D.O student worried about Caribbean students taking our residencies....

[ChrisGriffen]

All I'm saying is that if the merger hadn't happened, it could be foreseeable that the ACGME could ban DOs.

......and what you are saying is wrong.

Edit: before the pre-med/m1 goons come in here spouting off... No, it really never was nor ever will be a possibility.

And yes, we get it that AOA residencies dont accept MDs. We ****ing get it.

---

Members don't see this ad.

 

[NurWollen]

......and what you are saying is wrong.

You and I are simply both speculating. Neither of us has anything but an opinion on the matter, and we have differing opinions.

 

[ChrisGriffen]

You and I are simply both speculating. Neither of us has anything but an opinion on the matter, and we have differing opinions.

No. You are posting nonsense that has been put to rest 1000 times already.

 

[NurWollen]

No. You are posting nonsense that has been put to rest 1000 times already.

Lol whatever. I stand by what I said, which if you read my post was to say that the merger is a good thing.

 

[Mad Jack]

All I'm saying is that if the merger hadn't happened, it could be foreseeable that the ACGME could ban DOs. DOs weren't always allowed in MD residencies. Any idea of how the government would respond is speculation. You're probably right in that it would be in the government's best interest to prevent the ACGME from doing this, but who knows what crap congress can pull. Anyway, it's a moot point because of the merger.



Again, I was referring to things pre-merger.


2nd year DO student. I was simply making the point that before the merger, DOs were at the mercy of the ACGME when it comes to everyone getting residency spots. Now, since the ACGME is the accrediting organization for DO residencies, they can't very well exclude DOs.

Pre-merger it was totally feasible. Unlikely, but doable. They'd already put in motion a ban on DOs from AOA residencies going into the fellowship match, and there was really nothing stopping them from strong-arming the AOA into a forced merger by banning DOs from the match.

 

[NurWollen]

Pre-merger it was totally feasible. Unlikely, but doable. They'd already put in motion a ban on DOs from AOA residencies going into the fellowship match, and there was really nothing stopping them from strong-arming the AOA into a forced merger by banning DOs from the match.

Exactly!

 

[jw3600]

Pre-merger it was totally feasible. Unlikely, but doable. They'd already put in motion a ban on DOs from AOA residencies going into the fellowship match, and there was really nothing stopping them from strong-arming the AOA into a forced merger by banning DOs from the match.

Is this really that hard to understand?^^

 

[user3]

mods, please BAN chrisgriffen.

 

[ChrisGriffen]

Pre-merger it was totally feasible. Unlikely, but doable. They'd already put in motion a ban on DOs from AOA residencies going into the fellowship match, and there was really nothing stopping them from strong-arming the AOA into a forced merger by banning DOs from the match.

No. They said that in order to be eligible for ACGME fellowship you needed to either complete an ACGME residency or obtain approval from a program director. This was hardly a "ban on DOs". This was proposed because international doctors were completing "residencies" in other countries to be eligible for US fellowships.

.... And it was never implemented.

Again

All of this has been discussed before. Please stop.

 

[Mad Jack]

No. They said that in order to be eligible for ACGME fellowship you needed to either complete an ACGME residency or obtain approval from a program director. This was hardly a "ban on DOs". This was proposed because international doctors were completing "residencies" in other countries to be eligible for US fellowships.

.... And it was never implemented.

Again

All of this has been discussed before. Please stop.

It was also largely done because certain DO residencies were viewed as subpar- radiology, anesthesia, and derm, amongst others. Sure, PDs could technically make an exception for a DO, but they likely never would have. And the only reason it never went through was because the merger happened. It was pretty widely accepted that one of the biggest factors behind the merger was the closure of fellowship opportunities for the majority of DOs.

 

[ChrisGriffen]

It was also largely done because certain DO residencies were viewed as subpar- radiology, anesthesia, and derm, amongst others. Sure, PDs could technically make an exception for a DO, but they likely never would have. And the only reason it never went through was because the merger happened. It was pretty widely accepted that one of the biggest factors behind the merger was the closure of fellowship opportunities for the majority of DOs.

. That "ban on DOs" was dropped about a full year before the merger was proposed.

... And how would the merger change that??? The merger doesnt make any DO programs more "up to par". It just changes the name of who is accrediting them.

Lots of things on SDN are widely accepted. That doesnt make them true.

 

[ChrisGriffen]

mods, please BAN chrisgriffen.

If anyone needs to get banned, its the pre-med who is constantly giving advice to other pre-meds. Hmm.

 

[NurWollen]

mods, please BAN chrisgriffen.

Nah, I hate about half of what he says but love the other half.

 

[NurWollen]

No. They said that in order to be eligible for ACGME fellowship you needed to either complete an ACGME residency or obtain approval from a program director. This was hardly a "ban on DOs". This was proposed because international doctors were completing "residencies" in other countries to be eligible for US fellowships.

.... And it was never implemented.

Again

All of this has been discussed before. Please stop.

My understanding is that the rule changes are in fact going in to affect. The just make an accepting for DO programs with 'provisional ACGME accreditation' or whatever they're calling it. I could he wrong though.

 

[SLC]

. That "ban on DOs" was dropped about a full year before the merger was proposed.

It was dropped when the AOA came to the table on the merger. And as soon as it was dropped, the AOA (mainly because of the ACOFP) got cold feet and backed out of the merger, this was during my M2 year and I remember because I and my classmates nearly mutinied over it.

Then the ACGME put the "fellowship ban" back into the picture when things fell apart. It was that re-instating of the fellowship restriction plan that brought the AOA back to the table for good. The ACOFP is still butt-hurt about it, I get angry emails about it every week (well I should say got rather than get since I recently un-subscribed from their emails.). It's because of the ACOFP's obstructionism that I will not seek dual board certification or in any other way associate myself with the osteopathic branch of my specialty.

 

[ChrisGriffen]

It was dropped when the AOA came to the table on the merger. And as soon as it was dropped, the AOA (mainly because of the ACOFP) got cold feet and backed out of the merger, this was during my M2 year and I remember because I and my classmates nearly mutinied over it.

Then the ACGME put the "fellowship ban" back into the picture when things fell apart. It was that re-instating of the fellowship restriction plan that brought the AOA back to the table for good. The ACOFP is still butt-hurt about it, I get angry emails about it every week (well I should say got rather than get since I recently un-subscribed from their emails.). It's because of the ACOFP's obstructionism that I will not seek dual board certification or in any other way associate myself with the osteopathic branch of my specialty.

.... As soon as the rule limiting DOs from ACGME fellowships was withdrawn, the AOA pulled out of the merger, because the Family Med doctors were upset about what?

I am lost here

 

[SLC]

.... As soon as the rule limiting DOs from ACGME fellowships was withdrawn, the AOA pulled out of the merger, because the Family Med doctors were upset about what?

I am lost here

They were concerned about "losing our distinctiveness" and also worried (and they still are) that DO's who did AOA residencies in the past, wouldn't be eligible to be PD's after the merger.

As soon as talks stalled and the DO establishment sorta walked away, the fellowship restriction was put right back into the plan. We all got emails from the AOA president half apologizing that they couldn't get things done. And the ACGME produced a scathing letter basically saying "WTF, we did everything you had asked for and you still reneg'd one our deal?"

It was infuriating for a while there.

 

[jakeislove]

mods, please BAN chrisgriffen.

I appreciate his consistency.

 

[hallowmann]

......and what you are saying is wrong.

Edit: before the pre-med/m1 goons come in here spouting off... No, it really never was nor ever will be a possibility.

And yes, we get it that AOA residencies dont accept MDs. We ****ing get it.

The issue was about OGME not being recognized by ACGME programs. It was on the table, it was going into effect, and basically the ACGME was ready to stand up and say that AOA programs were clearly subpar (something that I'm sure would have done wonders for or distinctiveness here and internationally).

It wasn't only about IMGs. If it was, they could have easily made an exception for AOA trained docs.

. That "ban on DOs" was dropped about a full year before the merger was proposed.

... And how would the merger change that??? The merger doesnt make any DO programs more "up to par". It just changes the name of who is accrediting them.

Lots of things on SDN are widely accepted. That doesnt make them true.

You have the sequence of events mixed up a bit here. The ACGME dropped the proposal when it looked like the AOA was going to follow through with the merger. At the time, it was set to go into effect in 2015, but was withdrawn (most likely because of the merger talks).

When the AOA backed out (in defense of "our" distinctiveness), the ACGME turned right around and put it back into effect to begin in 2016 (one year delayed). As it stands it will still be in effect come 2016, and the only way to get around it will be for the AOA training programs to get pre-accreditation status or get ACGME accredited. They are likely keeping it on the table to prevent the AOA from backing out again.

 

[Mad Jack]

mods, please BAN chrisgriffen.

He's not really ban-worthy with anything he's saying- he's just calling it like he sees it. It's not like MeatTornado, who often just takes stabs at DOs for the hell of it.

 

[hallowmann]

Why? He seems like he's making good points.

They're not going to ban him (nor should they) for having a different opinion, whether he's making good points or not.

 

[NurWollen]

All this talk about banning makes me wonder what ever happened to MedPR... I wonder if he's on here under a different handle.

 

[DrEnderW]

When the AOA backed out (in defense of "our" distinctiveness), the ACGME turned right around and put it back into effect to begin in 2016 (one year delayed). As it stands it will still be in effect come 2016, and the only way to get around it will be for the AOA training programs to get pre-accreditation status or get ACGME accredited. They are likely keeping it on the table to prevent the AOA from backing out again.

This is my understanding as well.

The exact language is:

"Eligibility Requirements – Fellowship Programs:

All required clinical education for entry into ACGME-accredited fellowship programs must be completed in an ACGME-accredited residency program, or in an RCPSC-accredited or CFPC- accredited residency program located in Canada.

Fellow Eligibility Exception:

A Review Committee may grant the following exception to the fellowship eligibility requirements: An ACGME-accredited fellowship program may accept an exceptionally qualified applicant**, who does not satisfy the eligibility requirements listed in Sections III.A.2. and III.A.2.a), but who does meet all of the following additional qualifications and conditions:

** An exceptionally qualified applicant has (1) completed a nonACGME-accredited residency program in the core specialty, and (2) demonstrated clinical excellence, in comparison to peers, throughout training. Additional evidence of exceptional qualifications is required, which may include one of the following: (a) participation in additional clinical or research training in the specialty or subspecialty; (b) demonstrated scholarship in the specialty or subspecialty; (c) demonstrated leadership during or after residency training; (d) completion of an ACGMEInternational-accredited residency program."

It doesn't explicitly say "DOs, kindly GTFO" but that added hurdle of a review committee and "exceptionally qualified applicant" wording does nothing but put up barriers and added hassle to already disadvantaged applicants.

So many people had to read this document before it was published... they would have added an "AOA residency" clause with the RCPSC info if they actually wanted to include AOA trained physicians.

 

[jw3600]

.... As soon as the rule limiting DOs from ACGME fellowships was withdrawn, the AOA pulled out of the merger, because the Family Med doctors were upset about what?

I am lost here

Some AOA leaders realized how useless they were and there was a chance to lose their enormous salaries, so they balked. The ACGME basically reminded them how they have very little bargaining power and this is really their only move. That and the thousands of letters from DO students (who this really affects) supporting the merger. And now here we are.

 

[user3]

Why? He seems like he's making good points.

He comes across as very rude.

 

[deleted480308]

He comes across as very rude.

Man up

 

[Goro]

It's going to be the other way around. We are expecting the Carib grads to be squeezed out.

Hey guys, I will be starting my 4th year of medical school in a D.O program starting this July. I'm ranked towards the bottom of my class and have low board scores. I will be applying to only primary care D.O programs. I'm worried that since the merger between D.O and M.D programs, all of the Caribbean students will flock in and take the D.O residencies that were only reserved to D.O students in years past. Does anyone have any information about this? Thanks for your help!

 

[Instatewaiter]

They tuk er' jobs!

No but seriously it's going to get more competitive for everyone.

 

[jakeislove]

It's going to be the other way around. We are expecting the Carib grads to be squeezed out.

Key word, LOL!

I'm guessing Caribbean grads will be screwed, first.

 

[235009]

It's going to be the other way around. We are expecting the Carib grads to be squeezed out.

....he said without citing any logic, reasoning or evidence

 

[jakeislove]

....he said without citing any logic, reasoning or evidence

They're counting on bias against IMG/FMG MDs being higher than it is against DOs.

 

[hallowmann]

They're counting on bias against IMG/FMG MDs being higher than it is against DOs.

Considering that's the way things are now, I don't see why it's hard to believe. If anything, the idea that things will suddenly shift the other way would really require an argument with evidence.

 

[jakeislove]

Considering that's the way things are now, I don't see why it's hard to believe. If anything, the idea that things will suddenly shift the other way would really require an argument with evidence.

Where does the bias concentrate once IMGs are no longer an issue?

 

[hallowmann]

Where does the bias concentrate once IMGs are no longer an issue?

I never said DOs wouldn't be next. I just agreed that IMGs will be first. If things don't change (i.e. MD and DO schools continue to proliferate while residencies don't expand) then we will start seeing DOs fail to attain GME.

Fortunately, even COCA has a safeguard in place by requiring a minimum of 98% GME placement from schools to maintain accreditation. Provided this is enforced, we'll just see DO schools close (or directly fund more GME) in order to keep placement rates up.

 

[jakeislove]

I never said DOs wouldn't be next. I just agreed that IMGs will be first. If things don't change (i.e. MD and DO schools continue to proliferate while residencies don't expand) then we will start seeing DOs fail to attain GME.

Fortunately, even COCA has a safeguard in place by requiring a minimum of 98% GME placement from schools to maintain accreditation. Provided this is enforced, we'll just see DO schools close (or directly funding more GME) in order to keep placement rates up.

We'll have a better idea and less need to speculate in a few years.

 

[hallowmann]

We'll have a better idea and less need to speculate in a few years.

Yeah, but then we wouldn't be able to talk about things in the future that won't directly affect us. Where's the fun in that?

 

[jakeislove]

Yeah, but then we wouldn't be able to talk about things in the future that won't directly affect us. Where's the fun in that?

1+ year ago we were told that Caribbean route to residency was closing and that schools should stop accepting student's money in bad faith.

Even without the merger: There will be more US MD/DO applicants than available positions in around 5 years. The merger could be a clever way to make more spots available for US MDs and delay GME funding increases until enough offshore schools close.

 

[hallowmann]

1+ year ago we were told that Caribbean route to residency was closing and that schools should stop accepting student's money in bad faith.

Even without the merger: There will be more US MD/DO applicants than available positions in around 5 years. The merger could be a clever way to make more spots available for US MDs and delay GME funding increases until enough offshore schools close.

Yeah, but the fact that it seems likely that most AOA PDs will be keeping their jobs makes it even more likely that they'll still prefer DOs, even over US MDs, but it certainly doesn't hurt US MDs. I wouldn't be surprised if the expansion of MD schools and even the merger in some part is a strategy to put a squeeze on Carib schools, like you say. I heard that both Ross and SGU have reduced their class sizes over the last year or two.

The funny thing is, I think it's all about Carib schools taking rotation spots. It's funny that the thing that actually improves IMG education (stable clinicals) is what made them a target in the first place.

 

[Goro]

That's because you're not privy to what people high up in ACGME and AOA are saying, if not outright planning.

But if you insist. This is only the tip of the iceberg.
http://www.nytimes.com/2010/12/23/nyregion/23caribbean.html?pagewanted=all&_r=0

That light you see at the end of the tunnel is not the exit, it's a train heading towards Carib diploma mill grads.

....he said without citing any logic, reasoning or evidence

 

[jakeislove]

Yeah, but the fact that it seems likely that most AOA PDs will be keeping their jobs makes it even more likely that they'll still prefer DOs, even over US MDs, but it certainly doesn't hurt US MDs. I wouldn't be surprised if the expansion of MD schools and even the merger in some part is a strategy to put a squeeze on Carib schools, like you say. I heard that both Ross and SGU have reduced their class sizes over the last year or two.

The funny thing is, I think it's all about Carib schools taking rotation spots. It's funny that the thing that actually improves IMG education (stable clinicals) is what made them a target in the first place.

As posted above: I was only able to ask one AOD PD. He'll be going by scores. Everyone should be able to live with something that simple.

My rotations were great learning experiences with MDs/DOs who were very passionate about teaching. Being downstate sucked (initially) but it grew on me.

It will also be interesting to see how fewer IMG residencies affects Canadian healthcare, long-term.

 

[jakeislove]

That's because you're not privy to what people high up in ACGME and AOA are saying, if not outright planning.

But if you insist. This is only the tip of the iceberg.
http://www.nytimes.com/2010/12/23/nyregion/23caribbean.html?pagewanted=all&_r=0

That light you see at the end of the tunnel is not the exit, it's a train heading towards Carib diploma mill grads.

Do US grads need that much protection from competition?

 

[Goro]

No, but patients need protection against inadequately trained doctors, who specifically go to these places because by paying large sums of money, they can skirt the requirements for medical students.

Unless you're OK with the idea that someone can get a MD degree simply by breathing and writing a tuition check?

I don't use the term "diploma mill" for laughs. My colleague Hushcom has a better term for it: "educational malpractice".

Do US grads need that much protection from competition?

 

[jakeislove]

No, but patients need protection against inadequately trained doctors, who specifically go to these places because by paying large sums of money, they can skirt the requirements for medical students.

Unless you're OK with the idea that someone can get a MD degree simply by breathing and writing a tuition check?

I don't use the term "diploma mill" for laughs. My colleague Hushcom has a better term for it: "educational malpractice".

The 6-8 cups of coffee I had this morning wore off.

So it's "all about the patients" and not protecting US grads? I'm respectfully calling BS and flat out asserting that if there were any mortality difference it would be highly politicized.

 

[Goro]

OK. Next question.

The 6-8 cups of coffee I had this morning wore off.

So it's "all about the patients" and not protecting US grads? I'm respectfully calling BS and flat out asserting that if there were any mortality difference it would be highly politicized.

 

[235009]

They're counting on bias against IMG/FMG MDs being higher than it is against DOs.

Why do you think DOs will get squeezed out before Caribbean grads when the evidence points to the opposite?

Let's break this down by how the merger is going to affect each group:

US MDs - Neutral or slight advantage: Most students won't even know that this happened. Won't affect 90% of applicants. Since there is no provision for a combined match there won't be more competition from DO students. In fact more DOs may be inclined to participate in the AOA match since those programs that apply for ACGME accreditation will have provisional accreditation for 5 years. This may lead to less competition from qualified DOs. In addition for those applying in fields that are competitive due to few residency spots they will have the option to apply to former-AOA programs as well.

DOs - Disadvantage: The merger essentially closes the backdoor that DOs had to practicing medicine wherein they did not have to meet any of the LCME, USMLE, or ACGME standards but be considered to have had equivalent training. Through extremely lax standards COCA and the AOA have expanded med school enrollment and in turn created low-quality residency programs (mostly IM and FM) that it can herd all the new graduates into regardless of their competency or level of achievement. The merger not only threatens to close these programs leaving a sizable number of DOs unmatched. On top of that it allows US MDs and more importantly IMGs and FMGs to apply to formerly AOA programs, injecting more competition into the process. There is no provision for a combined match which would mitigate some of these consequences. So bottom line for DOs is: more graduates, fewer programs, more competition all of which are disadvantageous for DOs as a whole since, among other things, match rates will decrease.

IMGs an FMGs - slight advantage: Put simply they'll have more programs to apply to with formerly AOA programs getting ACGME accreditation with a provision that they must accept applications from all. Until there is a provision for a combined match (which there isn't) DOs who in the past may have decided to take a chance with the ACGME match may decide to play it safe by applying in the AOA match since those programs will also have ACGME accreditation. This would mean less competition for IMGs/FMGs at low tier ACGME programs that are currently filled with IMGs and DOs. I haven't heard any logical argument as to why people think IMGs/FMGs will be "pushed out" ....it has just become one of those things that gets repeated over and over by people on pre-osteo and osteo forums without any supporting evidence. I want to be clear I'm not saying that IMG route is superior or preferable.... all I'm saying is that this merger isn't going to be the doomsday scenario for carib grads that some on this board are trying to portray.

That's because you're not privy to what people high up in ACGME and AOA are saying, if not outright planning.

But if you insist. This is only the tip of the iceberg.
http://www.nytimes.com/2010/12/23/nyregion/23caribbean.html?pagewanted=all&_r=0

That light you see at the end of the tunnel is not the exit, it's a train heading towards Carib diploma mill grads.

thanks for posting a link to an article from 4 years ago that everyone has already read. you've again contributed nothing substantial to this discussion.

No, but patients need protection against inadequately trained doctors, who specifically go to these places because by paying large sums of money, they can skirt the requirements for medical students.

Unless you're OK with the idea that someone can get a MD degree simply by breathing and writing a tuition check?

I don't use the term "diploma mill" for laughs. My colleague Hushcom has a better term for it: "educational malpractice".

Carib grads do need to pass all 4 step exams. Also you learn to be a doctor in residency and carib grads have to go through the same residencies as US MDs. There's no backdoor and no watered down version. So while the attrition rate makes carib schools a poor educational and financial choice, those who make it to the finish line (i.e. finish residency) aren't inadequately trained. I would be more concerned about bottom-of-the-class DOs who do not take any step exams, go to a joke AOA residency program and get labeled fully trained physicians ready to practice medicine. In the near future with the merger, DO schools may also be guilty of "educational malpractice" if they don't significantly cut down their class size since match rates will surely drop.

 

[hallowmann]

Let's break this down by how the merger is going to affect each group:

...
DOs - Disadvantage: The merger essentially closes the backdoor that DOs had to practicing medicine wherein they did not have to meet any of the LCME, USMLE, or ACGME standards but be considered to have had equivalent training. Through extremely lax standards COCA and the AOA have expanded med school enrollment and in turn created low-quality residency programs (mostly IM and FM) that it can herd all the new graduates into regardless of their competency or level of achievement. The merger not only threatens to close these programs leaving a sizable number of DOs unmatched. On top of that it allows US MDs and more importantly IMGs and FMGs to apply to formerly AOA programs, injecting more competition into the process. There is no provision for a combined match which would mitigate some of these consequences. So bottom line for DOs is: more graduates, fewer programs, more competition all of which are disadvantageous for DOs as a whole since, among other things, match rates will decrease...

Let's take a look at the ridiculousness of your argument. The point you felt you had to make is that AOA programs were so inferior that they were pumping out subpar physicians through a backdoor into medicine, afterall nothing could compare to the amazingness of programs accredited by the ACGME, because you know every program is JHU, MGH, etc.

Even if we were to assume this, you'd think that no ACGME programs would have ever accepted DOs from TRIs into advanced positions. I mean afterall, they're subpar programs, how could those almighty ACGME programs, the bastions of education that they universally are, accept the unwashed masses from the AOA TRIs? Or what about the ACGME fellowships that regularly accepted AOA trained DOs? Surely those DOs must have tricked programs into thinking they came from ACGME residencies through some slight of hand, a skill that us DOs perfect for 3-5 hours a week in MS1 & 2. Maybe they have like a remediated form of GME for those poor uneducated DOs, like GME light.

If the programs were so bad, why on Earth would the ACGME agree to continue accepting students from programs whether they get ACGME accredited or not, provided they just apply? It must have been yet another Osteopath mind trick played on the ACGME.

Oh yes, you caught us, DOs that go into AOA programs are accepted without having to do anything at all. They can just walk in, you know. As long as we can sign our name, we get offered an AOA position. I mean it's not like we have licensing exams that are very similar to yours (or that half of us take and pass your licensing exam every year in addition to our own).

Also, I mean it's universally understood that AOA programs are incredibly inferior right? That's why the ACGME IM residency review committee just declared that AOA board certified DO PDs can remain as PDs of ACGME accredited IM programs (i.e. that they are equivalent to ABIM certified PDs).

The only reason the ACGME wanted to now place restrictions on AOA trained DOs was as a power play to force the AOA's hand into the merger so that they can have more power over US GME. It has nothing to do with eliminating a "backdoor". If you think this really has to do with the quality of programs, you're as naive as the osteopaths that think no MDs could possibly apply osteopathic principles in their practice of medicine.

As for the combined match, it'll happen. It can't be a guarantee in the merger because other parties (i.e. those outside of the organizations in the merger) are involved in the match process. It'll happen because of the big motivator of all things: money. Programs aren't going to pay to participate in 2 matches if they don't have to. But whatever, I'll just wait for time to prove me right on that one.

As far as the other BS you're spewing, I'll just wait for DO match rates to plummet. It's ok, I won't hold my breath, but feel free to hold yours.

You know, I used to think you were just a sheltered elitist. With this post, you've more or less just demonstrated your overall ignorance.

...IMGs an FMGs - slight advantage: Put simply they'll have more programs to apply to with formerly AOA programs getting ACGME accreditation with a provision that they must accept applications from all. Until there is a provision for a combined match (which there isn't) DOs who in the past may have decided to take a chance with the ACGME match may decide to play it safe by applying in the AOA match since those programs will also have ACGME accreditation. This would mean less competition for IMGs/FMGs at low tier ACGME programs that are currently filled with IMGs and DOs. I haven't heard any logical argument as to why people think IMGs/FMGs will be "pushed out" ....it has just become one of those things that gets repeated over and over by people on pre-osteo and osteo forums without any supporting evidence. I want to be clear I'm not saying that IMG route is superior or preferable.... all I'm saying is that this merger isn't going to be the doomsday scenario for carib grads that some on this board are trying to portray...

All you need to do is actually look at the facts. ACGME PDs have said on average that they are more likely to rank DOs than US-IMGs, and even more so than non-US IMGs. Look at the past two PD surveys. AOA PDs (i.e. DOs) are going to more likely rank DOs than IMGs just like ACGME PDs (for the most part MDs) are more likely to rank US MDs. Sure, IMGs can apply to more programs, but seeing as how programs will take 5 years to transition, and in 5 years there are going to be about 2000-3000s more AMGs than there are now, that doesn't bode well.

But, whatever, why am I even trying to make a reasoned argument with you over this. You'll still just flee to some mantra of how DOs are inferior, IMGs are the real winners of the merger (uh huh, I won't hold my breath for their match rates to go up), and every ACGME institution has rigorous programs to which AOA programs can only dream of comparing themselves.

 

[hse]

skinmd=meattornado sounds like an img troll

 

[235009]

Let's take a look at the ridiculousness of your argument. The point you felt you had to make is that AOA programs were so inferior that they were pumping out subpar physicians through a backdoor into medicine, afterall nothing could compare to the amazingness of programs accredited by the ACGME, because you know every program is JHU, MGH, etc.

Even if we were to assume this, you'd think that no ACGME programs would have ever accepted DOs from TRIs into advanced positions. I mean afterall, they're subpar programs, how could those almighty ACGME programs, the bastions of education that they universally are, accept the unwashed masses from the AOA TRIs? Or what about the ACGME fellowships that regularly accepted AOA trained DOs? Surely those DOs must have tricked programs into thinking they came from ACGME residencies through some slight of hand, a skill that us DOs perfect for 3-5 hours a week in MS1 & 2. Maybe they have like a remediated form of GME for those poor uneducated DOs, like GME light.

If the programs were so bad, why on Earth would the ACGME agree to continue accepting students from programs whether they get ACGME accredited or not, provided they just apply? It must have been yet another Osteopath mind trick played on the ACGME.

Oh yes, you caught us, DOs that go into AOA programs are accepted without having to do anything at all. They can just walk in, you know. As long as we can sign our name, we get offered an AOA position. I mean it's not like we have licensing exams that are very similar to yours (or that half of us take and pass your licensing exam every year in addition to our own).

Also, I mean it's universally understood that AOA programs are incredibly inferior right? That's why the ACGME IM residency review committee just declared that AOA board certified DO PDs can remain as PDs of ACGME accredited IM programs (i.e. that they are equivalent to ABIM certified PDs).

The only reason the ACGME wanted to now place restrictions on AOA trained DOs was as a power play to force the AOA's hand into the merger so that they can have more power over US GME. It has nothing to do with eliminating a "backdoor". If you think this really has to do with the quality of programs, you're as naive as the osteopaths that think no MDs could possibly apply osteopathic principles in their practice of medicine.

As for the combined match, it'll happen. It can't be a guarantee in the merger because other parties (i.e. those outside of the organizations in the merger) are involved in the match process. It'll happen because of the big motivator of all things: money. Programs aren't going to pay to participate in 2 matches if they don't have to. But whatever, I'll just wait for time to prove me right on that one.

As far as the other BS you're spewing, I'll just wait for DO match rates to plummet. It's ok, I won't hold my breath, but feel free to hold yours.

You know, I used to think you were just a sheltered elitist. With this post, you've more or less just demonstrated your overall ignorance.



All you need to do is actually look at the facts. ACGME PDs have said on average that they are more likely to rank DOs than US-IMGs, and even more so than non-US IMGs. Look at the past two PD surveys. AOA PDs (i.e. DOs) are going to more likely rank DOs than IMGs just like ACGME PDs (for the most part MDs) are more likely to rank US MDs. Sure, IMGs can apply to more programs, but seeing as how programs will take 5 years to transition, and in 5 years there are going to be about 2000-3000s more AMGs than there are now, that doesn't bode well.

But, whatever, why am I even trying to make a reasoned argument with you over this. You'll still just flee to some mantra of how DOs are inferior, IMGs are the real winners of the merger (uh huh, I won't hold my breath for their match rates to go up), and every ACGME institution has rigorous programs to which AOA programs can only dream of comparing themselves.

Do you have any data to back up your claim that ACGME fellowships are "regularly accepting AOA trained DOs"? All the data I've seen doesn't differentiate whether the DOs that do make it to ACGME fellowship programs are AOA trained or ACGME trained. The whole reason the merger even happened is because the ACGME threatened to prevent AOA trained DOs from applying to fellowship precisely because they think their training is sub-standard.

Your whole post is basically an attempt to twist my words followed by an epic battle between you and a straw man. I never said that ALL AOA programs are sub-par or inferior to ACGME programs but it is clear to most that a sizeable portion of the programs will be forced to shut down because they don't meet ACGME standards. Are you arguing that AOA standards are as rigorous as ACGME standards? They simply aren't.

Also, much of what you say is an attempt to tie together two things that aren't related. Letting AOA PDs stay in their positions has nothing to do with the quality of some of the AOA programs (i.e. the sub-standard ones that will be forced to shut down and their PDs will be out of a job).

I never said the combined match won't happen (calm down!) ....but the fact that the provision for one is not included in the merger agreement makes the merger as it stands now disadvantageous for DOs. As for programs participating in two matches: they won't. The dual accredited programs are already dropping AOA accreditation and will likely only participate in the ACGME match and from what I understand the AOA programs won't be participating in both matches, just the AOA match. Nothing will change for current ACGME programs.

IMGs will be able to apply to AOA residencies that get pre-accreditation (programs that apply for accreditation) right away, they will not have to wait for full accreditation in 5 years.

So stop with the blind rage, straw men and baseless arguments

skinmd=meattornado sounds like an img troll

I changed my handle...if you have a problem with that take it up with the mods for allowing members with certain badges to do so

I am a US MD ....as I've stated multiple times in the past

 

[hallowmann]

Do you have any data to back up your claim that ACGME fellowships are "regularly accepting AOA trained DOs"? All the data I've seen doesn't differentiate whether the DOs that do make it to ACGME fellowship programs are AOA trained or ACGME trained. The whole reason the merger even happened is because the ACGME threatened to prevent AOA trained DOs from applying to fellowship precisely because they think their training is sub-standard...

First off, my first point was TRIs, but that's not something you brought up, because there are very sizeable numbers of DOs that enter advanced ACGME positions with AOA training (especially in the 4 states that require DOs to have an AOA intern year).

Secondly, I personally know at least 5 DOs that have gone on to fellowships in ACGME programs after completing AOA residencies, that's my small anecdote, but its a common practice, at least in my area, for DOs to do this.

When I get a chance, I will get you real numbers based on my school's previous graduates, but for the time being, I concede, but let's even throw out that small part of my argument, the rest still stands. Have ACGME programs consistently taken DOs that are trained in AOA GME? Yes.

...Your whole post is basically an attempt to twist my words followed by an epic battle between you and a straw man. I never said that ALL AOA programs are sub-par or inferior to ACGME programs...

I'm sorry you're right, you just called AOA GME a "backdoor" to medicine. OK, that's much better.

...but it is clear to most that a sizeable portion of the programs will be forced to shut down because they don't meet ACGME standards...

Apparently, you just meant that "a sizeable portion of the programs" were sub-par and inferior. Do you have any evidence to prove that a sizeable portion of programs will be shutdown? (you see what I did there )

As of yet, they haven't even released the procedure for securing accreditation. You're basing this speculation on your own biases that you make clear in every single one of your posts. I honestly haven't seen any evidence that a sizeable portion of programs will shutdown. Everything I've heard from AOA PDs has been positive.

...Are you arguing that AOA standards are as rigorous as ACGME standards? They simply aren't...

I guess it depends on what you mean by rigorous. Do AOA programs produce physicians that are as capable as ACGME physicians? Every single program I've seen does, but hey, you may be right, which AOA programs have you visited? Which AOA PDs have you talked to? I mean you have such a clear view of the quality of AOA programs, you must have experience that others don't. Rather than just making statements accusing DOs of having a backdoor into medicine, why don't you actually share some real information with us, maybe you'll get a better response.

Do I think that as of right now, every AOA program would be able to follow the bureaucratic mess of ACGME regulations that I watch my family members (many of whom are ACGME faculty and a couple who are ACGME PDs) on a regular basis complain about? No, probably not. But up until now, they haven't had to. Does that mean that the quality of the education is so inferior that it offers a "backdoor" into medicine? No.

...Also, much of what you say is an attempt to tie together two things that aren't related. Letting AOA PDs stay in their positions has nothing to do with the quality of some of the AOA programs (i.e. the sub-standard ones that will be forced to shut down and their PDs will be out of a job)...

They're unrelated to you, because you missed the point.

ACGME PDs have to be certified by boards that cover ACGME trained individuals. If an ACGME review committee says that AOA PDs qualify, they are saying that the AOA training and certification boards are equivalent. Every AOA PD wasn't trained in their AOA program (I hope that's obvious), but they were, for the most part, trained in AOA programs. By certifying their training (I'm not talking about the programs they're running, just the individuals specifically), the ACGME review committee is saying that there isn't a significant difference in the quality of training. That's kind of contrary to your entire point.

...IMGs will be able to apply to AOA residencies that get pre-accreditation (programs that apply for accreditation) right away, they will not have to wait for full accreditation in 5 years...

No committees have even released the osteopathic requirements for MDs to apply to AOA programs, whereas programs can achieve pre-accreditation status as early as July. What makes you think MDs will be able to apply once pre-accreditation status occurs? Pre-accreditation status is not "Initial Accreditation", the typical accreditation that occurs when a program first starts. Pre-accreditation is a status created solely for the merger. It doesn't mean they are actually accredited.

Based on the ACGME documents, I understood pre-accreditation status, if anything, as a way for DOs in those programs to get around the 2016 common requirements. If you have info to the contrary, please share it. As I've understood it, MDs will not be able to apply to those programs until they attain "Initial Accreditation" (also not the same thing as full accreditation). That could happen anytime in the next 5 yrs, but won't happen for all the programs until 2020.

Now personally, I admit, I may have been annoyed at you in my previous reply, but that's really because you made some pretty douchie comments. What did you expect by saying that DOs had a "backdoor" to becoming physicians? There is no backdoor. Its not like you could get ABMS certified coming out of an AOA program. That comment's purpose was to belittle DO training, so excuse me if I took it personally.

 

[NurWollen]

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