Speaking as a DO MSIII, I can give you a little advice. Some this advice is from personal experience and some is from members of this forum and other residents I have rotated with. Also, check out the post a few weeks back about DO friendly allopathic programs.
1.) Being a DO, you are at a disadvantage because the DO curiculum tends to slightly favor primary care. This presents two problems of varying revelancy:
a.) your pre-clinical education may leave you underprepared for the MD boards, which you MUST take (most program directors I talked with will not convert your COMLEX scores to USLME equivalents). The USMLE I favors the hardcore basic sciences much more heavily than the COMLEX I and it doesn't have the freebie OMT questions to help boost your scores. Stay away from the all out text books and buy some board review books early and hit path/phys/biochem/statistics hard. I chose to take the USMLE I 6 months after the COMLEX I so I could get some clinical experience under my belt and study a little more. Well, it back-fired because I did not do nearly as well as I had hoped to. The clinical stuff didn't help much and I forgot a lot of the buzz words and little stuff that scores easy points. Also, I didn't have half the time I thought I would for extra studying.
b.) in general, there is an assumption that DO's are trained to enter primary care fields and therefore should do this. This is by no means universal, and it tends to vary regionally, but it does in fact exist. Do NOT let any of the DO elitists/optimists tell you any different. Nor should you let any MD push you around and tell you it's impossible.
2.) Study hard. Ortho is competitive no matter where you go, MD or DO. Just like your MCAT score was a factor in getting into med school, so too will class rank and board scores. They will help you get an interview; the rest is up to you. I made the mistake of blowing off COMLEX I because I thought my CV was strong enough for any DO program I wanted. Now, as my allopathic prospects are thining, the DO option is becoming less of a back-up plan.
3.) Research, research, research. I am not talking about clinical research, although that definitely helps, too. I am talking about researching programs. Find out which program fits your needs in terms of location/hospital size/how many residents/are they DO friendly. Start early and build some contacts. Use the networks you already have started through your previous job.
4.) As far as the AOA internship goes, this is a problem I am having also. You can apply to the AOA to have your first year of MD ortho residency count as your internship year. This is becoming easier every year as the requirements become less strict. There are still many reqs but there is almost always some loophole. The main, and most difficult, req is that you have to do 6 months of primary care. This is a somewhat risky option because if you don't get approved you will limit where you can practice. The second option is to do your internship after your residency but this would suck big time; 12 months of scutwork after 12 months of cheif ortho resident. The third option is to go ahead and do your residency and then apply to MD ortho programs. This is risky because if you don't get into an MD program, nearly all of the DO spots will be taken because they tend to fill from the intern class at each program and the DO match is 6 weeks earlier than the MD match. I could go on for hours with regard to this topic, but I won't.
Everything I mentioned above is my personal opinion based on my experiences and schooling. Your med school may have a different approach and curriculum. This whole message may not even pertain to you, but most likely some, if not all of it, will.
The whole key to ortho, wether you are an MD or DO student, is to be realistic. See where you fit in, do your homework, rotate where you want to go, and work you ass off. Being overly optimistic or pessimistic will get you nowhere fast. It's almost too early for you to be thinking about all this - you need to concentrate on school and study for boards. The rest of it will fall into place after those two peices have been secured.
Good luck!
