2435 OGME slots for 3724 New DOs - Nice Job AOA

[MichiganDO]

5000 DOs for 2400 slots?

The AOA intern/resident registration program offered 2,435 this year.
This year Osteopathic Colleges will graduate 3,724 osteopathic students.

Class sizes are scheduled to increase to over 5000 DOs per year by 2013.

5000 DOs for 2400 slots? Are students concerned about this issue?

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[Medicinewarrior]

5000 DOs for 2400 slots?

The AOA intern/resident registration program offered 2,435 this year.
This year Osteopathic Colleges will graduate 3,724 osteopathic students.

Class sizes are scheduled to increase to over 5000 DOs per year by 2013.

5000 DOs for 2400 slots? Are students concerned about this issue?

i think this will open the door for many DO's to fill the vast amount of unfilled allopathic spots. That in itself may perhaps limit the amount of FMGs that fill allopathic primary care -don't know if that is a good thing or a bad thing.

 

[Lokhtar]

But even with 3724 new DOs and only 2400 spots, many of those 2400 spots are unfilled, right? Why would they spend money to create more spots if their current spots aren't being filled?

 

[JaggerPlate]

But even with 3724 new DOs and only 2400 spots, many of those 2400 spots are unfilled, right? Why would they spend money to create more spots if their current spots aren't being filled?

They are in fields that unfortunately, no one wants. I'd go out on a limb and say the majority of spots that don't fill are FP and IM, definitely PCP fields. I really doubt it's derm and ortho going unfilled. I think people would like more spots in specialized fields ... but who knows if that will happen, and cutting PCP fields to create more specialized residencies seems hypocritical.

 

[MichiganDO]

Yes, the above statements are true. But, 10 years from now when less ACGME spots are open to DOs, seeing as MDs are increasing by 30%, then what?

How can the AOA be serious about osteopathic education when it essentially banks on the idea that half its students will enter into ACGME programs?

Why are we creating more schools and slots in schools when we cannot offer these graduates adequate training post graduation?

 

[SomeDoc]

Yes, the above statements are true. But, 10 years from now when less ACGME spots are open to DOs, seeing as MDs are increasing by 30%, then what?

How can the AOA be serious about osteopathic education when it essentially banks on the idea that half its students will enter into ACGME programs?

Why are we creating more schools and slots in schools when we cannot offer these graduates adequate training post graduation?

Hah, ironic isn't it?

 

[SomeDoc]

5000 DOs for 2400 slots?

The AOA intern/resident registration program offered 2,435 this year.
This year Osteopathic Colleges will graduate 3,724 osteopathic students.

Class sizes are scheduled to increase to over 5000 DOs per year by 2013.

5000 DOs for 2400 slots? Are students concerned about this issue?

It is definitely cause for concern. But equally shocking is the blatant self-contradiction of the AOA and COCA- maintaining "distinctiveness" at all costs by having graduates train in non-AOA programs by necessity, and by fervently attempting to maintain the status quo regarding a degree which identifies graduates internationally as non-physicians.

I am not going to be surprised to see some pretty big changes in the near future, when progressive physicians begin to start getting elected into office.

 

[Medicinewarrior]

taken from http://www.natmatch.com/aoairp/

-results- tab

1000 unfilled spots for the 2009 match on 02/09/2009

422 1 year transitional year spots
170 Internal Medicine
300 Family Medicine

 

[SomeDoc]

taken from http://www.natmatch.com/aoairp/

-results- tab

1000 unfilled spots for the 2009 match on 02/09/2009

422 1 year transitional year spots
170 Internal Medicine
300 Family Medicine

No surprise that the transitional year spots are the most unfilled.

Grads aren't foolish to waste an entire years worth of their lives doing service for a hospital as an underpaid worker/losing the opportunity to earn a year's worth of a physician's salary, if they have no plans on practicing in one of the "5 states". And then there's resolution 42.

 

[Haole]

No surprise that the transitional year spots are the most unfilled.

Grads aren't foolish to waste an entire years worth of their lives doing service for a hospital as an underpaid worker/losing the opportunity to earn a year's worth of a physician's salary, if they have no plans on practicing in one of the "5 states". And then there's resolution 42.

Wouldn't the transitional year count as an internship? How would this be a waste if you were to match into an advanced position requiring you to find your own internship before beginning residency as a PGY2? What am I missing? I don't think they are there so people can do them just for the heck of it.

 

[cliquesh]

I think the AOA, or at least President DiMarco, is aware of the issue. Hopefully, the next president will continue DiMarco's agenda.

There is something I find odd, though. Last year, there were 2700 something spots and this year there are only 2400 something spots. Hrmmm....

Atleast some desirable fields have expanded from last year. The number of Ortho, for instance, increased by 18%.

 

[schrute]

Not to belabor my point:

"The osteopathic profession cannot be the sole provider of its clinical and graduate education, but nor should it be. The tradeoff, however, is that an increasing reliance on allopathic education (particularly post graduate) potentiates the absurdity of “osteopathic existentialism.” Many DOs, particularly those in the upper echelons of our profession, lament this quid pro quo while conveniently ignoring the paradoxical relationship between osteopathic autonomy and the need for allopathic assistance, but nothing short of restricting osteopathic physicians to the role of family practitioners will change this.

This lack of commitment to the osteopathic profession is of primary importance because it fosters complacency as DOs completely break from the AOA and receive ACGME training, affiliation and accreditation. IE: Osteopathic education is merely a gateway to becoming a physician, with no stipulations that require a long-term committed association with the AOA. I’m not suggesting it could or should be any other way, especially considering the paucity of specialty & subspecialty training programs, and the number of newly minted DOs far exceeding the number of available OGME spots. I am suggesting, however, that osteopathic clinical and graduate medical education has become a superfluous entity insomuch as it is “a” route for training DOs versus “the” route, further fostering the “only necessary when convenient” association to the osteopathic profession."

 

[SomeDoc]

Wouldn't the transitional year count as an internship? How would this be a waste if you were to match into an advanced position requiring you to find your own internship before beginning residency as a PGY2? What am I missing? I don't think they are there so people can do them just for the heck of it.

Good luck finding a non-primary-care ACGME PGY2-X program which will accept an AOA TRI as PGY-1.

Even if you're going the AOA route, some specialties have modified the TRI requirement, where it is factored in the overall length of the program (shorter than having to do a separate internship).

 

[Colbert]

I'm in the second year at Touro-NY, and being interested in pediatrics I noticed there were only two osteopathic pediatric residency programs in the state of New York. I went to one of our deans (a self proclaimed big shot in AOA) to ask him how to petition the AOA to create my programs. This was roughly our conversation:

Me: Dr. X, there are only two peds programs in the state, how do I petition the AOA to create more?
Dr. X: Just go into family practice and focus on peds later.
Me: But I don't want to do family practice, I want to do peds.
Dr. X: Well then do your residency somewhere else and move back here.
Me: But I don't want to move my family all across the country, besides the mission of our school is to train doctors for NYC. I'm just asking what the process to petition the AOA to create more residencies is.
Dr. X: If you're worried just make sure you're competitive enough to get one of the spots.
Me: Well what about the other 20 people in our class that want to do peds in addition to people applying to them from other schools.
Dr. X: Just do family practice.
Me: Listen, I'm just asking you how to petition the AOA...
Dr. X: We don't need more residency programs, just do family practice.

 

[cliquesh]

Wow, that is just terrible. The more and more I hear about Touro, the worse it sounds.

If I were you, I would go to the president's blog and write a comment. He will likely respond to you if its semi-intelligent. But the AOA can't just make residencies out of thin air. A hospital needs to want to start a program and, more importantly, needs to get funding for it, and the funding comes from the government, which the AOA can do nothing about other than lobby for more of it.

 

[bkpa2med]

Dude just go allopathic. Don't waste your time talking with the tools at your school.

 

[Lokhtar]

I'm in the second year at Touro-NY, and being interested in pediatrics I noticed there were only two osteopathic pediatric residency programs in the state of New York. I went to one of our deans (a self proclaimed big shot in AOA) to ask him how to petition the AOA to create my programs. This was roughly our conversation:

Me: Dr. X, there are only two peds programs in the state, how do I petition the AOA to create more?
Dr. X: Just go into family practice and focus on peds later.
Me: But I don't want to do family practice, I want to do peds.
Dr. X: Well then do your residency somewhere else and move back here.
Me: But I don't want to move my family all across the country, besides the mission of our school is to train doctors for NYC. I'm just asking what the process to petition the AOA to create more residencies is.
Dr. X: If you're worried just make sure you're competitive enough to get one of the spots.
Me: Well what about the other 20 people in our class that want to do peds in addition to people applying to them from other schools.
Dr. X: Just do family practice.
Me: Listen, I'm just asking you how to petition the AOA...
Dr. X: We don't need more residency programs, just do family practice.

That's shocking. You were simply asking how to petition for more spots.

 

[scpod]

I'm in the second year at Touro-NY, and being interested in pediatrics I noticed there were only two osteopathic pediatric residency programs in the state of New York. I went to one of our deans (a self proclaimed big shot in AOA) to ask him how to petition the AOA to create my programs. This was roughly our conversation:

Me: Dr. X, there are only two peds programs in the state, how do I petition the AOA to create more?
Dr. X: Just go into family practice and focus on peds later.
Me: But I don't want to do family practice, I want to do peds.
Dr. X: Well then do your residency somewhere else and move back here.
Me: But I don't want to move my family all across the country, besides the mission of our school is to train doctors for NYC. I'm just asking what the process to petition the AOA to create more residencies is.
Dr. X: If you're worried just make sure you're competitive enough to get one of the spots.
Me: Well what about the other 20 people in our class that want to do peds in addition to people applying to them from other schools.
Dr. X: Just do family practice.
Me: Listen, I'm just asking you how to petition the AOA...
Dr. X: We don't need more residency programs, just do family practice.

This would be bad if it was true. However, if you really approached a bigshot in the AOA he would tell you that, "You cannot petition the AOA to create a spot becasue they don't create residencies. Residencies are created by individual hospitals, often with help from a medical school. The AOA is working rather hard, though, with congressional leaders to pass legislation that provides "virgin" hospitals with million-dollar, interest-free loans to establish new residencies in family medicine, internal medicine, pediatrics, general surgery, emergency medicine, obstetrics/gynecology, preventive medicine, and psychiatry."

Your version, though, sounds better if all you want to do is bitch about the AOA.

 

[Buckeye(OH)]

Wouldn't the transitional year count as an internship? How would this be a waste if you were to match into an advanced position requiring you to find your own internship before beginning residency as a PGY2? What am I missing? I don't think they are there so people can do them just for the heck of it.

Because almost all programs are linked and there are few PGY2 spots open, if any.

So, in other words, you get to be an intern TWICE!!!!

 

[Peptoboy]

Yes, the above statements are true. But, 10 years from now when less ACGME spots are open to DOs, seeing as MDs are increasing by 30%, then what?

How can the AOA be serious about osteopathic education when it essentially banks on the idea that half its students will enter into ACGME programs?

Why are we creating more schools and slots in schools when we cannot offer these graduates adequate training post graduation?

Why does it seem that there is so much pessimism about the Osteopathic profession in these threads, is there ever going to be a thread made about the great opportunity it is to become a fully licensed physician. From all of the articles I have read, including from the AMA, the D.O. is beginning to be looked upon very favorably and the majority of those who don't look upon it that way are the older generation physician, which like the D.O. older generation cannot give up the past. The AMA had said it was looking to augment class size by 30%, but from the latest data on the AMA website, it appears that goal may come up short. Some schools are actually even doing the opposite in these economic times and cutting back seats and faculty. An example is the University of Utah program, it cut seats by 22%. I think the AMA is going to continue to need the D.O. services in the future. I do agree that the AOA needs to start owning up to their own physicians and creating quality opportunities for them along with opening its doors to Allopathic physicians in the future.

 

[MossPoh]

For every school that cuts slots in the allopathic world there may still be another that expands it. That isn't even counting the deluge of new allopathic schools AND osteopathic schools. You have to expand spots in both the osteopathic and allopathic world. They simply need to approach things differently. If they want more primary care doctors then they shouldn't simply put more people on the market and have the worse ones get funneled into primary care because they can't get anything else. They have to change the core of medical education, as well as make becoming a PCP worthwhile for the best and brightest. This is complicated and will piss people off either way. Someone will lose money whenever someone else gains it. People don't like losing money. Training programs also need to be solvent and capable of evolving with the demands at the time. That goes back to funding and making it profitable for the hospital while reducing the amount of hoops they have to jump through.

 

[SomeDoc]

For every school that cuts slots in the allopathic world there may still be another that expands it. That isn't even counting the deluge of new allopathic schools AND osteopathic schools. You have to expand spots in both the osteopathic and allopathic world. They simply need to approach things differently. If they want more primary care doctors then they shouldn't simply put more people on the market and have the worse ones get funneled into primary care because they can't get anything else. They have to change the core of medical education, as well as make becoming a PCP worthwhile for the best and brightest. This is complicated and will piss people off either way. Someone will lose money whenever someone else gains it. People don't like losing money. Training programs also need to be solvent and capable of evolving with the demands at the time. That goes back to funding and making it profitable for the hospital while reducing the amount of hoops they have to jump through.

Basically, not going to happen- unless there are very few PCP's around. And then again, midlevels will fill in that void. When midlevels are beginning to compete with you for the same PT pool, making primary care look competitive is going to be really hard to do.

 

[DrWBD]

This would be bad if it was true. However, if you really approached a bigshot in the AOA he would tell you that, "You cannot petition the AOA to create a spot becasue they don't create residencies. Residencies are created by individual hospitals, often with help from a medical school. The AOA is working rather hard, though, with congressional leaders to pass legislation that provides "virgin" hospitals with million-dollar, interest-free loans to establish new residencies in family medicine, internal medicine, pediatrics, general surgery, emergency medicine, obstetrics/gynecology, preventive medicine, and psychiatry."

Your version, though, sounds better if all you want to do is bitch about the AOA.

Colbert didn't just join SDN yesterday. Calling him a liar just because you don't agree with him isn't cool.

If we're judging who between the two of you is posting fiction, the whole "the AOA is working rather hard to make new residencies" bit should take the award, hands down. They're been saying that for YEARS. As those with a bit more experience than you can point out, OGME, and GME in general, has remained stagnant for the last two decades. In fact, there are more applicants now per residency position than just about any other point in history! (See Table 4) The government simply doesn't want too many residencies because they're the ones who will be footing the bill. No amount of lobbying by the AOA/AOIA will change that.

 

[DOinMS]

The osteopathic profession cannot be the sole provider of its clinical and graduate education, but nor should it be.

I don't understand why you claim that the AOA shouldn't be the sole provider of its clinical and graduate education. I think, in principle at least, it should do just that. The fact of the matter is that GME isn't nearly as profitable as foundational medical education. As long as COCA allows schools to pop up, and have no commitment to providing adequate GME, this problem will continue.

I would also contend that GME fails to prove itself as a viable business model. Why should the government continue to fund positions that go unfilled year after year? Maybe more funding is not the answer, but instead, allocate current funding where it is needed most. Restrict mid-levels to primary care and use government funding to support GME specialty positions that are in demand or programs that are up-and-coming (e.g. ACHD specialists). Just as the days of the GP passed, maybe the days of the FP or general internist have as well.

 

[Haole]

Because almost all programs are linked and there are few PGY2 spots open, if any.

So, in other words, you get to be an intern TWICE!!!!

The reason I ask is that I have applied to acgme anesthesia. Most of the programs are categorical, but there are a couple that are advanced. I tried to interview at as many anesthesia programs as I could which left no time to interview for acgme internship spots. I didn't worry about it because I knew I could easily scramble into an aoa transitional year for my internship if I match into an advanced allo position. I dont foresee a problem if I do this, do you?

 

[Haole]

Good luck finding a non-primary-care ACGME PGY2-X program which will accept an AOA TRI as PGY-1.

Even if you're going the AOA route, some specialties have modified the TRI requirement, where it is factored in the overall length of the program (shorter than having to do a separate internship).

What about an AOA TRI would be unacceptable? What do programs require that the transitional year lacks? I still dont get how doing a transitional year would require someone to do an extra year. Anyone else have any experience with this?

 

[zmeister22]

What about an AOA TRI would be unacceptable? What do programs require that the transitional year lacks? I still dont get how doing a transitional year would require someone to do an extra year. Anyone else have any experience with this?

I have seen several ACGME programs that accept only ACGME accredited internship years. AOA is often not recognized. How often this happens, I have no idea, but it does happen.

 

[scpod]

I still dont get how doing a transitional year would require someone to do an extra year. Anyone else have any experience with this?

I've known some people who didn't match into the ACGME residency that they wanted. They ended up scrambling into a DO rotating internship and re-applied for the match the following year. There aren't many PGY-2 spots available, though, so they had to do PGY-1 all over again.

 

[meister]

That is just terrible, and if ACGME does what people have been chattering about and locks out DOs due to MDs not being able to match into AOA spots what is going to happen to the hundreds of DOs that don't match anywhere? We'll have a bunch of transitional interns postposting their lives for a while?

Can we just ****ing merge the professions already? This **** is ridiculous, someone needs to kill the AOA bureacracy once and for all. Ugh.

 

[Peptoboy]

That is just terrible, and if ACGME does what people have been chattering about and locks out DOs due to MDs not being able to match into AOA spots what is going to happen to the hundreds of DOs that don't match anywhere? We'll have a bunch of transitional interns postposting their lives for a while?

Can we just ****ing merge the professions already? This **** is ridiculous, someone needs to kill the AOA bureacracy once and for all. Ugh.

Is there a place that I can find that information about the ACGME locking out D.O.'s and leaving hundreds of spots unfilled? Go to the AMA website and read some of their resolutions about Osteopathic Physicians and then tell me that they are "going to lock out" D.O.'s. There is a new one by the Orthopaedic physician foot and ankle society up right this moment. http://www.ama-assn.org/ama1/pub/upload/mm/377/res302a08.pdf

 

[aimee21]

I agree that it's highly unlikely that ACGME will prohibit DOs from entering residency programs. I've never heard nor read anywhere about this happening anytime in the near future. It would honestly be quite ridiculous and completely hypocritical considering the AMA's policies about DOs.

If you have read this though, please post the reference .

 

[meister]

I agree that it's highly unlikely that ACGME will prohibit DOs from entering residency programs. I've never heard nor read anywhere about this happening anytime in the near future. It would honestly be quite ridiculous and completely hypocritical considering the AMA's policies about DOs.

If you have read this though, please post the reference .

There's a reason I said "chattering." I think it mostly has to do with MD students being a little bitter that DOs get access to ACGME spots while MDs are locked out of AOA spots.

Anyway my general point about uniting the profession still stands as having two separate training and licensing systems only hurts us all.

 

[ih8biochem]

I haven't heard of a lockout in the future but I have spoke to my PD who seems to have a fairly good sense the climate of ACGME residency training and he foresees a contraction of residency programs in the future. Reason being, the cost of training doctors is becoming a more and more expense endeavor on top of shrinking Medicare reimbursement and the big uncertainty of what Obama plans on doing. The climate is at a "wait and see" mode right now. Not expanding. And my PD has heard of proposals for one spot per allopathic graduate, justifying that by claiming the ACGME has no obligation to train international/DO graduates.

 

[Peptoboy]

I haven't heard of a lockout in the future but I have spoke to my PD who seems to have a fairly good sense the climate of ACGME residency training and he foresees a contraction of residency programs in the future. Reason being, the cost of training doctors is becoming a more and more expense endeavor on top of shrinking Medicare reimbursement and the big uncertainty of what Obama plans on doing. The climate is at a "wait and see" mode right now. Not expanding. And my PD has heard of proposals for one spot per allopathic graduate, justifying that by claiming the ACGME has no obligation to train international/DO graduates.

Well, I hope it doesn't play out as you have said. That would really kill their little plan to solve the U.S. physician shortage problem, because even with foreign and Osteopathic grads, there remains a shortage in the future. I am not trying to say that anyone is wrong, I am just trying to say that from all that I have read and considering our economic situation right now; I think the AMA is becoming more inclined to be accepting of D.O. students. I think progress is being made in the positive direction at least regarding this point.