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Originally Posted by the alchemist

actually what soulinneed said is true. all the pm&r residencies i know of start w/ pgy-2 but i admit that i could be wrong since this is not the specialty i'm going into so i haven't researched this but def the majority are. so u do have to do an intern yr. currently, 4 MD specialties that start pgy-2 accept a DO intern year: anes, pm&r, radiology, and family/derm (yes, there are these hybrid fm programs w/ a concentration in derm). anything else you would have to repeat the intern year. for instance, if u did a DO intern year and want to go neuro, you would have to repeat an MD intern year b4 doing the 3 years of MD neuro. but most, if not, all MD neuro programs are categorical anyways but i do know of someone in this predicament - lost MD neuro spot and scrambled into a DO intern year. this person will have to do MD internship if the neuro program accepts this person back (was verbally promised they would once internship was completed somewhere else since intern year was under the IM dept and that dept let this person go). so rarely, things like this happen.

not sure if the acgme proposal was voted down...heard different rumors about this and it seems we won't have a def answer til june or so.

i said that if this proposal went through, any md residency/fellowship would require the md intern year as opposed to those specialties that currently accept DO/MD intern year.

Originally Posted by the alchemist

actually i don't think that this true. yes, in the past, the AMA did take this stance and there was the CA merger debacle...but as the old guard changes, i find that not all younger physicians (the future AMA leaders) think this way and don't consider there to be a big difference b/t the 2 professions. yes, there will always be monopolistic territorialism but i think the perception of how MDs view DOs has changed a lot since the 1970s. also even though FMGs are considered MD for all extensive purposes, many of them get an equivalent degree but its not called MD in their country (i'm thinking of india and i think also china where the degree is actually MBBS). they're considered MD b/c obviously if u had to choose b/t our American MD and DO, MD is easier to give them as an equivalent title

This is not about what you think or feel or find... The facts are that the AMA has tried to fight DOs for the past 100+ years and the only time they started playing nice was when we secured licensure in all 50 states in the 80s at which point they had no choice.

Giving up our autonomy is asking for trouble! AMA would like nothing more than to get rid of DOs (for a good reason which is more revenue/control by AMA). Next time you wanted to know what the "future AMA leaders" think of DOs go check out the allo forums and report back!

Originally Posted by the alchemist

i think that you make some assumptions here w/o evidence. having just gone through the interview process as a DO awaiting the MD match, i don't agree with your statement entirely. yes, AMGs are preferred over FMGs and this is becoming even more so with more AMGs graduating and not having a proportional increase in ACGME spots available so the FMGs will feel the crunch first then DOs/carib AMGs. but in some places that i rotated at, if the institution/dept had a lot of FMG/caribbean attendings, i saw more of them getting accepted than DOs (at this place, it was 40% MD, 40% caribbean AMG or FMG, 20% DO and many of my schoolmates rotate at this MD institution that is close to our school)

1) Let's get our vocab. right: Caribbean grads by any definition are NOT AMGs. According to SDN even DOs aren't AMGs (which is BS but I can't change the world singlehandedly [also it says a lot about the "future AMA leaders"]). The US citizens who attend foreign schools (e.g. Carib schools) are IMGs and that is to be distinguished from FMGs who are foreign nationals attending foreign schools.

2) The NRMP match rates speak for themselves. If your n=1 differs from the NRMP that doesn't change the overall picture. Also DOs are 20% of the US medical students out of which only about 1/2 participate in the NRMP match. Therefore, DOs will be considered over-represented in any ACGME program where more than 10% of their US graduated residents are DOs.

3) It doesn't matter how many carib grads are in a program. What matters is what percentage of their graduating class matches, which is about 50% (btw, that is after kicking out/not graduating 50% of their matriculating class). As apposed to DO schools which have a match rate of 87-89% (AOA + ACGME) with attrition rates less than 10%.

Originally Posted by the alchemist

there are some programs that just want the best candidates regardless of MD/DO/FMG and think of them all as equivalent and don't have different board score requirements for each group (washu comes to mind b/c this is what most of their attendings said to me on interview day). and there are some acgme programs that don't really accept DOs or require 2-3 USMLES to apply (only a handful out of the ones i applied to but i did get rejected from not having the prereq usmle scores in by then and was told this was the reason and this from lower tier schools when i got interviews at top/high tier programs). but you are right that for the majority of programs, FMGs need higher board scores than they allow for AMG candidates.

Most programs don't have different board score requirements for MD vs DO. If they do they don't take DOs. But ALL programs have different board score requirements for FMGs/IMGs, especially for FMGs. IMGs because of their perceived educational quality (or lack thereof) and FMGs because they study for the USMLE usually after they graduate by taking 1-2 year(s) off or doing "research" while dedicating most of their time to studying for the boards. Therefore, it wouldn't be fair to US MD/DO if they considered their scores equivalent to ours, when we only get 1-2 month(s).

Any program that tells you otherwise, is either BSing you or is a community program in the middle of nowhere and doesn't get any AMGs so they don't have to worry about it.

To repeat my self: "AMGs with 85/85 USMLE scores are almost always preferred over FMGs with 99/99 on the USMLE by the PDs. Furthermore, a Harvard grad with a 85/85 is perceived better than some random state university grad with a 85/85. Do I agree with that? No; Is it a fact? Yes!"

Originally Posted by the alchemist

and non-physicians can take USMLE. i know my professor at a DO school who is a PHD took it. not for anything related to her career but i think she said she was taking it to give feedback on the test. i can't remember if she said that she would give feedback to nbme or to some other organization but she did get permission from nbme to take it for that reason. so there is probably a small group of non-physicians who take usmle for various reasons. not sure about the NP thing that docespana talked about but i wouldn't be surprised.

The argument wasn't about who can take the USMLE but about whether or not NBME could restrict a group of people (e.g. DOs) from taking it if we abolished COMLEX and therefore, effectively preventing us from getting licensed. The conclusion to that was YES they could!

So, who currently is allowed to take the test is irrelevant as it could be changed any day!

Found this FAQ list aacom.org came up with. As of the now the proposal is still up in the air. Still hoping it gets officially shut down:

http://www.aacom.org/InfoFor/student...omeandgme.aspx

Originally Posted by donkeykong1

Found this FAQ list aacom.org came up with. As of the now the proposal is still up in the air. Still hoping it gets officially shut down:

http://www.aacom.org/InfoFor/student...omeandgme.aspx

Any updates on this decision? When is the decision deadline?

Anyone know anything about getting ACGME credit for a parallel program?

Add me to the list of DOs that want this to pass. Hell, I hope MD residencies stop accepting DOs in the near future. If the DO world can't provide the their ever-so-awesome training to their own graduates, then hopefully their current power structure will crumble, as they should.

Originally Posted by toothless rufus

Any updates on this decision? When is the decision deadline?

Anyone know anything about getting ACGME credit for a parallel program?

should know by sometime in june.

Originally Posted by upright

Add me to the list of DOs that want this to pass. Hell, I hope MD residencies stop accepting DOs in the near future. If the DO world can't provide the their ever-so-awesome training to their own graduates, then hopefully their current power structure will crumble, as they should.

Of course, this is after you've already secured an ACGME residency spot, yes?

New update: http://www.do-online.org/TheDO/?p=92491

Originally Posted by tkim

Of course, this is after you've already secured an ACGME residency spot, yes?

Hahaha, nice.

Originally Posted by gmreed2

New update: http://www.do-online.org/TheDO/?p=92491

I was at a meeting with the AOA president and this is basically what he said. I mean, I wouldn't expect his story to differ from the party line's.

He basically was blaming the ACGME for wanting power and money, citing they're trying to accredidate overseas programs and all of a sudden have a problem after 40 years of allowing DOs into ACGME fellowships. Unlike the AOA, they aren't as focused on the US at this current time. Blah blah blah.

I think it's a rather simple concept: They're tired of our residencies not being open to them.

Originally Posted by Bacchus

I was at a meeting with the AOA president and this is basically what he said. I mean, I wouldn't expect his story to differ from the party line's.

He basically was blaming the ACGME for wanting power and money, citing they're trying to accredidate overseas programs and all of a sudden have a problem after 40 years of allowing DOs into ACGME fellowships. Unlike the AOA, they aren't as focused on the US at this current time. Blah blah blah.

I think it's a rather simple concept: They're tired of our residencies not being open to them.

Yup.

Can you blame them?

Originally Posted by LSU Alex

Can you blame them?

Nope.

Originally Posted by Bacchus

I think it's a rather simple concept: They're tired of our residencies not being open to them.

There seem to be two very different arguments regarding this going on here.

1) AOA training is insufficient to meet ACGME standards, and therefore AOA grads can't be prepared for advanced ACGME training

2) ACGME wants in on AOA spots.

#2 tends to falter in the face of #1, no?

Originally Posted by Bacchus

I was at a meeting with the AOA president and this is basically what he said. I mean, I wouldn't expect his story to differ from the party line's.

He basically was blaming the ACGME for wanting power and money, citing they're trying to accredidate overseas programs and all of a sudden have a problem after 40 years of allowing DOs into ACGME fellowships. Unlike the AOA, they aren't as focused on the US at this current time. Blah blah blah.

I think it's a rather simple concept: They're tired of our residencies not being open to them.

what, if any, power would the AOA have here? I am just curious what the "pursue aggressive... whatevers" means

Originally Posted by SpecterGT260

what, if any, power would the AOA have here? I am just curious what the "pursue aggressive... whatevers" means

I thought they have been pursuing this for months, this isn't an update on what has been accomplished at all from what I can tell.

That's fine. I'm asking what is their mode of "pursuit"? They can take as aggressive a stance as they want and the ACGME can just say "no". Their residencies, their choice, honestly. The AOA will have to play ball if this policy gets to the end stages of approval

Originally Posted by SpecterGT260

That's fine. I'm asking what is their mode of "pursuit"? They can take as aggressive a stance as they want and the ACGME can just say "no". Their residencies, their choice, honestly. The AOA will have to play ball if this policy gets to the end stages of approval

Supposedly, discrimination.

It seems as if they are willing to go at bat and throw all that is necessary at this, as in lobbying, political power and attorneys.

Originally Posted by LSU Alex

Can you blame them?

I don't blame them one bit. Also, I do feel if residencies would be opened to ACGME graduates, it would push DO students further into primary care for the simple fact the ACGME grads may be more well qualified.

Originally Posted by Bacchus

Supposedly, discrimination.

It seems as if they are willing to go at bat and throw all that is necessary at this, as in lobbying, political power and attorneys.

I think that is a long shot.... especially when MDs are not allowed in the AOA match (yes I know that has been gone over in this thread...) but OMM is no more a suitable excuse for exclusion from AOA than whatever the ACGME comes up with. It will be interesting to see how this all works out, but barring the effects of lobbying a discrimination case should rightfully just end in egg-on-face for the AOA

Originally Posted by SpecterGT260

I think that is a long shot.... especially when MDs are not allowed in the AOA match (yes I know that has been gone over in this thread...) but OMM is no more a suitable excuse for exclusion from AOA than whatever the ACGME comes up with. It will be interesting to see how this all works out, but barring the effects of lobbying a discrimination case should rightfully just end in egg-on-face for the AOA

Agreed. The AOA needs to ask the AMA what can they do to join together. OMM is not a reason to exclude the MDs from AOA residency(and I want to do an AOA residency but if I am not able to keep up with my M.D. counterpart am I really worthy of the spot in the first place??)

Also as far as M.D.'s taking over our competive residencies, I would hope that we have students that are strong enough(grades, work ethic, etc...) to not let this occur or maybe there could be some way to blind the process where you couldn't tell if an applicant was a D.O. or M.D. and base it on Board scores, grades etc.....

Only some thoughts and I hope I am not offending anyone. Typing on Iphone so sorry if typos present.

Originally Posted by Bacchus

I don't blame them one bit. Also, I do feel if residencies would be opened to ACGME graduates, it would push DO students further into primary care for the simple fact the ACGME grads may be more well qualified.

We'll never know til they take those chances.

AOA message:
1. We're different, but we are equal.
2. We're different, but we want you to train us. You have to give us access to your residencies/fellowships.
3. We're different, and it would be inappropriate to train you. So, we need you to kindly back away from our GME.
4. We like pudding pops...

So during 3rd and 4th year of medical school combined, I had 1 D.O. preceptor (thank goodness for not having to hear "think osteopathically" any more). I also had 6.5 hours of OMT lectures (half-hour noon conferences). So even at the undergraduate level, we're essentially being trained as allopaths. Hell, I may not be qualified for a D.O. residency...

Originally Posted by LSU Alex

We'll never know til they take those chances.

AOA message:
1. We're different, but we are equal.
2. We're different, but we want you to train us. You have to give us access to your residencies/fellowships.
3. We're different, and it would be inappropriate to train you. So, we need you to kindly back away from our GME.
4. We like pudding pops...

So during 3rd and 4th year of medical school combined, I had 1 D.O. preceptor (thank goodness for not having to hear "think osteopathically" any more). I also had 6.5 hours of OMT lectures (half-hour noon conferences). So even at the undergraduate level, we're essentially being trained as allopaths. Hell, I may not be qualified for a D.O. residency...

that is exactly it... I was talking to other DO students both on here and IRL about how intense OMM training really is and how far it sets you guys away. something like an hour or two a week for the first two years (so 32-64 hours) and some exams which may not qualify as time spent training and marginal use in the clinic years..... So MD students are excluded because of something that could reasonably be cranked out in a few weekends? There is no reason OMM couldnt be taught in the residency except that many of the residencies arent even using it to begin with

Originally Posted by SpecterGT260

that is exactly it... I was talking to other DO students both on here and IRL about how intense OMM training really is and how far it sets you guys away. something like an hour or two a week for the first two years (so 32-64 hours) and some exams which may not qualify as time spent training and marginal use in the clinic years..... So MD students are excluded because of something that could reasonably be cranked out in a few weekends? There is no reason OMM couldnt be taught in the residency except that many of the residencies arent even using it to begin with

I will agree with this. In general I think the thing with legitimate OMM (ie nothing involving craniosacral) is the learning curve it takes for people to develop manual ability/palpation sensitivity. I think a few weekends are enough to memorize the techniques (especially not difficult if you have a decent understanding of anatomy) but OMM involves physical manipulation (ie not something that can be measured with labs/imaging/rulers) and it takes some time to learn what feels normal vs abnormal and improved vs worsened, etc. Keep in mind I'm not at all an enthusiast of OMM...I'm sure any medical student can supplement their boards studying with Savarese, which can be read cover-to-cover in a day, and still do well above average on COMLEX without ever having laid hands on a person.

Originally Posted by ensuii

I will agree with this. In general I think the thing with legitimate OMM (ie nothing involving craniosacral) is the learning curve it takes for people to develop manual ability/palpation sensitivity. I think a few weekends are enough to memorize the techniques (especially not difficult if you have a decent understanding of anatomy) but OMM involves physical manipulation (ie not something that can be measured with labs/imaging/rulers) and it takes some time to learn what feels normal vs abnormal and improved vs worsened, etc. Keep in mind I'm not at all an enthusiast of OMM...I'm sure any medical student can supplement their boards studying with Savarese, which can be read cover-to-cover in a day, and still do well above average on COMLEX without ever having laid hands on a person.

Yes... I have a bad habit of ignoring muscle memory in the training. However I suspect that allopathic physical exam skills can get someone a long ways towards being able to manually ID normal and abnormal. The "ridiculous OMM claims" thread mentioned a lecturer who claimed to be able to feel a thread through a phone book. DOs aren't blessed with extra sensitivity vs any other group of people. Without intending to turn this into another "OMM is bs" thread, without questioning the sensitivity of OMMs identification of abnormal, I do somewhat question the specificity.

Is that book anatomy heavy in general or too OMM focused to be of use to an MD? Im all about quick and dirty high yield reviews lol

Originally Posted by ensuii

I will agree with this. In general I think the thing with legitimate OMM (ie nothing involving craniosacral) is the learning curve it takes for people to develop manual ability/palpation sensitivity. I think a few weekends are enough to memorize the techniques (especially not difficult if you have a decent understanding of anatomy) but OMM involves physical manipulation (ie not something that can be measured with labs/imaging/rulers) and it takes some time to learn what feels normal vs abnormal and improved vs worsened, etc. Keep in mind I'm not at all an enthusiast of OMM...I'm sure any medical student can supplement their boards studying with Savarese, which can be read cover-to-cover in a day, and still do well above average on COMLEX without ever having laid hands on a person.

I don't even think you need Savarese. With someone explaining to you the absolute basics, you could get away with using the Dr. Simmons Cram Pages for COMLEX. That's what I used for Level 1 and 2 and did fine. Will probably borrow Savarese for Level 3, as I am hoping for a knockout on that one. I don't want to have to fool with USMLE S3 if it isn't necessary.

OMM Cram Pages

And no, this shouldn't become an "OMM is crap" thread. I am not advocating that at all. It's just not enough to keep MDs from doing DO residencies... and at this point, it's not even enough to justify a difference in degrees. 32 - 64 hours is a little off... more like 140 - 160 over 2 years depending on which school you go to. And if you are crazy enough to be a TA in OMM (yeah, that was me), add another 70 - 80 hours. Don't use Savarese for anatomy. Just... don't.

The palpatory finesse of DOs and their students is often touted. I don't know how well it actually holds up though. I am not aware of any studies comparing the palpatory findings of MDs to DOs or their respective students and I know there was a small study done at PCOM (I think more of a requirement for the undergraduate OMM fellows) between interexaminer reliability and diagnosis of pelvic/sacral/inominate dysfunctions that was all over the map. I had been diagnosed in 5 minutes by two different fellows and the result was two different somatic dysfunctions.

As far as Savarese goes, it is a good book but it's too focused on OMM (imagine that) to be worth the investment to someone not preparing for an OMM exam (in school or on the boards). There are tables of attachments, function, innervation, etc. but they could be made by anyone or be found on the internet. I wouldn't buy it unless I had an OMM exam to take.

Originally Posted by SpecterGT260

Yes... I have a bad habit of ignoring muscle memory in the training. However I suspect that allopathic physical exam skills can get someone a long ways towards being able to manually ID normal and abnormal. The "ridiculous OMM claims" thread mentioned a lecturer who claimed to be able to feel a thread through a phone book. DOs aren't blessed with extra sensitivity vs any other group of people. Without intending to turn this into another "OMM is bs" thread, without questioning the sensitivity of OMMs identification of abnormal, I do somewhat question the specificity.

Is that book anatomy heavy in general or too OMM focused to be of use to an MD? Im all about quick and dirty high yield reviews lol

Well, I think it depends on how diligently you try to hone your physical exam skills. I left like in Clin Skills, there's a lot of "going through the motions" and not a whole lot trying to figure out things like "tissue texture" (I can't believe I used that term...) whereas OMM lab should force you a little more to look for those abnormalities.

It's pretty heavy OMM in general I think...the cram pages are probably a lot more higher yield and I'll probably just stick to it for step 2 but if you're looking to get the most "content" its probably the next best thing besides reading FOUNDATIONS

Getting back on topic. Not too hopeful about the whole pursue aggressivly thing either

Ya Im thinking it is a whole lot of talk and no action. Better move would be to set up enough of our own residencies with enough of ALL specialties not a whole ass ton of family med residencies. But likely wont happen in our lifetimes. Quite frankly id rather see all DO schools become MD, have one match, and open up OMM to all medical schools.

Originally Posted by sylvanthus

Ya Im thinking it is a whole lot of talk and no action. Better move would be to set up enough of our own residencies with enough of ALL specialties not a whole ass ton of family med residencies. But likely wont happen in our lifetimes. Quite frankly id rather see all DO schools become MD, have one match, and open up OMM to all medical schools.

So much uncertainty nowadays!

The thing he mentioned about a dual acgme/aoa task force holding residency programs accountable under one set of standards sounded cool.

Also, I bet if we could get all DO students from OMS1-IV to vote on just having one match while keeping the degree the same, there would be a majority vote FOR the cause. Training and the quality of residencies would improve, and there would be a much more level playing field when it comes to applying for residency.

It seems like the COSGP doesn't have any leverage with the AOA executives, hence student voices might be heard but hardly ever put into action.

Originally Posted by sylvanthus

Ya Im thinking it is a whole lot of talk and no action. Better move would be to set up enough of our own residencies with enough of ALL specialties not a whole ass ton of family med residencies. But likely wont happen in our lifetimes. Quite frankly id rather see all DO schools become MD, have one match, and open up OMM to all medical schools.

After just taking Step II (USMLE) today and having Level II (COMLEX) looming 3.5 days down the pipeline, I would do anything to just have one degree and one testing system right now. Good lord I am not looking forward to 400 questions of COMLEX

Originally Posted by DocEspana

After just taking Step II (USMLE) today and having Level II (COMLEX) looming 3.5 days down the pipeline, I would do anything to just have one degree and one testing system right now. Good lord I am not looking forward to 450 questions of COMLEX

Here's my master plan for the AOA board lurkers on here:

1) Keep the MD and DO degrees separate

2) Have MDs sit on the NBOME and DOs on the NBME for transparent oversight on the COMLEX/USMLE,so that PDs from both sides better understand the exam.

3) Open the AOA residency/fellowship slots to MDs who take and pass the COMLEX.

4) Teach only evidence based OMM at schools and keep it to a minimum. the Osteopathic philosophy and degree itself as a brand is enough.

5) Board certification would still depend on whether one completes an AOA or ACGME residency

By following this the AOA and ACGME, MD and DO, would still be separate entities but even more level with each other.

I see no point in keeping them separate when the only difference is OMM. Also, opening up OMM to all
schools would allow more OMT practitioners than we currently produce.

Originally Posted by sylvanthus

I see no point in keeping them separate when the only difference is OMM. Also, opening up OMM to all
schools would allow more OMT practitioners than we currently produce.

one step at a time though. right now, if MD schools were given the option to incorporate OMM into their undergrad curriculums...they probably wouldn't go for it (though soem offer it as CME, and during allo PMR residencies). After a while, when MDs and DOs get to be examiners on allo/osteo boards and MDs can sit and study for the COMLEX, allopathic schools may want to adopt OMM as well, and then well who knows...there might be a merger of degrees. the point is, this all takes time. and i agree, the end goal would be to have just one degree and system.

Ya thats prob more doable. Then when the current old guard of the AOA dies/retires things are more likely to change.

Originally Posted by sylvanthus

Ya thats prob more doable. Then when the current old guard of the AOA dies/retires things are more likely to change.

I used to think that. I'm a whole lot less optimistic now. It seems like the only people who have the opportunity to find their way into leadership positions within the Osteopathic community are those who will kiss the butt of the establishment and spout the same BS the AOA leadership does now. The lack of organized opposition just means that the AOA can continue to cultivate a new generation of similar-minded folk who are dead-set on keeping any sort of "advancement" to a minimum. And ooohhhh boy are they quick to bring the hammer down and use the "unprofessional" characterization on anyone who dares to criticize publicly and non-anonymously. I don't ever see it changing.

So why not send people in to infiltrate the ranks? Fake it and change it from within.

.

Let's create a secret society, a brotherhood. Our ultimate goal would be to change the AOA by infiltration, as mentioned above. We can have secret and crazy rites and rituals. We'll be like the illuminati of the medical world... I just saw the Da Vinci code last night on Netflix lol.

Originally Posted by rafman

Let's create a secret society, a brotherhood. Our ultimate goal would be to change the AOA by infiltration, as mentioned above. We can have secret and crazy rites and rituals. We'll be like the illuminati of the medical world... I just saw the Da Vinci code last night on Netflix lol.

I had a psyc pt blame his failed rapping career on the Illuminati. He said they wanted him out of the picture because he was a "Rapper for Christ"... But I digress.

By the time one would "infiltrate" the AOA, they would be so brainwashed that they would stick with the status quo. Just like politicians, once your in, you suck.

Originally Posted by LSU Alex

I had a psyc pt blame his failed rapping career on the Illuminati. He said they wanted him out of the picture because he was a "Rapper for Christ"... But I digress.

By the time one would "infiltrate" the AOA, they would be so brainwashed that they would stick with the status quo. Just like politicians, once your in, you suck.

It seems like 'our generations' entire mentality is just different from the 'old guard', but I guess when people are enticed with power, compromising your intentions, however good they may be, seems like the status quo.

Originally Posted by sylvanthus

Ya Im thinking it is a whole lot of talk and no action. Better move would be to set up enough of our own residencies with enough of ALL specialties not a whole ass ton of family med residencies. But likely wont happen in our lifetimes. Quite frankly id rather see all DO schools become MD, have one match, and open up OMM to all medical schools.

Part of the problem is funding.
It would require 2000 more residency spots each year for an average of 4 years= 8,000 residency spots each year.

Funding for a single residency spot is $100,000.

Doing the math that would cost $800,000,000 PER YEAR!

An AOA cessation from ACGME programs would provide a unique situation. The constant adage touted by the AOA, "we are different, but equal," in my mind is shear duplicity. How can you be different if you are training in ACGME programs? It is time for the AOA to take the necessary measures and open more quality residency and fellowship programs, instead of using the ACGME's. With adequate measures in place, competition would be provided in the medical market place. In my mind, this is the perfect opportunity to up the standards for Osteopathic medical schools, coupled with an intensification in research at each program.

This is motivation for me to go to Osteopathic school, for I hope this atmosphere will spawn in my fellow medical students a desire to pursue, with an even greater stride, excellence. The only reason many of the ACGME programs garner so much prestige is due to public opinion and various talking heads purporting that they are the best, who seem to use their influence and anecdotal evidence to woo the masses.

I believe that the political measures put forth by the AMA to exclude osteopathic physicians from their programs will pass in their favor. If you have not noticed, since the 1910s, the allopaths have enforced their whims through brazen political policies, for they continue to maintain market power derived from, and maintain by the federal government.

http://mises.org/daily/4276

Yes, there is opposition, but through it all this could be a great opportunity.

Originally Posted by FormerCorpsman

I believe that the political measures put forth by the AMA to exclude osteopathic physicians from their programs will pass in their favor. If you have not noticed, since the 1910s, the allopaths have enforced their whims through brazen political policies, for they continue to maintain market power derived from, and maintain by the federal government.

From what I have read thus far, these measures were more directed at IMGs than they are at DOs. I'm not so sure that this is an attack on osteopathic medicine per se, although it may be a warning shot for the AOA to step its game up, which it obviously needs to do. I seriously doubt that the AOA will be able to survive on its own- that is without DO access to ACGME programs- especially considering the current fiscal climate where significant increases in GME funding is just not going to happen anytime soon. Let's not forget the spike in DO grads that will only add to the burden.

I admittedly have a limited perspective regarding the political nature of this situation (and let's face it, this is not about medicine, training competent physicians, or quality of care; it's about politics- maintaining separate entities that is), I think it's time that AOA residencies were open to MD students, and for there to be ONE organization that oversees and accredits programs. I'm almost hoping that the ACGME says "open DO residencies to MDs... AND your programs have to meet the same accreditation standards as ours or you're shut out!" I just ranted about this yesterday:

Originally Posted by Dharma

Why not open AOA residencies to MD students? Are people scared of MD students taking over DO residencies? They shouldn't be because it will work itself out. Those residencies out there that are competitive in the MD world will still be competitive (and likely still tough for most DO students to break into) and those programs with DO roots may still be known to have a more DO slant (dare I say 'preference'). Self-selection will ensue but with less definitive barriers. Yes, discrimination will still occur to some degree, and in some places quite possibly as much as ever... but in this case maybe even for an MD student who lacks certainly qualities that DO PD wishes to see in his residents.

Of course there would be kinks to work out, but at least everyone will be on the same page and ALL GME programs will be held up to the same standards and level of scrutiny across the country with less speculation (negative or otherwise). $hit, the AOA and the AMA (or is it ACGME in this case?) can still remain distinct to some degree so that they can keep their jobs and continue with the self-back-patting and what-not, but at least they can sit at the same table and work together under the same guise. If they really want to waste more money in the name of bureaucracy while simultaneously feeling better about themselves they can create an umbrella group that overseas the whole shebang.

Excuse the comparison but this all sounds a lot like the history of major league baseball to me... with the American League being the small guy with weaker teams and often losing their better players (sometimes unfairly) to the larger more established National League. They battled for years (even to the point of playing football games against each other after the season ended just so that they can beat the crap out of each other) but eventually they worked it out and became one organization while remaining somewhat distinct. This competition to settle their differences led to one of the greatest venue in sports- the World Series.

Ok, so maybe this isn't the best analogy (or even an appropriate one) comparing our national pastime with a profession where lives are regularly at risk and in the hands of its "players", but if anything, the fact that medicine is such serious business should be even more of an impetus to demand high quality standards in training across the board without avoidable political hogwash muddying the waters; both sides should come together for the sake of enhanced quality. The main concern should be quality not distinction, but it appears as if the latter takes precedence. Point being, from an arbitrary perspective all of this separate but equal talk comes off as disingenuous, especially after speaking with and working under established DO's and MD's in a clinical setting. I would like to believe that a majority are ready for significant changes. Maybe all of the ACGME talks this summer will play the role of catalyst.

Originally Posted by Dharma

From what I have read thus far, these measures were more directed at IMGs than they are at DOs. I'm not so sure that this is an attack on osteopathic medicine per se, although it may be a warning shot for the AOA to step its game up, which it obviously needs to do. I seriously doubt that the AOA will be able to survive on its own- that is without DO access to ACGME programs- especially considering the current fiscal climate where significant increases in GME funding is just not going to happen anytime soon. Let's not forget the spike in DO grads that will only add to the burden.

I admittedly have a limited perspective regarding the political nature of this situation (and let's face it, this is not about medicine, training competent physicians, or quality of care; it's about politics- maintaining separate entities that is), I think it's time that AOA residencies were open to MD students, and for there to be ONE organization that oversees and accredits programs. I'm almost hoping that the ACGME says "open DO residencies to MDs... AND your programs have to meet the same accreditation standards as ours or you're shut out!" I just ranted about this yesterday:

Supposedly this who thing was more directed at IMGs than DOs, but how hard would it have been to realize the impact on DOs and change the wording to allow osteopathic residencies to count? Heck they spelled out canadian residencies are ok. They knew what they were doing.

maybe i need to re-read it.... how is it directed at FMGs? They do not go AOA residencies which means all of them would be eligible for ACGME fellowships if they match here in the first place.

Originally Posted by SpecterGT260

maybe i need to re-read it.... how is it directed at FMGs? They do not go AOA residencies which means all of them would be eligible for ACGME fellowships if they match here in the first place.

"Requiring an ACGME-accredited residency program or RCPSC-accredited residency program in Canada as a prerequisite for clinical education for entry into an ACGME-accredited fellowship program."

this means if you're an FMG and completed a residency in X specialty and you want to come to the states to complete a fellowship...this would not be possible.

Then I was mistaken. I thought nearly every FMG had to retake residency when coming here regardless of past practice. I don't see how this is different for FMG than before.

Originally Posted by SpecterGT260

maybe i need to re-read it.... how is it directed at FMGs? They do not go AOA residencies which means all of them would be eligible for ACGME fellowships if they match here in the first place.

Someone on these boards (I think DocEspana) also made mention of a few conversations with AMA folks whom he has spoken with regarding the proposed changes.