ACGME & AOA Move Toward a Single Match

[GypsyHummus]

And this ladies and gentlemen, is what we call a compromise.

This is going to be really really bad for DO students graduating in the next 5-10 years, but good for the osteopathic profession in the long term. All this does is help to close the discrimination gap if everyone is held to the same standards.

It will suck for people who went to DO school shooting for that orthopedic spot knowing they had a better chance matching with AOA. I predict this will help DOs going into primary care fellowships like endo, cardio, super specialties, but hurt those going into a surgical field.

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[calvnandhobbs68]

Your assumption is that the AOA is making this up and that MD's are more qualified for traditionally DO residencies? Seems legit...

I don't think that's a terribly "way out there" thing to consider. Even the people that go unmatched in the highly competitive specialties tend to be top pool candidates. There aren't a ton of these residency spots in AOA but I'm betting it's going to make it even more competitive for DO students (which isn't good for them no matter how you look at it).

I really do think they will be moving into one giant cross-match if the AOA residencies are going to come under ACGME accreditation.

 

[MedPR]

Good step, but anyone with anti-DO bias is still going to hate on them.

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[mimi2kul]

Dont forget that any MD student interested in ANY previously AOA-only spot will be Required to have OMM traning of some sought. So pretty much whether MD students like it or not, they will have to learn OMM in order to have any shot at previously only DO residencies be it Derm/optho/ortho/surgery/rads or just whatever competitive specialty residency.

 

[calvnandhobbs68]

Dont forget that any MD student interested in ANY previously AOA-only spot will be Required to have OMM traning of some sought. So pretty much whether MD students like it or not, they will have to learn OMM in order to have any shot at previously only DO residencies be it Derm/optho/ortho/surgery/rads or just whatever competitive specialty residency.

Eh we'll see how intensive that training is. They're apparently currently in "talks" about it right now but I doubt the ACGME is going to be cool with the AOA making their students d*ck around too much with OMM stuff when they're supposed to be doing their residency. The ACGME has most of the leverage in this deal so I doubt things will be too rough for MD students trying to match to AOA residencies.

 

[Bacchus]

Lolz for AOA. Definite ceding of power.

I predict a fall in DOs specializing. There won't be any protected spots and they'll have to compete on the open market.

We don't know that. The full detail is not available yet. In an email from the AOA they said they will not remove OPP/OMM from their core competencies. The allopathic students will have to meet those requirements. How this will be done, I don't know.

I wouldn't be surprised either if there was some sort of regulation saying you need to have a certain percentage of MDs and DOs in your program.

 

[SoulinNeed]

We don't know that. The full detail is not available yet. In an email from the AOA they said they will not remove OPP/OMM from their core competencies. The allopathic students will have to meet those requirements. How this will be done, I don't know.

I wouldn't be surprised either if there was some sort of regulation saying you need to have a certain percentage of MDs and DOs in your program.

I HIGHLY doubt that this will happen. An ACGME program is not going to reject a qualified MD student for an underqualified DO student, and vice versa. Enforcing it would also be difficult, simply because the number of MD students far outnumbers DO students.

 

[Frazier]

We don't know that. The full detail is not available yet. In an email from the AOA they said they will not remove OPP/OMM from their core competencies. The allopathic students will have to meet those requirements. How this will be done, I don't know.

I wouldn't be surprised either if there was some sort of regulation saying you need to have a certain percentage of MDs and DOs in your program.

Hmm...disagree. I think that instilling some 'quasi-DO-affirmative action/quotas' would actually be very surprising.

We aren't talking med school accreditation, on what grounds will they enact that? ...Bringing "degree diversity" to the school residency program is essential to best serving patient well-being?

 

[mimi2kul]

Eh we'll see how intensive that training is. They're apparently currently in "talks" about it right now but I doubt the ACGME is going to be cool with the AOA making their students d*ck around too much with OMM stuff when they're supposed to be doing their residency. The ACGME has most of the leverage in this deal so I doubt things will be too rough for MD students trying to match to AOA residencies.

While DO students are not restricted into applying into MD residencies, the fact remains there are still some MD programs that will discriminate against a DO applicant regardless of their qualifications, you cannot force the specific programs to take a DO student and I see just the same thing happening with the MD students trying to apply to a previously DO only residency. At the end of the day, it will depend on the PD's to decide who they accept regardless of whether that MD applicant has a perfect application. It will be based upon how the PD's see you as a good fit for their program. I personaly love the move and the fact that we both can learn something from each other when training side by side. This decision was long overdue!

 

[calvnandhobbs68]

While DO students are not restricted into applying into MD residencies, the fact remains there are still some MD programs that will discriminate against a DO applicant regardless of their qualifications, you cannot force the specific programs to take a DO student and I see just the same thing happening with the MD students trying to apply to a previously DO only residency. At the end of the day, it will depend on the PD's to decide who they accept regardless of whether that MD applicant has a perfect application. It will be based upon how the PD's see you as a good fit for their program. I personaly love the move and the fact that we both can learn something from each other when training side by side. This decision was long overdue!

Oh definitely I was just talking with regards to the OMM requirement. I doubt the ACGME is going to make MD students jump through too many OMM hoops after they've basically given full access to ACGME fellowships to AOA residents.

 

[mimi2kul]

I dont think the AOA will accept the ACGME to make it a short deal either, considering the fact that we have to do several hours of OMM through out 1st and 2nd year, and also 1month of OMM rotation before graduating. It will surely be the same hours an MD student will have to do or just a lil less but not by a huge difference to be considered competent with OMM skills. Anyone can read a book and pass a test but you have to be able to perform those skills to real patients.

 

[SoulinNeed]

I dont think the AOA will accept the ACGME to make it a short deal either, considering the fact that we have to do several hours of OMM through out 1st and 2nd year, and also 1month of OMM rotation before graduating. It will surely be the same hours an MD student will have to do or just a lil less but not by a huge difference to be considered competent with OMM skills. Anyone can read a book and pass a test but you have to be able to perform those skills to real patients.

The problem with this is that ACGME has all the leverage.

 

[Arbor Vitae]

I honestly don't understand why they're so hell bent on keeping them separate. From my [limited] exposure to DO physicians, they have all told me that they practice the same as their MD counterparts. If the end result of patient care is the same regardless of MD or DO, why keep two separate systems?

Yeah, I don't get why we need 2 separate systems. I think there was a point where they could have combined, but the DOs were stubborn and wanted to be different and govern themselves. I think it's they reconsidered just merging to all be the same organization. What would be the difference really? Lower tier schools would still produce mainly PCPs.

 

[mimi2kul]

The problem with this is that ACGME has all the leverage.

NOPE! I do not see it as a leverenge, I see it as a compromise btw both parties. Remember the AOA still stands and it is not going anywhere for both political and monetary reasons. The ACGME does not call all the shots, they work together! The last thing I see is AOA giving up any form of osteopathic philosophy/ OMM techniques. If an MD student wants an AOA residency so bad, they will just have to stick up with the OMM training and get what they want and can decide to abandon it later on. Oh heck, they can just go straight to the ACGME programs and dont worry about OMM. it will be their choice, but I dont see AOA watering down the OMM techniques that we are required to learn.

 

[SoulinNeed]

NOPE! I do not see it as a leverenge, I see it as a compromise btw both parties. Remember the AOA still stands and it is not going anywhere for both political and monetary reasons. The ACGME does not call all the shots, they work together! The last thing I see is AOA giving up any form of osteopathic philosophy/ OMM techniques. If an MD student wants an AOA residency so bad, they will just have to stick up with the OMM training and get what they want and can decide to abandon it later on. Oh heck, they can just go straight to the ACGME programs and dont worry about OMM. it will be their choice, but I dont AOA watering down the OMM techniques that we are required to learn.

Personally, I believe that MD students will have to show some OMM competency to apply to AOA spots. The AACOM has already made that clear. However, I don't think the ACGME will force MD students do some strenuous OMM preparation. Maybe it'll just be added to the USMLE as an optional portion or something, but I don't think it'll be something huge. Just my speculation, though.

 

[calvnandhobbs68]

NOPE! I do not see it as a leverenge, I see it as a compromise btw both parties. Remember the AOA still stands and it is not going anywhere for both political and monetary reasons. The ACGME does not call all the shots, they work together! The last thing I see is AOA giving up any form of osteopathic philosophy/ OMM techniques. If an MD student wants an AOA residency so bad, they will just have to stick up with the OMM training and get what they want and can decide to abandon it later on. Oh heck, they can just go straight to the ACGME programs and dont worry about OMM. it will be their choice, but I dont see AOA watering down the OMM techniques that we are required to learn.

Dude are you joking? Look back at the history of this...it all started when the AOA started flipping a **** when the ACGME said last year they wouldn't let students in AOA residencies go to ACGME fellowships. Don't kid yourself. The AOA options were either 1) Let the ACGME screw them over by basically taking out ACGME fellowships for AOA residency trained students or 2) Cut a deal with the ACGME. They decided to choose 2.

Not to mention go to your own boards...tons of DO students think OMM is a joke anyway. Sorry if you're some OMM fanatic. As was said, I doubt they'll make them waste their time taking some OMM class for AOA residencies after they've basically just let DOs easily enter ACGME residencies through a combined match.

 

[drizzt3117]

A lot of you ppl just don't get it. The ACGME forced the AOA to accept this deal to keep what they already have. In return they open thousands of residency spots to their grads. These residency spots will be ACGME certified, not AOA. They'll be regulated by the LCME. You're smoking crack if you think the ACGME is going to ask their grads to pay anything less than lip service to OMM. In 10 years when there's 4000 more MD students, it may be hard for DO students to get a spot at all.

I'm not saying this is a bad deal for the AOA; they probably did as well as they could. It's always bad when you're negotiating to keep something you already have and the other side has all the leverage. However, down the road this may very well lead to the end of the dual degree system.

 

[Bacchus]

It was part of the agreement OPP/OMM REMAINS as a core competency.

 

[calvnandhobbs68]

It was part of the agreement OPP/OMM REMAINS as a core competency.

I guess it depends on what you mean by "competency". I severely doubt MD students will have to take the same amount of time doing OMM as DO students do.

From their own website:

"Allowing MDs to enter into osteopathic-focused training programs will also be part of our transition discussions with ACGME. However, if they are allowed into osteopathic-focused programs, we would work with ACGME to identify educational prerequisites or other accomplishments or "check points" expected for MDs to meet in regard to OPP and OMM. The same would apply for IMGs."

http://www.osteopathic.org/inside-aoa/Pages/acgme-frequently-asked-questions.aspx

 

[Badgers326]

Or you could just see some of the former AOA residencies discriminating against the MDs.

 

[drizzt3117]

I guess it depends on what you mean by "competency". I severely doubt MD students will have to take the same amount of time doing OMM as DO students do.

From their own website:

"Allowing MDs to enter into osteopathic-focused training programs will also be part of our transition discussions with ACGME. However, if they are allowed into osteopathic-focused programs, we would work with ACGME to identify educational prerequisites or other accomplishments or “check points” expected for MDs to meet in regard to OPP and OMM. The same would apply for IMGs."

http://www.osteopathic.org/inside-aoa/Pages/acgme-frequently-asked-questions.aspx

So basically lip service.

 

[drizzt3117]

Or you could just see some of the former AOA residencies discriminating against the MDs.

PDs are going to look for the best possible candidates. At the very least you'll see some dilution, at worst DOs will get crowded out. As more MD spots open and the applicant base gets more diluted, you'll see a more significant difference in the quality of applicants as well. I think the more established DO schools will probably be fine for awhile, but the newer and sketchy ones... Look out.

 

[blizzah]

Or you could just see some of the former AOA residencies discriminating against the MDs.

Yeah, and I could win the lottery next week

 

[Poetic Silence]

The way I'd like to see it is that every grad of American medical school graduates with an MD while those who complete an osteopathic residency are granted the additional DO (diplomat of osteopathy) as the founder of osteopathic medicine intended.

DO should be in addition to MD, not an alternative to MD, and only if people wish to study it in an AOA residency.

This, though, is a fantastic step for American physicians. I may look into osteopathic medical school more seriously now.

 

[RandomChampion]

The way I'd like to see it is that every grad of American medical school graduates with an MD while those who complete an osteopathic residency are granted the additional DO (diplomat of osteopathy) as the founder of osteopathic medicine intended.

DO should be in addition to MD, not an alternative to MD, and only if people wish to study it in an AOA residency.

This, though, is a fantastic step for American physicians. I may look into osteopathic medical school more seriously now.

that's not really what's going on, and there's more to DO vs MD if youre looking at it in terms of principles.

Edit: didnt see your "like" in there. whoops nevermind

 

[xBODOMx]

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[g2daizh]

Does anyone know how this will affect boards?

 

[Dharma]

This is the first step at turning DO schools into training PCPs only

[YOUTUBE]http://www.youtube.com/watch?v=CEH66V2jMxU[/YOUTUBE]

 

[Oo Cipher oO]

[YOUTUBE]http://www.youtube.com/watch?v=CEH66V2jMxU[/YOUTUBE]

You are right. Us DO students are doomed to FM. How will we ever compete with the mighty MD students?

DO students have been matching into ACGME residencies for decades (some specialties more than others). I don't expect you will see any significant drop in the number of DOs going into a competitive specialty between now and then.

 

[RomanTaylor]

You are right. Us DO students are doomed to FM. How will we ever compete with the mighty MD students?

DO students have been matching into ACGME residencies for decades (some specialties more than others). I don't expect you will see any significant drop in the number of DOs going into a competitive specialty between now and then.

Oppa! NOW it's a party!

 

[MedPR]

Or you could just see some of the former AOA residencies discriminating against the MDs.

That would be both ironic and idiotic.

 

[mehc012]

You are right. Us DO students are doomed to FM. How will we ever compete with the mighty MD students?

DO students have been matching into ACGME residencies for decades (some specialties more than others). I don't expect you will see any significant drop in the number of DOs going into a competitive specialty between now and then.

Right, many DOs do match into ACGME residencies in competitive specialties. I wouldn't expect that number to drop. I'm much more concerned about the DOs who now match into non-ACGME residencies in competitive specialties. Those are the ones at risk when they merge, if only because there's a much larger MD applicant pool.

Assuming the residencies which are currently ACGME certified continue to accept a similar number of MDs and DOs as they do now, that means that if any MD gets into a previously DO-specific competitive residency, than the number of DOs matching into that specialty decreases. Period.

 

[Trauma_DOc]

Ultimately at least in former AOA residencies the best applicant will be chosen regardless of some arbitrary initials. Over time it will balance out. Before this DOs could not be instructors at ACGME residencies now that is no longer the case. The descision opens a lot of opportunities for DOs. The military has had combined DO/MD residencies for years and are near equal in makeup relative to application numbers. For those who say DOs can't match competitive "MD" residencies, graduates from my school matched to Mayo and Hopkins last year.

 

[calvnandhobbs68]

I really think the people who got screwed the most in this deal are the IMGs (US or non). With basically who knows how many more DOs applying to ACGME spots the IMGs are most likely going to be the ones to get pushed out of everywhere first. I'm not terribly concerned for US MD or DO graduates at this point until we start to reach saturation of all residency spots.

 

[mehc012]

Ultimately at least in former AOA residencies the best applicant will be chosen regardless of some arbitrary initials. Over time it will balance out. Before this DOs could not be instructors at ACGME residencies now that is no longer the case. The descision opens a lot of opportunities for DOs. The military has had combined DO/MD residencies for years and are near equal in makeup relative to application numbers. For those who say DOs can't match competitive "MD" residencies, graduates from my school matched to Mayo and Hopkins last year.

I'm not saying they can't (they already do)...I'm saying that of the ones who will, many already do. The only change this will make for DOs getting into MD residencies is that it will remove the problem of the dual match systems. On the other hand, DOs currently have some protected residencies in competitive fields, so once those are open to the entire applicant pool, it's likely that some MDs will make it into them; which means fewer DOs will.

I'm also not talking about competitive locations (Mayo, Hopkins), I'm talking about competitive specialties.

 

[PartyAnimal]

Another good question is how this will impact US IMGs?

 

[Chiroptile]

As a current osteopathic student, I would just like to say.. I always thought it was weird that we could match ACGME while MD kids could not do AOA.. Didn't like it.. Was very excited to hear the news today. Only fair, and a win-win for both parties, the way I see it.

 

[blizzah]

As a current osteopathic student, I would just like to say.. I always thought it was weird that we could match ACGME while MD kids could not do AOA.. Didn't like it.. Was very excited to hear the news today. Only fair, and a win-win for both parties, the way I see it.

uhhhhhhh how is it a win for DO? nothing was gained by DO schools today other than a slightly closer affiliation with md. but now md students can take your residencies

 

[Chiroptile]

Not here to argue.. I'm in medical school to become a physician, and the more streamlined that process is, the fewer hoops to jump through, the better for me, and for you. I'm not worried about MDs being able to match AOA. I'm worried about getting a good score on my boards and performing on rotations.

 

[FrkyBgStok]

this is all assuming that the health care system and training stays as it is, which it probably won't. there is a problem with a lack of PCPs. What happens when insurance companies, medicare, name your system start paying less for specialties and the wage gap is closed. people are probably going to go into specialties less if PCP works 50 hours and pays $180k and ortho works 70 hours and pays $200k. and if everyone has access to the same residencies, maybe time will allow people to choose schools based on fit and location as opposed to letters. why wouldn't this bring DO school entrance stats up? why couldn't you see some of your better DO schools with 3.6, 31 stats? Moreover, why do people automatically assume that the future MD students will always and forever be better than the future DO students? if this becomes a joint degree or even a DMD vs. DDS type of thing, which would that mean DOs are going to be PCPs exclusively?

 

[toxicwombat]

Not here to argue.. I'm in medical school to become a physician, and the more streamlined that process is, the fewer hoops to jump through, the better for me, and for you. I'm not worried about MDs being able to match AOA. I'm worried about getting a good score on my boards and performing on rotations.

Well said.

 

[SoulinNeed]

this is all assuming that the health care system and training stays as it is, which it probably won't. there is a problem with a lack of PCPs. What happens when insurance companies, medicare, name your system start paying less for specialties and the wage gap is closed. people are probably going to go into specialties less if PCP works 50 hours and pays $180k and ortho works 70 hours and pays $200k. and if everyone has access to the same residencies, maybe time will allow people to choose schools based on fit and location as opposed to letters. why wouldn't this bring DO school entrance stats up? why couldn't you see some of your better DO schools with 3.6, 31 stats? Moreover, why do people automatically assume that the future MD students will always and forever be better than the future DO students? if this becomes a joint degree or even a DMD vs. DDS type of thing, which would that mean DOs are going to be PCPs exclusively?

Specialty pay will likely drop over the next decade, but it's not getting anywhere near that level. Ortho will still pay MUCH higher than PCP, lol.

 

[FrkyBgStok]

Specialty pay will likely drop over the next decade, but it's not getting anywhere near that level. Ortho will still pay MUCH higher than PCP, lol.

Nice thought, but be aware that in other countries, PCPs make more than specialists. I hope you are right.

 

[Life Sucks]

Healthcare.........a mess that's Papier-mâché ; bawled up with string barely holding it.

 

[NickNaylor]

Specialty pay will likely drop over the next decade, but it's not getting anywhere near that level. Ortho will still pay MUCH higher than PCP, lol.

Other than the increased length of training there is nothing intrinsic to being a specialist versus a PCP that warrants the drastically higher pay. Especially as payer systems shift more to performance-based than procedure-based schemes, the traditionally high-paying surgical specialties will be hard hit. Non-surgical specialties (e.g., IM fellowships) might fare a little better though.

(sent from my phone)

 

[Drrrrrr. Celty]

uhhhhhhh how is it a win for DO? nothing was gained by DO schools today other than a slightly closer affiliation with md. but now md students can take your residencies

Plenty of qualified DO's opt out of the MD match for the safety of the DO match. This combined with the fact that it's doubtful that too many formerly AOA residencies will be taking many MD's thanks to the OMM requirement.
So I'd still say that the average DO student benefits from this and will continue to benefit from this.

 

[zoner]

this is all assuming that the health care system and training stays as it is, which it probably won't. there is a problem with a lack of PCPs. What happens when insurance companies, medicare, name your system start paying less for specialties and the wage gap is closed. people are probably going to go into specialties less if PCP works 50 hours and pays $180k and ortho works 70 hours and pays $200k. and if everyone has access to the same residencies, maybe time will allow people to choose schools based on fit and location as opposed to letters. why wouldn't this bring DO school entrance stats up? why couldn't you see some of your better DO schools with 3.6, 31 stats? Moreover, why do people automatically assume that the future MD students will always and forever be better than the future DO students? if this becomes a joint degree or even a DMD vs. DDS type of thing, which would that mean DOs are going to be PCPs exclusively?

Nice post

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[drizzt3117]

Plenty of qualified DO's opt out of the MD match for the safety of the DO match. This combined with the fact that it's doubtful that too many formerly AOA residencies will be taking many MD's thanks to the OMM requirement.
So I'd still say that the average DO student benefits from this and will continue to benefit from this.

Nothing in the agreement talked about a OMM requirement. Read it again.

 

[XCourtSmash]

Nothing in the agreement talked about a OMM requirement. Read it again.

Well according to the DO thread, the guy watching the livestream of the AACOM Q&A last night:

-2015, all AOA programs will receive ACGME accreditation, in addition to AOA Accred

-by 2018 all programs will be up to par (or face closure)

-Its not certain whether MDs (US, IMG, FMG) will be able to attend AOA programs. This will be decided over the next 3 years and will be program to program (so, maybe some programs will allow MD, and some wont, etc)

From the FAQ of AACOM:

Allowing MDs to enter into osteopathic-focused training programs will also be part of our transition discussions with ACGME. However, if MDs are allowed into osteopathic-focused programs, we would work with ACGME to identify educational prerequisites or other accomplishments or “check points” expected for MDs to meet in regard to OPP and OMM, and ambulatory training. The same would apply for IMGs.

So it sounds like IF they allow MD's into the AOA spots, they will require them go through a test or some OMM classes before allowing them to apply for the AOA spots. Doesn't seem to difficult though, but a slight hassle.

 

[HM3]

You will see more DO grads going into PC specialties. You can try to spin it any way you want. This is not necessarily a bad thing.