POMA Resolution for DO State Licensure, re: Res 42

[hallowmann]

OK, so this just in: POMA has passed a Resolution modifying the requirements for DO state licensure (its one of the states that requires an AOA TRI or "equivalent" for licensure). Here it is below.

"Resolution 2015-2
Reaffirmation of Policy for Pennsylvania Osteopathic State Licensure
RESOLVED, that osteopathic medical licensure in Pennsylvania may be obtained by meeting the following criteria:

1. Graduation from an accredited school of osteopathic medicine, and either:

2. Successful completion of the first year of an osteopathic residency (osteopathic recognized program in the new Unified Residency wording) program that includes the components of a rotating internship, including proof of osteopathic manipulative medicine integration into training rotations; or a one month rotation in osteopathic manipulative medicine; or the successful completion of a Modular Core Competency Program in osteopathic medicine as presented and supported by one of the OPTIs of Pennsylvania, or

3. Successful completion of the first two years of an ACGME residency (Unified) program (other than an osteopathic recognized program) that includes the components of a rotating internship, including proof of osteopathic manipulative medicine integration into training rotations; or a one month rotation in osteopathic manipulative medicine; or the successful completion of a Modular Core Competency Program in osteopathic medicine as presented and supported by one of the OPTIs of Pennsylvania; and, be it

FURTHER RESOLVED, that participation in a weekend seminar/ course in osteopathic medicine or attendance at a state osteopathic convention is not an acceptable alternative to this pathway for Pennsylvania osteopathic state licensure. (Passed)"

If I'm understanding this right there's one big change: Basically its not required that you complete a TRI, but it is required that you have some post-graduate OMM training in the form of an OMM rotation or an MCCP program at a PA OPTI.

So in other words, you can either do a rotational internship with "Osteopathic focus" that documents incorporation of OMM, or that includes an OMM rotation, or completion of a MCCP at a PA OPTI, OR you can do 2 yrs of an ACGME residency that includes components of a rotational internship, an OMM rotation or complete an MCCP at a PA OPTI.

This basically eliminates the need for Resolution 42, but means we'll have to do some OMM training in order to get licensure. Seems pretty good to me, and I guess it makes sense.

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[WhendoIstartfirstaid?]

DOs cant get licensed by the regular state medical board in PA?

 

[hallowmann]

DOs cant get licensed by the regular state medical board in PA?

What does regular mean? PA (like many of the states in the country) have separate DO and MD medical boards. If your state only has one medical board, then both DOs and MDs get licensed by that one board. If your state has both (like PA), then DOs get licensed by the DO medical board and MDs get licensed by the MD medical board.

For additional info, I believe the following states have separate DO and MD boards: AZ, CA, FL, ME, MI, NV, NM, OK, PA, SD, TN, UT, VT, WA, & WV.

http://www.fsmb.org/state-medical-boards/contacts

 

[WhendoIstartfirstaid?]

What does regular mean? PA (like many of the states in the country) have separate DO and MD medical boards. If your state only has one medical board, then both DOs and MDs get licensed by that one board. If your state has both (like PA), then DOs get licensed by the DO medical board and MDs get licensed by the MD medical board.

For additional info, I believe the following states have separate DO and MD boards: AZ, CA, FL, ME, MI, NV, NM, OK, PA, SD, TN, UT, VT, WA, & WV.

http://www.fsmb.org/state-medical-boards/contacts

well that is a kick in the balls, my home state where I hope to practice is on that list. Having to do an OMM rotation even in an acgme residency makes me want to punch a wall.

Thank you so much for the information though.

 

[hallowmann]

well that is a kick in the balls, my home state where I hope to practice is on that list. Having to do an OMM rotation even in an acgme residency makes me want to punch a wall.

Thank you so much for the information though.

This info above is only for PA. Most states don't require DOs to do OMM training, but PA, MI, FL, and OK all require DOs to complete an AOA TRI or use Res. 42 to get their non-AOA internship approved. Res. 42 is going to be eliminated by 2020, so these states are likely in the process of changing policies, which is why POMA passed this (which the SBOM - PA DO board - will likely agree with).

If you're not in any of the 4 states above, you don't have to worry about it.

 

[NurWollen]

Man, I guess the new requirement isn't really that onerous... but man, it seems so contrived. Like, really, you can't just nix the requirement?

What I find ironic is: what percentage of the POMA board members actually practice OMM themselves? I bet it's not a majority.

 

[hallowmann]

Man, I guess the new requirement isn't really that onerous... but man, it seems so contrived. Like, really, you can't just nix the requirement?

What I find ironic is: what percentage of the POMA board members actually practice OMM themselves? I bet it's not a majority.

Yeah, obviously it would be better if there was no requirement. Does a Pathologist or Radiologist really need to do a 1 month rotation in OMM during their intern year? But given their previous record, this is a welcome improvement.

 

[NurWollen]

Yeah, obviously it would be better if there was no requirement. Does a Pathologist or Radiologist really need to do a 1 month rotation in OMM during their intern year? But given their previous record, this is a welcome improvement.

Yeah, what sucks is that people in residency use their electives to help direct their careers in a certain direction. Also, do you think ACGME residencies are going to bend over backwards to help their DO residents do a one month OMM rotation?

 

[hallowmann]

Yeah, what sucks is that people in residency use their electives to help direct their careers in a certain direction. Also, do you think ACGME residencies are going to bend over backwards to help their DO residents do a one month OMM rotation?

In PA, probably, elsewhere, probably not. Most DOs I know in PA didn't really have issues getting Res. 42, which involved some osteopathic stuff during intern year, so I can't imagine an "OMM" elective (i.e. FM with a DO at a place that has OMT clinic hours) would be impossible.

I could see programs outside of those states having an issue with it though, which is most likely why they added the extra option to do that MCCP thing at a PA OPTI (hey, if you can't make them do an elective in OMM, might as well charge them $$$ for "training").

 

[kenjixshadow]

This info above is only for PA. Most states don't require DOs to do OMM training, but PA, MI, FL, and OK all require DOs to complete an AOA TRI or use Res. 42 to get their non-AOA internship approved. Res. 42 is going to be eliminated by 2020, so these states are likely in the process of changing policies, which is why POMA passed this (which the SBOM - PA DO board - will likely agree with).

If you're not in any of the 4 states above, you don't have to worry about it.

So say, if you take the USMLE 3 (assuming take all USMLE 1, 2 CK, and 2 CS) and not COMLEX 3, and apply to Res. 42, plus not practicing in the 4 required fully completed COMLEX, you should be fine right?

 

[TopTomato]

In PA, probably, elsewhere, probably not. Most DOs I know in PA didn't really have issues getting Res. 42, which involved some osteopathic stuff during intern year, so I can't imagine an "OMM" elective (i.e. FM with a DO at a place that has OMT clinic hours) would be impossible.

I could see programs outside of those states having an issue with it though, which is most likely why they added the extra option to do that MCCP thing at a PA OPTI (hey, if you can't make them do an elective in OMM, might as well charge them $$$ for "training").

Can you elaborate more on this MCCP? The thought of matching into an ACGME program and still having OMM shoved down my throat sounds terrible, but maybe i'm not understanding the new changes?

 

[hallowmann]

So say, if you take the USMLE 3 (assuming take all USMLE 1, 2 CK, and 2 CS) and not COMLEX 3, and apply to Res. 42, plus not practicing in the 4 required fully completed COMLEX, you should be fine right?

If you're a DO, you should take the COMLEX Level 3. You don't know where you're going to be and some states (usually the ones with a separate osteopathic medical licensing board) require that DOs take all levels of the COMLEX for licensure (that is a completely separate requirement).

Based on something I read on a post some time ago, I believe the following states require DOs to take all levels of the COMLEX: PA, MI, FL, OK, ME, TN, CA, & AZ. If anyone has more updated info, please correct me.

Res. 42 is ONLY for the 4 states, you don't need it otherwise. Res. 42 will end in 2020, so the 4 states that have this requirement will need to change their policies one way or another.

Can you elaborate more on this MCCP? The thought of matching into an ACGME program and still having OMM shoved down my throat sounds terrible, but maybe i'm not understanding the new changes?

If you want an unlimited PA license, you have to have OMM shoved down your throat at some point in residency. Up until now, that was during intern year when you had to fulfill the requirements for Res.42 (like give an OMM presentation to your ACGME program during grand rounds, attend a DO conference, etc.).

I personally have no idea what the MCCP is, but I imagine its some sort of OMT training program. I think MDs can also take them to get OMT training.

Also, @group_theory has vastly more knowledge about medical licensure, so they may want to chime in.

 

[IslandStyle808]

Yeah, obviously it would be better if there was no requirement. Does a Pathologist or Radiologist really need to do a 1 month rotation in OMM during their intern year? But given their previous record, this is a welcome improvement.

If I recall Pathology doesn't even have an intern year, unless you do a TRI + the residency. Yeah it would be pretty ridiculous, especially for path.

 

[hallowmann]

Looked into it a bit more, and I actually think more states require DOs to take COMLEX Level 3 than on that original list. WV for example does.

Also, apparently WV also requires 40 hrs of CME in OPP for anyone who didn't do an AOA internship or get Res. 42 approval. In other words, if your state has an osteopathic medical board, be prepared for the possibility you'll have some OMM requirements to get licensure.

I said it before, but I'll reiterate for emphasis, with the way things are now, if you are a DO, take the COMLEX Level 3.

EDIT: Some states like WA accept the USMLE Step 3, but require you to take a WA State OPP exam.

 

[kenjixshadow]

If you're a DO, you should take the COMLEX Level 3. You don't know where you're going to be and some states (usually the ones with a separate osteopathic medical licensing board) require that DOs take all levels of the COMLEX for licensure (that is a completely separate requirement).

Based on something I read on a post some time ago, I believe the following states require DOs to take all levels of the COMLEX: PA, MI, FL, OK, ME, TN, CA, & AZ. If anyone has more updated info, please correct me.

Res. 42 is ONLY for the 4 states, you don't need it otherwise. Res. 42 will end in 2020, so the 4 states that have this requirement will need to change their policies one way or another.

Ah ok got it, any state that has separated DO licensure will not accept USMLE 3.

I just searched SDN and this link came up. Apparently, the following states require comlex if it is your first license but are willing to take usmle if you are trying to gain licensure by state reciprocity:

Michigan
Tennessee

Source: http://forums.studentdoctor.net/thr...h-md-and-do-take-the-same-board-exams.487318/

 

[TopTomato]

If you're a DO, you should take the COMLEX Level 3. You don't know where you're going to be and some states (usually the ones with a separate osteopathic medical licensing board) require that DOs take all levels of the COMLEX for licensure (that is a completely separate requirement).

Based on something I read on a post some time ago, I believe the following states require DOs to take all levels of the COMLEX: PA, MI, FL, OK, ME, TN, CA, & AZ. If anyone has more updated info, please correct me.

Res. 42 is ONLY for the 4 states, you don't need it otherwise. Res. 42 will end in 2020, so the 4 states that have this requirement will need to change their policies one way or another.



If you want an unlimited PA license, you have to have OMM shoved down your throat at some point in residency. Up until now, that was during intern year when you had to fulfill the requirements for Res.42 (like give an OMM presentation to your ACGME program during grand rounds, attend a DO conference, etc.).

I personally have no idea what the MCCP is, but I imagine its some sort of OMT training program. I think MDs can also take them to get OMT training.

Also, @group_theory has vastly more knowledge about medical licensure, so they may want to chime in.

Interesting, to be honest I thought if I matched an ACGME residency I would be done with OMM for good.

 

[hallowmann]

Ah ok got it, any state that has separated DO licensure will not accept USMLE 3...

It seems like that's not necessarily true. WA for example accepts the USMLE series, but also requires an additional state-run OPP exam. It seems to really vary from state to state, so to be safe, I'd just take the 1 day COMLEX Level 3 exam some time during PGY-1, and just not worry about it. Every state accepts the COMLEX series from DOs for licensure, so its just safer.

You can feel free to take the USMLE Step 3 also, but its main benefit is only for the few programs that require it (as opposed to requiring the 3rd level of either exam) and for the additional recognition it offers internationally.

Interesting, to be honest I thought if I matched an ACGME residency I would be done with OMM for good.

Sorry if its disappointing, but you could potentially be done with OMM for good in PGY-1 if that helps at all.

 

[Kevin Baker]

So no moonlighting until PGY 3 plus whatever processing time. That sucks. PA DOs you know what to do

 

[kenjixshadow]

@hallowmann "the additional recognition it offers internationally." That is my reason to take USMLE 3.

Well it seems like it's better to stay away from PA for residency. Thanks Hallowmann for the warning us before hand.

 

[hallowmann]

@hallowmann "the additional recognition it offers internationally." That is my reason to take USMLE 3.

Well it seems like it's better to stay away from PA for residency. Thanks Hallowmann for the warning us before hand.

If I recall correctly, the "temporary" medical license given to people doing residency in a state is different than the permanent unrestricted license that we're talking about in this thread. I was under the impression that many states don't have the same requirements for a temporary license (i.e. they don't require the TRI for it). This is probably state dependent though, so be aware.

If you just don't want to deal with it at all, avoid ACGME programs in PA, MI, OK, and FL, at least until they clarify any changes in their requirements.

 

[TopTomato]

If I recall correctly, the "temporary" medical license given to people doing residency in a state is different than the permanent unrestricted license that we're talking about in this thread. I was under the impression that many states don't have the same requirements for a temporary license (i.e. they don't require the TRI for it). This is probably state dependent though, so be aware.

If you just don't want to deal with it at all, avoid ACGME programs in PA, MI, OK, and FL, at least until they clarify any changes in their requirements.

I gotta admit I probably don't know enough about res 42 as much as I should. But let's say hypothetically speaking I match an ACGME program in NJ and graduate from it. How would that affect my abilities to practice as an attending in let's say PA? I'm just assuming that during my PGY-1 year I wouldn't have any OMM exposure, or would I?

 

[Dharma]

I gotta admit I probably don't know enough about res 42 as much as I should. But let's say hypothetically speaking I match an ACGME program in NJ and graduate from it. How would that affect my abilities to practice as an attending in let's say PA? I'm just assuming that during my PGY-1 year I wouldn't have any OMM exposure, or would I?

I believe you will need to have satisfy one of the requirements listed above. That said, who knows what will happen in years to come with this merger mess (but I certainly would expect the worse case scenario to play it safe). I wouldn't necessarily consider using an elective month for OMM as "no big deal" if I weren't interested in OMM. Elective months are far and few during residency and provide time to explore subspecialties of interest that could lead to fellowship, as opposed to fulfilling some b.s. requirement. Personally speaking, I'd rather just not live in one of the states listed and use MY elective as I see fit.

DISCLAIMER: I actually like OMM. So, not an OMM hater. I do find all of these requirements annoying though.

 

[hallowmann]

I gotta admit I probably don't know enough about res 42 as much as I should. But let's say hypothetically speaking I match an ACGME program in NJ and graduate from it. How would that affect my abilities to practice as an attending in let's say PA? I'm just assuming that during my PGY-1 year I wouldn't have any OMM exposure, or would I?

To get licensure, you'd have to do something (apply via Res42 - during residency, OMM elective month - during residency, or MCCP in OMM at a PA OPTI).

I'm guessing the easiest thing would be the MCCP at a PA OPTI, but I'm only saying that because it's something you could basically do anytime (like I said, I don't know what the training actually entails). If you don't want to lose an elective or waste time with paperwork and at an AOA conference during residency for something you might not even need, that's probably a good option. You may have to use attending vacation time for it though.

I believe you will need to have satisfy one of the requirements listed above. That said, who knows what will happen in years to come with this merger mess (but I certainly would expect the worse case scenario to play it safe). I wouldn't necessarily consider using an elective month for OMM as "no big deal" if I weren't interested in OMM. Elective months are far and few during residency and provide time to explore subspecialties of interest that could lead to fellowship, as opposed to fulfilling some b.s. requirement. Personally speaking, I'd rather just not live in one of the states listed and use MY elective as I see fit.

DISCLAIMER: I actually like OMM. So, not an OMM hater. I do find all of these requirements annoying though.

I guess big deal depends on how many electives your residency gives you, how interested you are in OMM, and how interested you are in other subspecialties.

Obviously this is not ideal, but it is an improvement, especially with the MCCP (assuming its not prohibitively expensive or time consuming). Up until now, there was no reliable retroactive way to get approval for a non-AOA TRI. It was possible, but from what I heard it was very difficult to fulfill the requirements after you finished training. This basically opens up a way for DOs that never expected to move to PA to do so.

 

[Dharma]

This basically opens up a way for DOs that never expected to move to PA to do so.

What are the options for DOs well into their career who are thinking about moving to PA?

 

[hallowmann]

What are the options for DOs well into their career who are thinking about moving to PA?

The previous option was attempting to get retroactive Res. 42 approval, which I have heard was difficult. With the change, it seems like now there's an option to complete an OMM MCCP training at a PA OPTI.

It's still early though, and I have yet to find such a program in PA from a cursory Google search, so I guess we'll have to wait and see.

EDIT: Based on wording, I think the MCCP thing is just a CME training module in OMM, but I have no idea what would fulfill that requirement, like if there are specific hour requirements or what.

 

[AnonymousD.O.]

This is still so confusing to me, probably because I'm only a second year. But take Penn State Medical for instance, they have ALOT of D.O.s in many of their residencies. I assume that there is something they have in place to keep D.O.s in state, as PSU like many schools is passionate about getting their grads to practice in needed areas of PA. The wording of this is so blah.

Anyway thanks @hallowmann for posting this, many are trying to keep tabs on what comes of this

 

[Ceusina]

3. Successful completion of the first two years of an ACGME residency (Unified) program (other than an osteopathic recognized program) that includes the components of a rotating internship, including proof of osteopathic manipulative medicine integration into training rotations; or a one month rotation in osteopathic manipulative medicine; or the successful completion of a Modular Core Competency Program in osteopathic medicine as presented and supported by one of the OPTIs of Pennsylvania

I'm somewhat confused. My plan is to complete an ACGME gen surg residency, hopefully in Pennsylvania. So, what this is saying is that I have to complete all the components of a rotating internship (aka 6 months of things other than surgery... FM/IM/Peds, etc.), but have two years instead of one year to meet these requirements AND still have to do a month of OMM or go to a MCCP (whatever that is).

If I'm understanding the resolution update correctly, this does NOT help me at all. Because there's still NO CHANCE that a gen surg residency would have me doing 6 months of rotations outside of the OR, even if it's stretched out over 2 years versus 1 (like it currently is).

Am I missing something?!

I can't wait to say good riddance to AOA and POMA.

 

[hallowmann]

I'm somewhat confused. My plan is to complete an ACGME gen surg residency, hopefully in Pennsylvania. So, what this is saying is that I have to complete all the components of a rotating internship (aka 6 months of things other than surgery... FM/IM/Peds, etc.), but have two years instead of one year to meet these requirements AND still have to do a month of OMM or go to a MCCP (whatever that is).

If I'm understanding the resolution update correctly, this does NOT help me at all. Because there's still NO CHANCE that a gen surg residency would have me doing 6 months of rotations outside of the OR, even if it's stretched out over 2 years versus 1 (like it currently is).

Am I missing something?!

I can't wait to say good riddance to AOA and POMA.

The resolution says "components" of a rotating internship, which may or may not mean EVERY component of a rotating internship. A pre-lim surgery year may fulfill that requirement, but you'd have to find that info out.

What year are you? If you are a 3rd year going into 4th and you know you want to be in PA, you may be better off just planning to do Res. 42. If you're earlier in the process than that, I'd wait a bit more to see exactly how things turn out.

Also, I've heard that many ACGME GenSurg programs in PA don't look at DO applicants who haven't done a TRI first. In other words they only interview DO applicants who are in their intern years, and that will basically extend your residency by one year. This is likely program specific, so you should really contact with the programs you're interested.

I just know in my area of PA, people have consistently said that programs don't accept DO seniors, only DOs in intern year. It's for that reason that many people I hear about interested in GenSurg go to OH, NY, or NJ to complete an ACGME GenSurg residency with Res.42 approval.

 

[Ceusina]

The resolution says "components" of a rotating internship, which may or may not mean EVERY component of a rotating internship. A pre-lim surgery year may fulfill that requirement, but you'd have to find that info out.

What year are you? If you are a 3rd year going into 4th and you know you want to be in PA, you may be better off just planning to do Res. 42. If you're earlier in the process than that, I'd wait a bit more to see exactly how things turn out.

Also, I've heard that many ACGME GenSurg programs in PA don't look at DO applicants who haven't done a TRI first. In other words they only interview DO applicants who are in their intern years, and that will basically extend your residency by one year. This is likely program specific, so you should really contact with the programs you're interested.

I'm a 3rd year. None of the ACGME prelim (or categorical) surgery internships I've looked at meet all of the requirements... but some meet about half, so maybe that'd be enough... who knows.

I'm trying to avoid doing a DO TRI at all costs. I know several people in PA who did TRIs with the intention of applying to surgery, only to find themselves without a surgery residency the following year, having to scramble into a prelim surgery year, then finally landing a categorical spot (essentially making gen surg 7 years). Not ideal. I'd much rather apply to both prelim and categorical positions (with the goal of obtaining a categorical spot, obviously) and skip a DO TRI entirely... six years is certainly better than seven. Especially since that TRI would (presumably) have very little benefit to me... other than guaranteeing I won't have any issues with licensing. I'd like to think that by the time I'm done with residency the whole resolution 42 thing will no longer exist, but that's probably wishful thinking.

I do, however, know of DOs in PA who did a surgery prelim year (not a DO TRI) and then matched into categorical positions... they didn't have any trouble getting approval of their intern year through the "old" resolution 42... but I don't know the specifics of how they were approved. I also know there are DOs in PA that matched into categorical spots initially, without either a TRI or prelim year. How they managed to do it, I have no idea.

It's so frustrating because anecdotally, "everyone" who applies for resolution 42 gets approved, but when I read the requirements, I find it hard to believe that every DO surgery resident that applied for resolution 42 actually met all of the requirements.

For me, moving outside of PA for residency would be a nightmare. Ultimately, I'll apply widely and I'll go wherever I end up matching, but leaving my geographic region for residency would truly be disastrous (for personal/family reasons).

Last question: Let's say I match into a categorical ACGME gen surg spot in PA (I've spoken with program directors in PA who are now (within the last year) considering DO applicants without a TRI), would I have any issues completing my residency? Once I'm done with residency could I get a license in a different state and move to that state to practice?

 

[hallowmann]

I'm a 3rd year. None of the ACGME prelim (or categorical) surgery internships I've looked at meet all of the requirements... but some meet about half, so maybe that'd be enough... who knows.

I'm trying to avoid doing a DO TRI at all costs. I know several people in PA who did TRIs with the intention of applying to surgery, only to find themselves without a surgery residency the following year, having to scramble into a prelim surgery year, then finally landing a categorical spot (essentially making gen surg 7 years). Not ideal. I'd much rather apply to both prelim and categorical positions (with the goal of obtaining a categorical spot, obviously) and skip a DO TRI entirely... six years is certainly better than seven. Especially since that TRI would (presumably) have very little benefit to me... other than guaranteeing I won't have any issues with licensing. I'd like to think that by the time I'm done with residency the whole resolution 42 thing will no longer exist, but that's probably wishful thinking.

I do, however, know of DOs in PA who did a surgery prelim year (not a DO TRI) and then matched into categorical positions... they didn't have any trouble getting approval of their intern year through the "old" resolution 42... but I don't know the specifics of how they were approved. I also know there are DOs in PA that matched into categorical spots initially, without either a TRI or prelim year. How they managed to do it, I have no idea.

It's so frustrating because anecdotally, "everyone" who applies for resolution 42 gets approved, but when I read the requirements, I find it hard to believe that every DO surgery resident that applied for resolution 42 actually met all of the requirements.

For me, moving outside of PA for residency would be a nightmare. Ultimately, I'll apply widely and I'll go wherever I end up matching, but leaving my geographic region for residency would truly be disastrous (for personal/family reasons).

Last question: Let's say I match into a categorical ACGME gen surg spot in PA (I've spoken with program directors in PA who are now (within the last year) considering DO applicants without a TRI), would I have any issues completing my residency? Once I'm done with residency could I get a license in a different state and move to that state to practice?

I'd look into closer Res 42, and talk to surgeons that completed it. It hasn't changed, so I think you can still use it to get a pre-lim surg year approved. From what I've heard, they were very lax with accepting certain rotations as fulfilling requirements, when really they don't. It may mean some minor "adjustments" in what your program calls certain rotations, but I think it's doable.

I don't think you'll have any issue getting trained in PA and licensed elsewhere, the issue only comes in if you need permanent PA licensure. Invisible double check what the temporary license requirements are, but I highly doubt you'll have a problem.

It looks like you're on top of it though, so as long as you keep communicating with programs, you should be fine.

The whole thing is a big pain, especially with how frequently things seem to change, but it's the system we have to work with.

 

[Uafl112]

this is all a load of barnacles

 

[group_theory]

Before anyone does any planning or celebrating, or complaining

Keep in mind this is not the PA Osteopathic Board of Medicine, but a resolution adopted by the Pennsylvania Osteopathic Medical Association ... it doesn't have any legal standing ... not until the state legislature changes the rules and the PA BOM adopts those changes into its rules/regulations.

Right now it's just a state association who adopted a policy/position statement and will lobby the legislature on such position.

As it stands right now - you can do residency in PA without having it be AOA approved internship or AOA-approved ACGME via Res 42. You just can't get an unrestricted license in PA

As it stands now, you can do a residency elsewhere in the US, but without doing an AOA internship or AOA-approved ACGME via Res 42, you can't get an unrestricted license in PA

As it stands now, if you want a unrestricted license to practice osteopathic medicine in PA, you must have an AOA-approved internship (whether through an AOA residency or Resolution 42). You do not need an AOA internship to do a residency in PA.

Any changes will have to be made through the state legislature (and sign by the governor, and adopted by the PA BOM)

*another requirement is actually an OMM practical - fortunately the state board has decided to accept COMLEX 2-PE as meeting that requirement. The state board also accepts the AOBFP board certification exam as meeting that requirement. But older DOs (those who graduated before COMLEX 2-PE) who are not board certified in family medicine through the AOA will have to sign up and take an OMM practical in order to practice in PA

 

[TopTomato]

Before anyone does any planning or celebrating, or complaining

Keep in mind this is not the PA Osteopathic Board of Medicine, but a resolution adopted by the Pennsylvania Osteopathic Medical Association ... it doesn't have any legal standing ... not until the state legislature changes the rules and the PA BOM adopts those changes into its rules/regulations.

Right now it's just a state association who adopted a policy/position statement and will lobby the legislature on such position.

As it stands right now - you can do residency in PA without having it be AOA approved internship or AOA-approved ACGME via Res 42. You just can't get an unrestricted license in PA

As it stands now, you can do a residency elsewhere in the US, but without doing an AOA internship or AOA-approved ACGME via Res 42, you can't get an unrestricted license in PA

As it stands now, if you want a unrestricted license to practice osteopathic medicine in PA, you must have an AOA-approved internship (whether through an AOA residency or Resolution 42). You do not need an AOA internship to do a residency in PA.

Any changes will have to be made through the state legislature (and sign by the governor, and adopted by the PA BOM)

*another requirement is actually an OMM practical - fortunately the state board has decided to accept COMLEX 2-PE as meeting that requirement. The state board also accepts the AOBFP board certification exam as meeting that requirement. But older DOs (those who graduated before COMLEX 2-PE) who are not board certified in family medicine through the AOA will have to sign up and take an OMM practical in order to practice in PA

Please forgive my ignorance on this topic, but judging by the language you're using right now i'm guessing that there's such a thing as a "restricted license". Would a restricted license be something like just not being able to do OMM/OMT but still practice medicine? For instance if a person did an ACGME residency and did not meet the requirements for res 42, could they still practice in PA but with the restriction of not being allowed to perform manipulations?

 

[joeDO2]

Please forgive my ignorance on this topic, but judging by the language you're using right now i'm guessing that there's such a thing as a "restricted license". Would a restricted license be something like just not being able to do OMM/OMT but still practice medicine? For instance if a person did an ACGME residency and did not meet the requirements for res 42, could they still practice in PA but with the restriction of not being allowed to perform manipulations?

they are talking about limited license as in the case of a training program (your residency license)

 

[hallowmann]

Please forgive my ignorance on this topic, but judging by the language you're using right now i'm guessing that there's such a thing as a "restricted license". Would a restricted license be something like just not being able to do OMM/OMT but still practice medicine? For instance if a person did an ACGME residency and did not meet the requirements for res 42, could they still practice in PA but with the restriction of not being allowed to perform manipulations?

Its temporary license for residency/fellowship. Unrestricted is the full licensure given to attendings practicing in the state. DOs may only be licensed by the SBOM, so there's no way to get unrestricted licenses without fulfilling the requirements.

Like I said earlier, SBOM will likely do as POMA recommends, so in the future, there may be the options discussed in this thread. It'll also likely happen in the next few years, as Res42 is supposed to end in 2020.

 

[group_theory]

they are talking about limited license as in the case of a training program (your residency license)

Its temporary license for residency/fellowship. Unrestricted is the full licensure given to attendings practicing in the state. DOs may only be licensed by the SBOM, so there's no way to get unrestricted licenses without fulfilling the requirements.

Like I said earlier, SBOM will likely do as POMA recommends, so in the future, there may be the options discussed in this thread. It'll also likely happen in the next few years, as Res42 is supposed to end in 2020.

I have read the notes by joeDO2 and hallowmann, reviewed the pertinent data, and examined the patient

Agree with assessment and plan as written by the medical students with the following addition: SBOM will do what the law says, so POMA will lobby the state legislature to amend the practice act to make those changes. Won't prevent someone in the legislature from adding amendments that can really screw up POMA's proposal.

 

[dozitgetchahi]

The Resolution 42 garbage was one reason why all PA ACGME residency programs I interviewed at got ranked near the bottom (there were other reasons too). When the programs discussed their schedules at the interviews, it seemed like all sorts of silly gyrations were necessary to make the intern year Res 42-compatible. It really messed up your intern schedule at some of the programs. I just decided it wasn't worth bothering with.

 

[Dr. Zombie]

So what are the four states needing Res 42 or some bs to get an unrestricted license?
I wanna do a standard ACGME residency with zero OMM but still have the option of practicing in FL seamlessly.

 

[meliora27]

So what are the four states needing Res 42 or some bs to get an unrestricted license?
I wanna do a standard ACGME residency with zero OMM but still have the option of practicing in FL seamlessly.

FL is one of the states the requires an AOA Internship OR a Res 42 Waiver.

 

[kirkirkir]

Forgive me if it has already been addressed, but how does res42 play out with the merger? And if we (DO's) don't like it why does it exist?

 

[hallowmann]

So what are the four states needing Res 42 or some bs to get an unrestricted license?
I wanna do a standard ACGME residency with zero OMM but still have the option of practicing in FL seamlessly.

You're gonna have a tough time with that unless/until the FL DO board changes its requirements.

Four states that require AOA TRI (or Res. 42): PA, FL, MI, & OK.

Forgive me if it has already been addressed, but how does res42 play out with the merger? And if we (DO's) don't like it why does it exist?

Resolution 42 exists for the sole purpose of letting ACGME trained DOs get their intern year recognized as "AOA equivalent". The purpose of this is for those of us who want to practice in one of the 4 states whose DO state boards currently require an AOA intern year for licensure. It needs to exist for that reason. It is a solution, not the problem, which is the individual state requirement.

Over time virtually all states that had such a requirement in the past have withdrawn them, except for the 4 states above. The AOA created Res. 42 add a way around the requirement.

Res. 42 is set to end in 2020, as AOA internships will cease to exist. For this reason, states will have to modify their requirements to account for this change. It hadn't happened yet though.

 

[Dr. Zombie]

You're gonna have a tough time with that unless/until the FL DO board changes its requirements.

Four states that require AOA TRI (or Res. 42): PA, FL, MI, & OK.



Resolution 42 exists for the sole purpose of letting ACGME trained DOs get their intern year recognized as "AOA equivalent". The purpose of this is for those of us who want to practice in one of the 4 states whose DO state boards currently require an AOA intern year for licensure. It needs to exist for that reason. It is a solution, not the problem, which is the individual state requirement.

Over time virtually all states that had such a requirement in the past have withdrawn them, except for the 4 states above. The AOA created Res. 42 add a way around the requirement.

Res. 42 is set to end in 2020, as AOA internships will cease to exist. For this reason, states will have to modify their requirements to account for this change. It hadn't happened yet though.

I graduate in 2018. So do you feel when I'm done with residency, I should be ok, despite having "osteopathic focused" programs.

 

[hallowmann]

I graduate in 2018. So do you feel when I'm done with residency, I should be ok, despite having "osteopathic focused" programs.

You'll have to wait until closer to the time to know for sure. They still might have some sort of requirements, like POMA proposed, but who knows.

 

[Mad Jack]

Yeah, obviously it would be better if there was no requirement. Does a Pathologist or Radiologist really need to do a 1 month rotation in OMM during their intern year? But given their previous record, this is a welcome improvement.

Given my love of psychiatry, the case could be made that OMM would actually be detrimental for me to use on the vast majority of my patients. "Oh, you struggle with depression because you were molested as a child? That's terrible! But before we get to that, I just need to palate you from head to toe..." "Oh, you think the FBI has implanted tracking devices in your body? Let me just feel for some reflexes near the supposed implantation site..." It's just nonsense to require of a psychiatrist.

 

[Dr. Zombie]

If I do an ACGME Residency and decide to go through Res 42, where would I be able to find information on what kind of rotations I will need to satisfy Intern year for Internal Med?

 

[hallowmann]

If I do an ACGME Residency and decide to go through Res 42, where would I be able to find information on what kind of rotations I will need to satisfy Intern year for Internal Med?

The AOA outlines what is required to fulfill Res. 42, and you can also contact them for more clarification. From what I've heard, its a process people start at the very end of 4th year (like May/June) and the beginning of intern year (July). That way you can actually communicate with the program you matched into.

As far as what is required for IM (if that's what you're asking), I think you'll be fine relying on your IM program to make sure you fulfill the requirements for IM (assuming of course we're talking about a categorical program).

 

[Dr. Zombie]

The AOA outlines what is required to fulfill Res. 42, and you can also contact them for more clarification. From what I've heard, its a process people start at the very end of 4th year (like May/June) and the beginning of intern year (July). That way you can actually communicate with the program you matched into.

As far as what is required for IM (if that's what you're asking), I think you'll be fine relying on your IM program to make sure you fulfill the requirements for IM (assuming of course we're talking about a categorical program).

So basically, if I match categorical IM, its smooth sailing and I won't need to do anything else?

 

[hallowmann]

So basically, if I match categorical IM, its smooth sailing and I won't need to do anything else?

You still need to fulfill the requirements for Res. 42, but there's no chance you wouldn't fulfill the requirements for IM, because your program won't let you be in that situation.

 

[Dr. Zombie]

You still need to fulfill the requirements for Res. 42, but there's no chance you wouldn't fulfill the requirements for IM, because your program won't let you be in that situation.

I'm almost even tempted to just do an AOA IM and avoid having to go to some conference on my vacation time or attend OMM clinics.

 

[hallowmann]

I'm almost even tempted to just do an AOA IM and avoid having to go to some conference on my vacation time or attend OMM clinics.

You could always do a dual-accredited one. I think there's 25-30 of them mostly in NY, NJ, PA & MI.