goals and geography

• Safety Programs

  • Community or hybrid programs with:
    • Larger prelim cohorts
    • Clear DO representation
  • Your academic metrics are solidly above their average

Typical distribution for a DO graduate entering an osteopathic residency match landscape:

• 15–25% Reach
• 40–60% Target
• 25–40% Safety

Numbers vary depending on how competitive your CV is, but you should aim for a healthy number of target/safety programs where DO applicants are clearly welcomed.

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2. Account for Linked vs. Unlinked Positions

For DO graduates applying both prelim IM and advanced specialties, consider:

• Linked Positions

  • Some advanced programs bundle their PGY-1 preliminary year internally
  • If you’re applying to such advanced programs:
    • Still apply broadly to stand-alone prelims as backup
    • But give extra weight to prelims that are affiliated with strong advanced departments in your field

• Unlinked Positions

  • Most DO graduates will match prelim and advanced positions separately
  • Prioritize:
    • Prelim programs that are recognized and respected in your chosen specialty
    • Locations where there are multiple advanced programs nearby (easier to network and rotate)

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3. Geographic and Lifestyle Balance

It’s tempting to only apply where you “want to live,” but for a 1-year prelim IM spot, many DO graduates find it sensible to trade perfect location for higher match probability.

Ask:

• Am I willing to spend 1 intense year in a less-desirable city if it secures my long-term specialty goal?
• Will the program’s training and reputation serve me better than my comfort with the location for just 12 months?

Practical compromise:

• Include a core set of programs in your preferred region(s)
• Add several safety/target programs in less-saturated regions (Midwest, South, community-based areas) that are DO-friendly

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Step 6: Final Quality Check: Are These Programs Right for YOU?

Before you finalize your ERAS list and fees, revisit your original written goal and your three-column constraints.

Ask yourself for each program:

1. Does this program reasonably accept DO graduates?

   • If DO representation is nearly zero and your application is average, consider dropping or classifying it as a true reach.

2. Will this prelim year support my long-term plan?

   • Enough inpatient exposure?
   • Opportunities for letters in your advanced specialty (if needed)?
   • Reasonable schedule and wellness support to avoid burnout before PGY-2?

3. Would I actually attend if this were my only match?

   • If you know you would never rank a program, do not apply.

Action item: Once your list passes this test, lock it in. Over-tweaking late in the cycle leads to anxiety more than benefit.

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FAQs: DO Graduates Researching Preliminary Medicine Programs

1. As a DO graduate, should I prioritize DO-friendly programs even if they’re less prestigious?
Yes, especially for a prelim IM year. You want:

• A high likelihood of matching
• A supportive, non-biased environment
  Prestige matters far less for a one-year prelim than for your ultimate advanced specialty. A DO-friendly community or hybrid program where you’ll thrive, get strong clinical skills, and secure excellent letters is usually a better choice than a top-tier academic center that rarely trains DOs.

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2. How many preliminary medicine programs should a DO graduate apply to?
It depends on your profile, but a common range is:

• 20–40 prelim IM programs for an average DO applicant also applying to advanced specialties
• More if:
  • You have red flags (exam failures, gaps), or
  • You are regionally very restricted
    Talk with your school advisor for personalized numbers, but in general, err slightly on the side of more for prelims, since you only have one shot at aligning PGY-1 and PGY-2.

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3. Is it necessary to take USMLE if I already have COMLEX scores as a DO?
Many internal medicine programs accept COMLEX alone, and this is increasingly common. That said:

• Some highly competitive or historically MD-dominated programs still prefer or require USMLE.
• For prelim IM specifically, many DOs match successfully with COMLEX only, particularly in DO-friendly or community-based programs.
  If you already have USMLE scores, use them. If not, carefully weigh the cost/benefit with your advisor; often, focusing on strengthening your application (letters, rotations, personal statement) is more impactful than adding late USMLE scores.

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4. How can I tell if a program treats prelim residents fairly?
Look for:

• Explicit mention of prelims on the program website
• Clear description of prelim curriculum and responsibilities
• Evidence that prelims attend the same conferences and teaching rounds as categoricals
• Resident lists that identify prelims and show they are integrated
• Feedback from current or past prelims (via alumni or outreach) about:
  • Inclusion in teaching
  • Fair rotation and call distribution
  • Support for their advanced specialty plans
    If you consistently see that prelims are invisible or rarely discussed, that’s a warning sign. It may still be worth ranking if needed, but should not be at the top of your list.

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By approaching the osteopathic residency match with a structured program research strategy, you can transform a confusing array of prelim IM options into a targeted, realistic, and high-yield list. As a DO graduate, focusing on DO-friendly programs, strong clinical training, and supportive prelim cultures will maximize both your match chances and your readiness for the advanced specialty career you’re ultimately aiming for.