MD Residencies

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wallawalla

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Two questions:

1. Which 5 states are the ones in which you have to do an osteopathic internship in order to gain a license to practice medicine in that state?

2. In those states, can a DO match into an MD residency without having done an osteopathic internship? and if so, will there be any accreditation problems along the way in term of state licensure and MD board certification?

Thanks much for any answers.

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I can't answer those questions, but isn't doing an osteopathic internship absolutely required if you want membership in the AOA?


Tim of New York City.
 
Nope. You can try to get your residency approved by the AOA.

See RBorhani reply on another part of this board.
 
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the five states are: MI, FL, OK, WV, and PA
 
Right. You have to get the AOA to approve the internship, but isn't that a costly, not to mention time-consuming, thing to do?


Tim of New York City.
 
I have a question that might clarify this issue. Now, to let's say practice in MI, would I have to take a DO internship regardless of whether I choose a DO or MD residency? That is, if I was accepted into a MD residency, and didn't do a DO internship prior, that I would NOT be eligable to practice in MI? So, if the the answer is "YES", then if I want to practice in MI I am forced to do a 1 year internship, correct? Then, after that internship, I can apply to MD residency, upon which that MD residency may or may not (they probably would)accept my DO internship. In conclusion, I think (correct me if I'm wrong), that if I want to practice in MI, and do a MD residency, this would be my only route: 1. 1 year DO intership. 2. Do a 2 or 3 year residency (I am assuming IM)at a MD resiency. 3. Eligable to practice medicine.
 
The problems is that many allopathic residency programs will not accept your AOA rotating internship as counting towards your residency in their program. Some may grant you "advanced status" in terms of pay, but you are still going to be a first year resident in their program, with all the hours (gasp) of a first year resident. Who wants to be an intern twice?!

I also have a question for everyone out there. The match rate for seniors at US allopathic institutions is in the 90s%. The match rate for independent applicants (which includes DOs and IMGs) is around 60% or so. The match rate for non seniors is around 40%. Are DOs who have completed the AOA rotating internship included in the "non senior" category or in the "independent applicant" category? Anybody knows?

 
Here are some facts:

Most ACGME residencies will not count your AOA rotating internship. Some do (i.e. anesthesiology at Henry Ford in Michigan).

If you want to practice in MI or do a residency in MI you better do a rotating AOA internship. This goes for the other fours states as well (PA, OK, WV, FL)although, Michigan is the most stringent of them all when it comes to your internship. Also know that if a program in one of these states makes an exception for you and takes you without doing an internship, you will not be allowed to moonlight.

Here is the problem (i.e. for me who wants to do EM). If I do my AOA rotating internship and then apply to ACGME programs, the program will not be fully funded for my last year of residency. Here is how it works, lets say I am interested in hospital X for an ACGME EM residency program that is funded for three post-graduate years by the government. If I do a rotating internship, which none of the EM programs that I have talked to currently count as year one, I will still be a PGY-I when I go into the residency program. Because I have had a year of post-graduate training (for my AOA internship) the government will now only give half-funding to the hospital for my last year of residency since I am taking four years after med school to complete a 3-year program. (This is something that has started as of couple of years ago due to Medicare budget cuts). Some ACGME EM programs are four-years but still if I do an AOA internship it will take me 5 years to complete a 4 year program unless the program gives me credit for all of my year one.

So if the ACGME program wants to take me they have to make an exception knowing that they will not get fully funded for my last year vs. if they take somebody right out of medical school. Some programs will make this exception if they like you enough and if they have enough money.

This scenario is not true for osteopathic residencies since the rotating internship is a requirement for these residencies and it is funded. All this gets a bit confusing to discuss over the Internet. You should contact a DME/residency director at a local hospital and go over this with him/her. Now back to my ERAS application....

P.S. ACGME: is what most people call "MD programs"
AOA: is what most people call "DO programs"


[This message has been edited by RBorhani (edited September 04, 1999).]
 
UHS2002,

It is my understanding that DO grads, along with IMGs, apply to the ACGME match as "independent" candidates. So, I would assume we would fall into that category on the match results you saw.

------------------
Old Man Dave
KCOM, Class of 2003
 
Actually DO's are considered independent applicants. Independent applicants include DO's, IMG's and Canadian's. The stats on match rates are all figured individually for these independent applicants by the ACGME.

The figures on success in the AMA match for independent applicants is misleading however, particularly for DO's. See, US born MD's are required to go through the match, but, independents can sign contracts with programs prior to the match. This is actually fairly common, particularly in primary care specialties and with DO's. Program Directors have an incentive to fill their programs with US grad's as renumeration from Medicare for these residents is higher than for IMG's. DO's are considered US grad's, plus they can sign up prior to the match, thus securing good resident selection and not leaving things entirely to chance in the Match. In my medical school class, ~25% of the grads doing ACGME residency signed contracts before the match. Those spots taken by those who signed contracts before the match were disclosed as not matching when the stats were run by the ACGME. So, these figures can be misleading.

As far as doing an AOA intership, be careful if you plan to do an MD residency. This was discussed earlier. The AOA year may not be accepted by the MD program and you may not be eligible for funding for the last year of the MD resicency. Funding for residency spots is a big deal to Residency Directors and lack of funding for one year could make the difference between being accepted/rejected to a program. If you are interested in doing a residency that requires a preliminary year (i.e.: anesthesia, some ER programs) then doing an AOA internship prob'ly wouldn't be a problem, but, double check with the residency program first.

Right now I'm going through the process of trying to obtain approval for my first year of AMA residency towards the AOA internship requirement. It has been a difficult process. Suggestion: if you are at all interested in practicing in one of the 5 states requiring an AOA internship, do one. If not, go to the best residency you can find.
 
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