What do you all think of this article?

[TheaterOfTheme]

Found this from 2 years ago ...

TLDR: AOA will be absorbed by LCME because of the same reasoning that led us to the residency merger.

http://aodme.org/wp-content/uploads/The_Unintended_Consequences_of_the_ACGME_Merger.pdf

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[TheaterOfTheme]

In addition, I was wondering where one can find an update for programs with pre-accreditation status...

 

[Drrrrrr. Celty]

I describe Gevitz as an irrational alarmist who's perceptions of what a modern osteopathic physician is, as static and dangerously out of touch.

The belief that Osteopathic Medicine in the US or OMM are going to die entirely is not realistic, nor is the notion that the end of the AOA will mean the end of either is just foolish. Plenty of OMM techniques will undoubtedly remain because they are useful in many settings.

 

[TheaterOfTheme]

I describe Gevitz as an irrational alarmist who's perceptions of what a modern osteopathic physician is, as static and dangerously out of touch.

The belief that Osteopathic Medicine in the US or OMM are going to die entirely is not realistic, nor is the notion that the end of the AOA will mean the end of either is just foolish. Plenty of OMM techniques will undoubtedly remain because they are useful in many settings.

I agree with your reasoning. But I can definitely see the LCME aiming to take over--and as a result a restructuring of DO schools. Not a bad thing, but most wouldn't survive as he explains.

Do you see a future where the DO degree still exists? There is a significant power loss now that the AOA does not accredit residencies. It seems somewhat uneven now.

 

[hossle12]

Most students choose DO to become a physician, not OMM or the osteopathic "philosophy". Unifying the process of applying to medical schools and keeping all medical schools to the same LCME standards makes sense. Making all residencies ACGME was a good start, hopefully actions like that continue.

This guy sounds a bit extreme though. It is near impossible to predict what will really happen with DO schools, OMM, the separate licensing exams, etc.

 

[Drrrrrr. Celty]

I agree with your reasoning. But I can definitely see the LCME aiming to take over--and as a result a restructuring of DO schools. Not a bad thing, but most wouldn't survive as he explains.

Do you see a future where the DO degree still exists? There is a significant power loss now that the AOA does not accredit residencies. It seems somewhat uneven now.

I think some restructuring is in order. However most would survive if given a 5-10 year time table to reach a level they consider adequate. Likewise certain programs would be restructured as rural med or primary care emphasis tracks. If DO schools in majority stopped existing we'd be hit hard in regard to just how much less physicians there would be for entire communities, not even considering the impact DO schools have on local communities and their healthcare system. So I'm not a big believer in the notion of the grand shutdown.

I'm not entirely sure whether or not the DO degree will remain. I've made clear before that I believe it does not elaborate our training and the degree is conflated internationally with other non-physicians. However I do not particularly think it's a big deal. What I do think however is that a future where COCA exists is less and less likely. I doubt LCME will inherently care if historically osteopathic medical schools continue dispensing the DO degree or training OMM.

I'd say that being given a disproportionate amount of seats on the ACGME is not a significant power loss.

 

[TheaterOfTheme]

I think some restructuring is in order. However most would survive if given a 5-10 year time table to reach a level they consider adequate. Likewise certain programs would be restructured as rural med or primary care emphasis tracks. If DO schools in majority stopped existing we'd be hit hard in regard to just how much less physicians there would be for entire communities, not even considering the impact DO schools have on local communities and their healthcare system. So I'm not a big believer in the notion of the grand shutdown.

I'm not entirely sure whether or not the DO degree will remain. I've made clear before that I believe it does not elaborate our training and the degree is conflated internationally with other non-physicians. However I do not particularly think it's a big deal. What I do think however is that a future where COCA exists is less and less likely. I doubt LCME will inherently care if historically osteopathic medical schools continue dispensing the DO degree or training OMM.

I'd say that being given a disproportionate amount of seats on the ACGME is not a significant power loss.

What is COCA's projected role in the future of the merger? Still accredidation, obviously? The AOA's role was OGME, correct? The LCME will obviously not care about those details, but are you implying they will likely become the overall accrediting board and COCA will dissipate?

 

[starri]

COCA will dissipate?

We can hope, right?

 

[IsWhat]

I think he is pretty spot on with his assessment and predictions. The only thing I think he is wrong about is where he states the LCME will force COCAs hand in order to merge undergraduate medical education. Honestly I don't think the LCME will need to - DO schools are going to be forced to make changes to their curriculum in order to put their students in a better position to do well on the USMLE and ultimately be competetive for ACGME residencies aka. Decrease OMM time and removing the COMLEX. These two things basically represent the dividing line between MDs and DOs, and the LCME/ACGME were smart enough to know that under single GME Osteopathic schools would be forced to degrade the "core" of their curriculum in order to make their students competetive.

By the time the LCME is ready to merge with COCA, I bet there will be no fuss from COCAs side - because by that time DO schools really won't be DO schools anymore, and like some of the Deans described in this paper said, "it will just make sense."

 

[DOFOSHO]

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[Mad Jack]

I agree with your reasoning. But I can definitely see the LCME aiming to take over--and as a result a restructuring of DO schools. Not a bad thing, but most wouldn't survive as he explains.

Do you see a future where the DO degree still exists? There is a significant power loss now that the AOA does not accredit residencies. It seems somewhat uneven now.

Most would survive by striking deals with current ACGME schools and becoming branch campuses, thus allowing them to ride on the research and other resources of the partner school, while giving the partner school a larger footprint and essentially a fully established teaching infrastructure. class sizes would likely shrink at many/most schools as a result, but they would survive, albeit in a new form.

 

[Mad Jack]

I think he is pretty spot on with his assessment and predictions. The only thing I think he is wrong about is where he states the LCME will force COCAs hand in order to merge undergraduate medical education. Honestly I don't think the LCME will need to - DO schools are going to be forced to make changes to their curriculum in order to put their students in a better position to do well on the USMLE and ultimately be competetive for ACGME residencies aka. Decrease OMM time and removing the COMLEX. These two things basically represent the dividing line between MDs and DOs, and the LCME/ACGME were smart enough to know that under single GME Osteopathic schools would be forced to degrade the "core" of their curriculum in order to make their students competetive.

By the time the LCME is ready to merge with COCA, I bet there will be no fuss from COCAs side - because by that time DO schools really won't be DO schools anymore, and like some of the Deans described in this paper said, "it will just make sense."

OMM takes very little time, it's ridiculous how much people exaggerate in that regard. It was all of 4-6 hours a week, much of which was devoted to non-OMM skills like physical assessment, clinical diagnosis, etc. Second year OMM was a joke, since we'd already learned basically all of it in first year.

 

[Dr. Death]

Most would survive by striking deals with current ACGME schools and becoming branch campuses, thus allowing them to ride on the research and other resources of the partner school, while giving the partner school a larger footprint and essentially a fully established teaching infrastructure. class sizes would likely shrink at many/most schools as a result, but they would survive, albeit in a new form.

This sounds like a wonderful dream. One that I don't think we'll see realized in the next 20 years

 

[Mad Jack]

This sounds like a wonderful dream. One that I don't think we'll see realized in the next 20 years

The LCME doesn't want the COCA. The merging of postgraduate education was largely at the behest of Medicare and the federal government, which was tired of two systems of residencies existing that could easily be merged into one for practical reasons. They don't give two ****s about undergraduate medical education, and the LCME has no desire to be forced to beat two and a half dozen plus schools into shape.

Maybe if the COCA makes the first move, but why would they want to, given that they'd basically be putting themselves out of jobs for the greater good?

 

[IsWhat]

OMM takes very little time, it's ridiculous how much people exaggerate in that regard. It was all of 4-6 hours a week, much of which was devoted to non-OMM skills like physical assessment, clinical diagnosis, etc. Second year OMM was a joke, since we'd already learned basically all of it in first year.

Over the course of two years, 4-6 hours is not insignificant. Not to mention the extra OMM rotations during third/fourth year (my school requires an OMM rotation in both years). Don't get me wrong - I actually really like OMM, but it pulls away from other studies and that's not really arguable.

 

[Mad Jack]

Over the course of two years, 4-6 hours is not insignificant. Not to mention the extra OMM rotations during third/fourth year (my school requires an OMM rotation in both years). Don't get me wrong - I actually really like OMM, but it pulls away from other studies and that's not really arguable.

Eh, most of us have more than 5-6 spare hours in a week. It just cuts into my screwing around time, honestly. The extra rotation might hurt for those going for competitive fields, but it's not killing 9 out of 10 DOs that weren't going into dermatoorthopedicneurosurgery. I just look at the time I spent on OMM as time I would have spent on SDN anyway, given that medical school and studying was really only a 40-50 hour a week endeavor, aside from block weeks in first year. There's plenty more time in the week, 4-6 hours of OMM aren't going to make or break you.

 

[hallowmann]

Found this from 2 years ago ...

TLDR: AOA will be absorbed by LCME because of the same reasoning that led us to the residency merger.

http://aodme.org/wp-content/uploads/The_Unintended_Consequences_of_the_ACGME_Merger.pdf

This article by Gevitz has been repeatedly discussed and people already sided to camps. In short he exaggerates the effects of the merger significantly. He exaggerates the closing of OGME significantly (28% have already applied for accreditation in only 1 yr of the 5 yr transition).

He pulls this whole LCME thing out of nowhere, and then says schools won't adapt to survive, which is ludicrous. A DO school hasn't closed since what the 1970s, and although it might not seem like it, COCA has increased standards over the last 10-20 yrs that are probably collectively tantamount to a current COCA to LCME transition. All the schools overnight would fail to be accredited sure, but it wouldn't happen overnight, there would be a transition and probationary period, during which virtually all schools would pass the LCME standards.

As far as the losing power thing goes because we lose accrediting GME, we gained 28% of the seats in a body that our students are directly dependant on, and without that and the 2016 common requirements going into effect we would have lost quite a bit more power.

Also, here is a quick list of threads discussing this document (there are more). We really don't need to keep rehashing it:

http://forums.studentdoctor.net/thr...ded-consequences-of-the-acgme-merger.1072349/
http://forums.studentdoctor.net/thr...ntended-consequences-of-acgme-merger.1075200/
http://forums.studentdoctor.net/thr...d-of-osteopathic-field-due-to-merger.1122486/

 

[Drrrrrr. Celty]

OMM takes very little time, it's ridiculous how much people exaggerate in that regard. It was all of 4-6 hours a week, much of which was devoted to non-OMM skills like physical assessment, clinical diagnosis, etc. Second year OMM was a joke, since we'd already learned basically all of it in first year.

OMM as a whole at KCU is pretty chill, though I think our competencies make it a lot harder. Like memorize everything and be ready to say and do it all, miss a single thing like that your hand is actually on top of structures A, but cannot remember that it's also structure B and you fail. Overall I think cutting back Sacral and Cranial would be nice though.

 

[Mr Roboto]

Overall I think cutting back eliminating Sacral and Cranial would be nice though.

FTFY

 

[TheaterOfTheme]

I was once again wandering around the web and found another interesting article about the single GME system. This one, now, is in favor.

http://jaoa.org/article.aspx?articleid=2094627

 

[TheaterOfTheme]

However, I am somewhat perplexed by this paragraph towards the end. Is the author suggesting that AOA positions will cease because of the merger? Or is he suggesting that somehow they will cease WITHOUT the merger?

"Currently, there are 2988 postgraduate year-1 osteopathic training positions in the United States,5 and the number of graduates from osteopathic medical schools is expected to increase to 6000 by 2019.6 Unfortunately, on the basis of my conversations with hospital administrators, I believe many of these postgraduate year-1 osteopathic training positions will cease to exist after 2015 regardless of the AOA endorsement of the MOU."

 

[Drrrrrr. Celty]

However, I am somewhat perplexed by this paragraph towards the end. Is the author suggesting that AOA positions will cease because of the merger? Or is he suggesting that somehow they will cease WITHOUT the merger?

"Currently, there are 2988 postgraduate year-1 osteopathic training positions in the United States,5 and the number of graduates from osteopathic medical schools is expected to increase to 6000 by 2019.6 Unfortunately, on the basis of my conversations with hospital administrators, I believe many of these postgraduate year-1 osteopathic training positions will cease to exist after 2015 regardless of the AOA endorsement of the MOU."

He believed that many residencies may stop existing, possibly this is a reference to TRIs.

 

[TheaterOfTheme]

He believed that many residencies may stop existing, possibly this is a reference to TRIs.

It was confusing that he said PGY1. That's what I thought it sounded like though--but why the prediction of 2015? And for what reason?


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[Goro]

Well, first off, AOA doesn't run the accrediting of DO schools, COCA does. While the former has this unfortunate mindset of "More DO schools good", the latter at least has some responsibility to bring this into being.

Personally, I'd love for LMCE to replace COCA! The profession gets hurt not by the "cult of Still" mindset, but by having poor clinical education in OMSIII and IV years.

But wishful thinking aside, AOA and LCME will give up their oversight of the DO schools over their dead bodies. I don't think it could happen without state legislatures getting involved.

Just remember that ACGME is responsible for post-graduate education. Very separate from medical school education.

Found this from 2 years ago ...

TLDR: AOA will be absorbed by LCME because of the same reasoning that led us to the residency merger.

http://aodme.org/wp-content/uploads/The_Unintended_Consequences_of_the_ACGME_Merger.pdf

 

[TheaterOfTheme]

Well, first off, AOA doesn't run the accrediting of DO schools, COCA does. While the former has this unfortunate mindset of "More DO schools good", the latter at least has some responsibility to bring this into being.

Personally, I'd love for LMCE to replace COCA! The profession gets hurt not by the "cult of Still" mindset, but by having poor clinical education in OMSIII and IV years.

But wishful thinking aside, AOA and LCME will give up their oversight of the DO schools over their dead bodies. I don't think it could happen without state legislatures getting involved.

Just remember that ACGME is responsible for post-graduate education. Very separate from medical school education.

Right, I understand the COCA is in charge of accreditation. --and now the AOA does not accredit residency training post merger. However, I was curious as to what the paragraph I quoted meant. Does this author mean that he believes all previously osteopathic residencies will disappear by 2015? I was really unclear about that.


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[Goro]

"The sky is falling! The sky is falling!


In fact, if we go forward with the ACGME merger, our doing so will most likely reduce the number of existing OGME slots and make it more difficult for DO graduates to find PGY‐1 positions.

Right, I understand the COCA is in charge of accreditation. --and now the AOA does not accredit residency training post merger. However, I was curious as to what the paragraph I quoted meant. Does this author mean that he believes all previously osteopathic residencies will disappear by 2015? I was really unclear about that.


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[TheaterOfTheme]

"The sky is falling! The sky is falling!


In fact, if we go forward with the ACGME merger, our doing so will most likely reduce the number of existing OGME slots and make it more difficult for DO graduates to find PGY‐1 positions.

Lol that's what it sounds like. Yet, the author is arguing in FAVOR of the merge. Hence my confusion to the point. I suppose this is outdated so it doesn't matter anyways.


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