ACGME Brings the Hammer Down on the AOA

[group_theory]

everyone do your part and cancel your membership to the AOA, they do not represent us

do not worry about backlash, in the end half of us wont have jobs with the way things go,

That's the problem. If you are in an AOA residency, you must be a membership in good standing with the AOA for 2 years immediately prior to taking the board-certification exam.
http://www.osteopathic.org/inside-a...rd-certification/Pages/certification-faq.aspx

If you completed an AOA residency, and took the AOA board (and currently board-certified), one of the condition to continued board-certified is maintaining membership with the AOA (OCC Component 5 requirement)
http://www.osteopathic.org/inside-a...ification/occ-requirements/Pages/default.aspx

Drop AOA membership voluntarily (or they drop you involuntarily for not having enough AOA 1A CME credits within a 3 year time period), and you are no longer board-certified, and cannot claim to be board certified. It may or may not affect you, depending on the requirements of your employers/hospitals/insurance contacts. Some hospital bylaws require active ongoing board certification to maintain hospital privileges. Some insurance contracts


"The requirement for membership in the American Osteopathic Association (AOA) is 120 CME hours. Of this total, 30 CME credits must be obtained in Category 1-A, and the remaining 90 credit hours of the CME requirement may be satisfied with either Category 1-A, 1-B, 2-A, or 2-B credits."
http://www.osteopathic.org/inside-a...ucation/Pages/2010-2012-cme-requirements.aspx


So for many current members of the AOA, they have no choice but to maintain their AOA membership (and go to AOA-approved meetings/conventions to get AOA 1A credits). They can't vote with their feet (or money) and leave the organization.


Simplest solution* - don't do an AOA residency. Do an ACGME residency. You don't have to worry about qualifying for ACGME fellowships, you don't have to worry about maintaining AOA membership to maintain board certification. And you have the option to leave the AOA if you are dissatisfied with their policy/representation. Your AOA-board colleagues will not have that luxury.



*easier said than done. For DO students interested in urology, neurosurgery, orthopedics, ENT, plastics surgery, ophthalmology, - due to the competitiveness and historical bias against DOs, AOA residencies may be the only options (a handful a year do end up in ACGME residencies)

**some states require AOA 1A CME credits to renew an unrestricted medical license. However, you don't need to be a member of the AOA to obtain CME credits (just have to pay the more-expensive non-member rates)

---

Members don't see this ad.

 

[Imnoglbln]

If you apply to a dually accredited program through the AOA match, do you have to submit USMLE scores if you took it? Or is COMLEX enough?

I know going through the ACGME match requires you to submit USMLE scores if you took it.

 

[HockeyDr09]

Some of us have tried to break into the AOA, they take their own like-minded people and relatives over all. I applied for several boards, bureaus, etc over a couple years and just bloody gave up after rejection after rejection. Why I am more involved with the AMA and ACEP/EMRA. There are definitely those of us who have tried.

I have recently (July) been appointed to a B/C/C, so it's not impossible for us to "break" into the AOA. There are usually over 200 applications (to my knowledge) for ~30 positions so you definitely need a bit a luck. I don't believe they only choose like-minded and relatives, because I do not really fall into either of those categories. It does seem like the students chosen are primarily students who are heavily involved in SOMA or COSGP (not saying you aren't), just because they have the experience, and have shown they are willing to dedicate the time and energy. It's one of the reasons I encourage people to get involved early on. That being said, you do NOT have to be a "puppet" to get involved.

I am not surprised that some students get nervous addressing the "real issues" when they move "up the ranks" and get to the point where they are directly heard by AOA leadership, it's more of a daunting task than most on here would believe. It's far easier to post on here and say you would tear into the AOA, then to actually stand face to face with them and say the comments posted on here.

As students we have some VERY legitimate issues that need to be addressed, and (wishful thinking) be corrected. If you've followed my posts (which I doubt anyone has) you'll see I'm not one who is afraid to share to my opinion on the matter, but you have to go about it the right way. Time will tell.

 

[sylvanthus]

I have recently (July) been appointed to a B/C/C, so it's not impossible for us to "break" into the AOA. There are usually over 200 applications (to my knowledge) for ~30 positions so you definitely need a bit a luck. I don't believe they only choose like-minded and relatives, because I do not really fall into either of those categories. It does seem like the students chosen are primarily students who are heavily involved in SOMA or COSGP (not saying you aren't), just because they have the experience, and have shown they are willing to dedicate the time and energy. It's one of the reasons I encourage people to get involved early on. That being said, you do NOT have to be a "puppet" to get involved.

I am not surprised that some students get nervous addressing the "real issues" when they move "up the ranks" and get to the point where they are directly heard by AOA leadership, it's more of a daunting task than most on here would believe. It's far easier to post on here and say you would tear into the AOA, then to actually stand face to face with them and say the comments posted on here.

As students we have some VERY legitimate issues that need to be addressed, and (wishful thinking) be corrected. If you've followed my posts (which I doubt anyone has) you'll see I'm not one who is afraid to share to my opinion on the matter, but you have to go about it the right way. Time will tell.

You don't think the above bolded includes "like minded" people?

 

[HockeyDr09]

You don't think the above bolded includes "like minded" people?

No, I don't. If you've heard some of the arguments that occur during our house of delegates regarding resolutions you'd quickly see that people have VERY different opinions on the ACGME merger, degree name change, and removal of cranial from our curriculum to just list a few. Each school has at least 2 representatives from every DO school for SOMA and 2 representatives from COSGP. The only "like minded" thing they have going for them is that they all go to DO schools.



Edit- I've added the resolution regarding the degree name change as an example. Just scroll down to the resolved as that's the action item. Does this sound like students who are like-minded to the AOA? Now it didn't pass the SOMA HoD, which I'm sure you'd say was because everyone is AOA loving, but it was a close vote, and you don't have to be "on the AOA's side" to disagree with it.

 

[sylvanthus]

No, I don't. If you've heard some of the arguments that occur during our house of delegates regarding resolutions you'd quickly see that people have VERY different opinions on the ACGME merger, degree name change, and removal of cranial from our curriculum to just list a few. Each school has at least 2 representatives from every DO school for SOMA and 2 representatives from COSGP. The only "like minded" thing they have going for them is that they all go to DO schools.



Edit- I've added the resolution regarding the degree name change as an example. Just scroll down to the resolved as that's the action item. Does this sound like students who are like-minded to the AOA? Now it didn't pass the SOMA HoD, which I'm sure you'd say was because everyone is AOA loving, but it was a close vote, and you don't have to be "on the AOA's side" to disagree with it.

Sounds like, as a whole, they are like minded to me. But, believe what you will.

 

[NontradCA]

As a premed applying in the current cycle I feel as though my diamond ring has fell into the garbage disposal while its on, and I'm reaching my hand in to get it.

 

[HockeyDr09]

Sounds like, as a whole, they are like minded to me. But, believe what you will.

How so?
Specifically, how do you find yourself "not like minded", but are able to categorize over 120 students you do not know from all over the country with different ideals, backgrounds, and experience as like minded?

 

[DrBowtie]

How so?
Specifically, how do you find yourself "not like minded", but are able to categorize over 120 students you do not know from all over the country with different ideals, backgrounds, and experience as like minded?

Selection bias. Becoming a rep is a voluntary choice. I'm sure those who are gunning for ACGME and ditching the AOA at first chance are wanting to put forth their efforts in more fruitful organizations for their CV.

 

[HockeyDr09]

Selection bias. Becoming a rep is a voluntary choice. I'm sure those who are gunning for ACGME and ditching the AOA at first chance are wanting to put forth their efforts in more fruitful organizations for their CV.

He already stated he applied for AOA positions, so I'm not sure I agree with that assessment. I speak from experience when I say that plenty of students who are in AOA "leadership positions" go or strongly consider going ACGME. Half of the AOA council of interns and residents are in ACGME programs.

Also, just because a student wants to get involved with advocating for their classmates through the AOA doesn't mean they all have the same stance on these issues, and I've already given examples of how different these opinions are. It's inaccurate to assume that these ~120 students are all like minded on the sole basis that they wanted to get involved.

 

[TrimtheChute]

If you apply to a dually accredited program through the AOA match, do you have to submit USMLE scores if you took it? Or is COMLEX enough?

I know going through the ACGME match requires you to submit USMLE scores if you took it.

When you apply to dual programs, each part has an AOA number and ACGME number. In ERAS if you select the DO match, you put in the dual program AOA number. When the program information is displayed, there is only an option to release COMLEX scores so I do not believe you have to release USMLE scores if you are only applying on the AOA side of the dual program. I was not able to find any way to release my USMLE scores when applying AOA.

 

[darklabel]

No, I don't. If you've heard some of the arguments that occur during our house of delegates regarding resolutions you'd quickly see that people have VERY different opinions on the ACGME merger, degree name change, and removal of cranial from our curriculum to just list a few. Each school has at least 2 representatives from every DO school for SOMA and 2 representatives from COSGP. The only "like minded" thing they have going for them is that they all go to DO schools.



Edit- I've added the resolution regarding the degree name change as an example. Just scroll down to the resolved as that's the action item. Does this sound like students who are like-minded to the AOA? Now it didn't pass the SOMA HoD, which I'm sure you'd say was because everyone is AOA loving, but it was a close vote, and you don't have to be "on the AOA's side" to disagree with it.

An MD, DO degree would've been amazing. I am saddened (and also curious) as to why it didn't pass.

 

[se20001984]

for the love of god,

please CHANGE THE NAME!!

noone cares of Osteopathy!

if you wanna do OMT go into an OMT-specific specialty, me touching someone 2 hrs a week isnt goin to make me an osteopath, its a decent tool but without proper training its a waste of time

i think MAJORITY of people what chance but are scared to say anything..

 

[calvnandhobbs68]

An MD, DO degree would've been amazing. I am saddened (and also curious) as to why it didn't pass.

Yeah that definitely wouldn't make things even more confusing at all.

 

[user3]

An MD, DO degree would've been amazing. I am saddened (and also curious) as to why it didn't pass.

Schools would skyrocket in competitiveness as soon as an MD was offered, and no one would bother putting the DO after their name.

 

[Silent Cool]

Schools would skyrocket in competitiveness as soon as an MD was offered, and no one would bother putting the DO after their name.

Yup.

Turn DO schoosl into MD schools. Offer OMM as an elective for those who actually want to learn it.

Done.

 

[DocEspana]

everyone do your part and cancel your membership to the AOA, they do not represent us

do not worry about backlash, in the end half of us wont have jobs with the way things go,

Can't really do that. Student membership is 100% because it has to be. Same way anyone who goes through aka residency is on the aoa as well. Quitting is difficult and not without repercussions for anyone who is still under an aoa purview.

 

[DocEspana]

I think sylvanthus's point is dead on, its also what you see at the AMA and it's ranks to a lesser degree. It SEEMS that the aoa student level does have significant variance and individual ideas. But the student level can't do anything without the real AOA. Becoming influential in the higher levels is not about getting that voting position.... I've been told that is selected from the kool aid drinkers as well, but that's less important. The power lies in the committee assignments. And committee assignments require a CV showing dedication to the AOA. Not that it requires you to write you are a zealot. But it requires you to state where you have been active so that your actions within the group can be assessed.

The only people getting the next level positions are screened and passed screening. What does that mean? I think we all guess the same thing, but unless someone higher in the AOA shows up we won't know. But I can tell you that iun the AMA, being involved isn't enough. You apply for a committee your activities are all checked... And not for "did yuou attend" but for "what did you contribute". If you pit forward a controversial policy from your student level committee they can trace who spearheaded the push for it and if it is you, you don't get the next position.

The thing with the AMA is that their political alignment and philosophies change dramatically every decade or less, so 50% of us will be students during a policy shift whet both the status quo and controversial changes are considered "desired" so the need to toe the line is only there at times. The AOA has seemed, to an observer, to be rather stagnant in their highly conservative (in many ways, not just natoonal politics) ways for generations. Without any chance in the leadership priorities the selecting force for the new generation of leaders is strong.

I know a few physicians who were extremely active in the AOA in the past and thought their generation would be the ones to change things. Without an exception they are all minimally active in the aoa and they state that less involved, less educated, and less eloquent members than them were rapidly elevated because they represented the past line. The physicians are now either disillusioned AMA members our entirely unaffiliated now.

 

[GUH]

Yup.

Turn DO schoosl into MD schools. Offer OMM as an elective for those who actually want to learn it.

Done.

I think SDN has a lot of DO students who would rather have been MD's.

It's this same attitude that led the California Osteopathic Association to push for the merger debacle we had back in the 1960's.

If you wanted to be an MD, why did you go to a DO school? If it was because your grades/scores weren't high enough, what makes you think you should have the MD degree?

As an MD attending who has seen this issue brought up and rehashed for 10 years, I have to say this makes sense to some degree. I never understood why the ACGME allowed for the system to be a one way street other than pure necessity. Moving forward, with the significant increase in MD spots, I thought one of two things would happen;

1) A merger such that the spots become interchangeable to some degree, that failed

2) ACGME tightening their criteria. The AOA doesn't really have a mechanism to allow MD grads into AOA residencies. To me and many of my colleagues it cannot and should not remain a one way street. If DO's want MD residency spots thats great, open up your spots as well. Or the flip side, tighten criteria and make it such that all MDs are situatied first and any remaining spots open up to DOs.

Controverisal maybe, but both sides have engaged in this back and forth for far too long with no real resolution.

I understand your concern, but given that most DO students in the ACGME match end up in primary care, don't you think that blocking out DO students could exacerbate the primary care physician shortage?

 

[VA Hopeful Dr]

I understand your concern, but given that most DO students in the ACGME match end up in primary care, don't you think that blocking out DO students could exacerbate the primary care physician shortage?

First, the previous poster said OK to opening ACGME spots AFTER all US MDs are matched. Second, there are bunches of FMG/IMGs out there as well.

 

[HockeyDr09]

I think sylvanthus's point is dead on, its also what you see at the AMA and it's ranks to a lesser degree. It SEEMS that the aoa student level does have significant variance and individual ideas. But the student level can't do anything without the real AOA. Becoming influential in the higher levels is not about getting that voting position.... I've been told that is selected from the kool aid drinkers as well, but that's less important. The power lies in the committee assignments. And committee assignments require a CV showing dedication to the AOA. Not that it requires you to write you are a zealot. But it requires you to state where you have been active so that your actions within the group can be assessed.

The only people getting the next level positions are screened and passed screening. What does that mean? I think we all guess the same thing, but unless someone higher in the AOA shows up we won't know. But I can tell you that iun the AMA, being involved isn't enough. You apply for a committee your activities are all checked... And not for "did yuou attend" but for "what did you contribute". If you pit forward a controversial policy from your student level committee they can trace who spearheaded the push for it and if it is you, you don't get the next position.

The thing with the AMA is that their political alignment and philosophies change dramatically every decade or less, so 50% of us will be students during a policy shift whet both the status quo and controversial changes are considered "desired" so the need to toe the line is only there at times. The AOA has seemed, to an observer, to be rather stagnant in their highly conservative (in many ways, not just natoonal politics) ways for generations. Without any chance in the leadership priorities the selecting force for the new generation of leaders is strong.

I know a few physicians who were extremely active in the AOA in the past and thought their generation would be the ones to change things. Without an exception they are all minimally active in the aoa and they state that less involved, less educated, and less eloquent members than them were rapidly elevated because they represented the past line. The physicians are now either disillusioned AMA members our entirely unaffiliated now.

You were told incorrectly, unless you believe I am a koolaid drinker (which you may, for all I know). All student committee positions are decided by a committee of students who are the leaders in SOMA and COSGP. I've already done my best to explain how large of variance there is between students who get involved in these organizations.

I know you know quite a bit about the AMA side (far more than me, admittidly), but neither you nor sylvanthus have seen first hand how students are elected and selected for these positions. I have, and I'm telling you that both of your assessments are incorrect.

It's fine if you do not trust my experience, or take my for my word, but it is what it is. The students who are involved in SOMA/COSGP and NOT like minded, they have huge variance in viewpoints. The students chosen of AOA's B/C/C's are decided on by the leaders of SOMA/COSGP, not practicing physicians that "drank the kool aid". Obviously the selection committee is going to choose people who are actively involved in SOMA/COSGP, what do you expect? It's easy to get involved in these organizations, and shows that you have experience.

 

[Doctor Bob]

As an MD attending who has seen this issue brought up and rehashed for 10 years, I have to say this makes sense to some degree. I never understood why the ACGME allowed for the system to be a one way street other than pure necessity.

...To me and many of my colleagues it cannot and should not remain a one way street. If DO's want MD residency spots thats great, open up your spots as well.

As a DO attending... I feel the same way. It has always bugged me to no end that the disparity exists. What's so special about DO residencies that MD students can't go to them? It's a bit of hypocrisy to bang a drum saying we're the same and should be allowed into your residencies, then turn around and say you're not as special as we are so our residencies are closed to you.

 

[darklabel]

Yeah that definitely wouldn't make things even more confusing at all.

A previous poster said the name should change to MDO, designate that you are a medical doctor, but also an osteopathic physician. I see nothing wrong with that.

Schools would skyrocket in competitiveness as soon as an MD was offered, and no one would bother putting the DO after their name.

Idk why thats an issue, the best should be physicians. However, I do like grade forgiveness where someone can change their life around and not be held back from old grades. But I know some people feel differently about this but oh well.

And to the Attending who said the Match should accommodate MD's first then leftovers go to DOs, I don't see why that has to be instituted. They are already heavily favored and if a DO nabs a spot in the ACGME, he damn well deserves it since it takes hard work to get one (from my understanding). If an MD doesn't match, its either because they shot too high or did REALLY poorly (multiple failed boards, etc).

 

[NeuroAP86]

To the poster saying that us MD should get the spot before any DOs, how is this any different than an FMG or IMG taking a US MD spot? There are many different medical degrees around the world but they all take the Usmle and are competitive for those same spots. So if I take the Usmle and do better than someone who is applying for the same spot that is an us MD, your telling me that person should get the spot instead of me? Sounds like a bunch of crap to me. Also, let's say they open up the DO spots to MD, how many us MD's are actually going to apply for the those spots??

 

[darklabel]

Darklabel,

That was me. As a pre-med you might not know how it works but the reality is that as it currently exists it is a one way street; DO grads can take ACGME residency spots while MD grads cannot get an AOA spot. My statement was that as long as that remains, all MD grads should have first pick over DO grads for ACGME spots only. The AOA needs to open up their residency spots to MDs or understand that the ACGME is well within its right to limit DOs into theirs, its simpe equity.

Ahh well, in that case I agree, it should be a two way street.

You're right, I'm pre-med, but always good to know what you're getting yourself into.

 

[Dharma]

As an MD attending who has seen this issue brought up and rehashed for 10 years, I have to say this makes sense to some degree. I never understood why the ACGME allowed for the system to be a one way street other than pure necessity. Moving forward, with the significant increase in MD spots, I thought one of two things would happen;

1) A merger such that the spots become interchangeable to some degree, that failed

2) ACGME tightening their criteria. The AOA doesn't really have a mechanism to allow MD grads into AOA residencies. To me and many of my colleagues it cannot and should not remain a one way street. If DO's want MD residency spots thats great, open up your spots as well. Or the flip side, tighten criteria and make it such that all MDs are situatied first and any remaining spots open up to DOs.

Controverisal maybe, but both sides have engaged in this back and forth for far too long with no real resolution.

This makes sense. The lack of reciprocity seems like a flawed approach, which outsiders (and attending MDs not so much in the know) may construe as a means for DO grads to gain "backdoor access" to competitive specialities. Whether true or not, many believe this and it only adds to the DO discrimination out there.

No one liked that kid down the street who would want to play with everyone else's toys but never shared his... what a brat!

 

[BinderClip]

To the poster saying that us MD should get the spot before any DOs, how is this any different than an FMG or IMG taking a US MD spot? There are many different medical degrees around the world but they all take the Usmle and are competitive for those same spots. So if I take the Usmle and do better than someone who is applying for the same spot that is an us MD, your telling me that person should get the spot instead of me? Sounds like a bunch of crap to me. Also, let's say they open up the DO spots to MD, how many us MD's are actually going to apply for the those spots??

Just to make sure I have your post interpreted correctly, you seem like you are going to enter the NRMP match and hope for an ACGME residency based on your scores. In addition, you do not seem to value any of the AOA residencies available, stating that US Seniors may NOT choose to match into those positions even if available.

Quite frankly, that is an incredibly myopic statement. First, the point of the discussions on the ACGME-AOA merger was not to debate whether or not DO Seniors should be able to match into ACGME programs. DO students, even with these newest Common Program Requirements revisions WILL be able to enter the NRMP match as long as they plan around the revised CPR. The second issue is, "Is it fair to expect one governing body's students to utilize the resources of another without the former giving anything back in return?"

I say, "No." Just because you see no value in AOA programs does not mean some US Seniors will feel the same. Consider competitive programs such as Ortho, Derm or other similar fields. Those students looking just to match may consider them ideal or at least worth looking into. Furthermore, not all US Seniors look to go into research - a community program may be something that aligns with their interests as opposed to a university program.

Long story short, your argument of, "The most qualified candidate should get the position," holds true both ways. It it incredibly hypocritical to justify it otherwise. Now, you might raise an interesting point as to whether or not Program Directors would be willing to adopt a meritocratic stance if both residnecy pathways are available. With respect to your last statement, we will never know until those programs are opened to the MD's.

 

[DocEspana]

You were told incorrectly, unless you believe I am a koolaid drinker (which you may, for all I know). All student committee positions are decided by a committee of students who are the leaders in SOMA and COSGP. I've already done my best to explain how large of variance there is between students who get involved in these organizations.

I know you know quite a bit about the AMA side (far more than me, admittidly), but neither you nor sylvanthus have seen first hand how students are elected and selected for these positions. I have, and I'm telling you that both of your assessments are incorrect.

It's fine if you do not trust my experience, or take my for my word, but it is what it is. The students who are involved in SOMA/COSGP and NOT like minded, they have huge variance in viewpoints. The students chosen of AOA's B/C/C's are decided on by the leaders of SOMA/COSGP, not practicing physicians that "drank the kool aid". Obviously the selection committee is going to choose people who are actively involved in SOMA/COSGP, what do you expect? It's easy to get involved in these organizations, and shows that you have experience.

Not student committees. "Student" anything is more or less irrelevant except to cut your teeth and get the experience to move up. I was talking about AOA committees. Same way I was saying being a voting member of the whole aoa is some tiny power, but its not really worth much. Being on an aoa committee is where the decisions are made.

What ive been told explicitly is that no one gets on a committee, regardless of the appearance of a voting system, without approval of the physician leadership. Or specifically, a non veto. Specifically I've talked to a physician who is still active in the AOA and AMA and he said that is the difference that drives him crazy, that there is veto from above to prevent "unqualified" people from being elected or appointed in to committees. Claims he has seen one used before. But he says that he's only seen it used for someone who was "popular but unqualified" so they vetoed an appointment.

The same guy also says that the mercurial nature of student stances undercuts everything they do. So we aren't talking about the worlds best advocate for students on either side of thebspectrum, to give context.

 

[Drrrrrr. Celty]

Darklabel,

That was me. As a pre-med you might not know how it works but the reality is that as it currently exists it is a one way street; DO grads can take ACGME residency spots while MD grads cannot get an AOA spot. My statement was that as long as that remains, all MD grads should have first pick over DO grads for ACGME spots only. The AOA needs to open up their residency spots to MDs or understand that the ACGME is well within its right to limit DOs into theirs, its simpe equity.

Except you're looking at it from the wrong perspective. Plenty of ACGME residencies will not look at DOs at all right now. In the end AOA residencies just bring DO students up to the same chances of getting a residencies in a specific field. If ACGME residencies were to suddenly and happily look at DO apps then maybe it'd be a fair exchange.

 

[HockeyDr09]

Not student committees. "Student" anything is more or less irrelevant except to cut your teeth and get the experience to move up. I was talking about AOA committees. Same way I was saying being a voting member of the whole aoa is some tiny power, but its not really worth much. Being on an aoa committee is where the decisions are made.

What ive been told explicitly is that no one gets on a committee, regardless of the appearance of a voting system, without approval of the physician leadership. Or specifically, a non veto. Specifically I've talked to a physician who is still active in the AOA and AMA and he said that is the difference that drives him crazy, that there is veto from above to prevent "unqualified" people from being elected or appointed in to committees. Claims he has seen one used before. But he says that he's only seen it used for someone who was "popular but unqualified" so they vetoed an appointment.

The same guy also says that the mercurial nature of student stances undercuts everything they do. So we aren't talking about the worlds best advocate for students on either side of thebspectrum, to give context.

I understand where your coming from, but I do not think you understand how AOA B/C/C's are organized. They ALL are official AOA committees. Students sit side-by-side with physicians. There is only one committee that is primarily students and that is the council of student affairs (which is logical to be primarily composed of students), which still has physician representation. Obviously the physicians opinion is more heavily weighed on a majority of the committee's, but seriously what to you expect. The AOA Student Trustee sits on the AOA Board of Trustees for student input directly into the AOA BOT. The Student Trustee is decided by students NOT by the AOA. There is no "veto" power for this position. As far as veto power for other positions, the AOA President has the power to veto a newly appointed member but its EXTREMELY rare, as you said, your "contact" has only seen it once. There are students who sit on a majority of the AOA's B/C/C's

I entirely understand your point that the students who are involved can be shut down by physicians, but this can happen in every major organization that allows students. My point is that students do have a fair amount of representation in the AOA, and if we get involved we can begin to have an influence. I'd rather try to get involved, then assume I'm going to get shut down because of a "veto power" that's used once in a blue moon, and I'd encourage other students who are interested in getting involved to do so instead of believing they are not going to ever have an impact.

 

[dozitgetchahi]

I think SDN has a lot of DO students who would rather have been MD's.

It's this same attitude that led the California Osteopathic Association to push for the merger debacle we had back in the 1960's.

If you wanted to be an MD, why did you go to a DO school? If it was because your grades/scores weren't high enough, what makes you think you should have the MD degree?

The point is that whether the AOA likes it or not, its schools have become the 'second pathway' to a US medical license for those who could not gain entry to MD institutions. It's the elephant in the room that nobody seems to want to talk about. At my school, the number of osteopathic 'true believers' was minimal, and the vast majority of the people in my class would openly admit that they would have rather been MDs. Hell, the AOA itself has conducted research indicating that >95% of its own physicians do not even practice the one modality that supposedly makes DOs 'unique' (i.e., OMM). I don't know about you, but when 95% of a given profession's practitioners don't even practice things that are unique to that profession, that doesn't sound like a thriving, 'independent' profession to me. It sounds like a situation where everyone has gotten off the bus.

Bottom line: the 'osteopathic profession' is in the midst of a massive identity crisis, and the AOA totally doesn't get it. Barely anyone else in the profession cares about the things that the people at the top care about, and no amount of hand-waving and speechmaking by the people at the top is going to change that. The era where osteopathic medicine actually was a 'unique, independent' profession has actually already passed.

 

[Imnoglbln]

Right now 60% of DO students match ACGME (correct me if I'm wrong). The ACGME needs DO's to match their IM/FM/Psych spots. They don't want to discourage applications to a degree where they would only get left-overspots.

 

[Imnoglbln]

I understand where your coming from, but I do not think you understand how AOA B/C/C's are organized. They ALL are official AOA committees. Students sit side-by-side with physicians. There is only one committee that is primarily students and that is the council of student affairs (which is logical to be primarily composed of students), which still has physician representation. Obviously the physicians opinion is more heavily weighed on a majority of the committee's, but seriously what to you expect. The AOA Student Trustee sits on the AOA Board of Trustees for student input directly into the AOA BOT. The Student Trustee is decided by students NOT by the AOA. There is no "veto" power for this position. As far as veto power for other positions, the AOA President has the power to veto a newly appointed member but its EXTREMELY rare, as you said, your "contact" has only seen it once. There are students who sit on a majority of the AOA's B/C/C's

I entirely understand your point that the students who are involved can be shut down by physicians, but this can happen in every major organization that allows students. My point is that students do have a fair amount of representation in the AOA, and if we get involved we can begin to have an influence. I'd rather try to get involved, then assume I'm going to get shut down because of a "veto power" that's used once in a blue moon, and I'd encourage other students who are interested in getting involved to do so instead of believing they are not going to ever have an impact.

I'm sorry but you have been drinking the koolaid. Even the top ACGME governmental body is elected, in the AOA this is not the case. You have already admitted that reporting the the AOA top officials is daunting task. This honest statement has confirmed my own experience, fear and obedience is a big part of the AOA culture.

 

[IMDoc607]

I think US seniors would definitely take advantage of the ability to apply to AOA spots in the competitive fields. Some of my classmates who didn't match cardiology or GI would of jumped at any fellowship.

 

[HockeyDr09]

I'm sorry but you have been drinking the koolaid. Even the top ACGME governmental body is elected, in the AOA this is not the case. You have already admitted that reporting the the AOA top officials is daunting task. This honest statement has confirmed my own experience, fear and obedience is a big part of the AOA culture.

ANY student position that reports to a massive physician organization would be a daunting task.An ACGME student trustee would be just as daunting. I think you're drinking the SDN kool-aid if you think it wouldn't be intimidating to speak freely about student issues to any major physician organization.Do you speak freely with Program Directors and your attendings about how they are wrong about that disease they told you you were wrong about when you know you're right about because you just looked it up? My point was that it's so easy to state your opinion on these forums, but I'd like to see many of the posters actually get involved and air these issues out in the real world.

 

[HockeyDr09]

With the increase in MD grads due to new schools and expansion at existing schools and the ever available FMG/IMG contingent, I dont see this as a problem. Real question is what would the AOA and DO grads do if those spots disappeared?

This is the real question, and one that really concerns me with the direction the AOA is heading. I spoke on the floor about the potential consequences of "veto'ing" the MOU, and how something like this could be a long term outcome. For the sake of DO students, let's hope something like this doesn't happen.

 

[darklabel]

With the increase in MD grads due to new schools and expansion at existing schools and the ever available FMG/IMG contingent, I dont see this as a problem. Real question is what would the AOA and DO grads do if those spots disappeared?

and you pretty much said why I am mostly pissed at the AOA as a potential DO student. The LCME is well on its way accrediting new schools and sure, the classes even entering now may not exactly see the full effect, but in the very long term, DOs would be in trouble when USMD graduates equal number of GME spots available in ACGME, then the ACGME will want nothing to do with the AOA.

I really hope the AOA comes to its senses because they need them so much more than the ACGME needs the AOA.

 

[DocEspana]

ANY student position that reports to a massive physician organization would be a daunting task.An ACGME student trustee would be just as daunting. I think you're drinking the SDN kool-aid if you think it wouldn't be intimidating to speak freely about student issues to any major physician organization.Do you speak freely with Program Directors and your attendings about how they are wrong about that disease they told you you were wrong about when you know you're right about because you just looked it up? My point was that it's so easy to state your opinion on these forums, but I'd like to see many of the posters actually get involved and air these issues out in the real world.

Students and residents (who usually caucus together) make up a huge percent (>33%) of the ama vote structure. With that much group power, the students and residents are deferred to quite often because we can vote as a block, unlike the physicians. It is very common to aggressively disagree with the physicians at the am a *on matters students have a horse in* because they know it's very difficult to pass anything without us and we have to be courted. Students are there biggest voting block in the full ama. Residents are the second biggest.

 

[evilbooyaa]

Right now 60% of DO students match ACGME (correct me if I'm wrong). The ACGME needs DO's to match their IM/FM/Psych spots. They don't want to discourage applications to a degree where they would only get left-overspots.

The ACGME does not 'need' DOs. If DOs had 0 access to ACGME residencies, there would likely still be enough IMGs/FMGs to fill most spots. I believe PDs prefer most DOs over most IMGs/FMGs, however, and therefore are more willing to give them spots.

I agree with wagy about opening up DO programs to MD applicants, even if there is a selection bias (like is present in some/most MD programs). At least have the theoretical possibility, or don't claim equivalence. Even if MDs were allowed to apply to DO programs, and there were some (a small percentage) DO residencies (analogous to Vanderbilt) who said they don't take MDs, period, fine.

 

[NeuroAP86]

I have no problem opening up DO residencies to MD's. I am sorry if I sounded like the opposite of that. I agree that it should be a two way street but I think the same thing that happens to those trying to match in competitive specialties in they will only take DOs. But we shall see where this all goes. The main reason I am going acgme is due the lack of DO residencies both in quality and quantity (neurology).

 

[Dharma]

Actually, it has been my experience, as someone who has been in academics in the past, that it goes the other way. DO grads don't gain backdoor access to competitive specialties like derm, plastics, rad onc, etc. very often. More often DOs end up in IM programs, anesthesia (increasingly competitive), etc rather than competitive specialties MD programs. I think that has been some of the concern with opening up DO residencies to MDs, the fear that DOs who already have a tough time getting int competitive specialty MD residencies woud then face similar competition for specialty DO spots which arent that numerous to begin with. But such is the nature of equity, if you want to have a chance at any MD spots you have to open up all DO spots to be truly fair.

I was referring to the more competitive specialities in AOA residencies that are currently not accessible to MD grads. Some worry about increased competition for those spots, but I say bring it. I don't think it's a stretch to say that those AOA programs would show favor towards DO grads, similar to that seen in current MD programs. If folks truly want an even playing field opening the doors sounds like the right thing to do. Fear is a funny thing though.

 

[as1212559]

Another thing to note is that just because mds may be allowed to apply for do residencies under a merger, doesn't mean they will suddenly match off the charts in the competitive do programs. Do programs are well known for being interested in students they know, and often will rank people who have auditioned higher than people with better numbers who haven't. This bias will surely extend to md students applying. So while the spots will be fair game for all, I wouldn't expect pcoms ortho program to suddenly be all mds or anything.

Plus if there are any hardcore do PDs they will stick to dos anyhow, just like some md PDs do.

 

[Dharma]

Another thing to note is that just because mds may be allowed to apply for do residencies under a merger, doesn't mean they will suddenly match off the charts in the competitive do programs. Do programs are well known for being interested in students they know, and often will rank people who have auditioned higher than people with better numbers who haven't. This bias will surely extend to md students applying. So while the spots will be fair game for all, I wouldn't expect pcoms ortho program to suddenly be all mds or anything.

Plus if there are any hardcore do PDs they will stick to dos anyhow, just like some md PDs do.

yep. which is why people shouldn't worry IMO. only ones that should worry are those who aren't up to par...

 

[GUH]

yep. which is why people shouldn't worry IMO. only ones that should worry are those who aren't up to par...

There are far fewer AOA than ACGME specialty slots, and many more MD graduates than DO graduates. Even if just a small fraction of those MD's take up what are now the few spots in competitive specialties reserved for DO's, it could have a very significant impact on the chances a DO has for matching into such specialties.

I would be fine with merging if and only if ACGME residency programs in competitive specialties are required to meet defined quotas of DO's in their programs.

 

[DrBowtie]

There are far fewer AOA than ACGME specialty slots, and many more MD graduates than DO graduates. Even if just a small fraction of those MD's take up what are now the few spots in competitive specialties reserved for DO's, it could have a very significant impact on the chances a DO has for matching into such specialties.

I would be fine with merging if and only if ACGME residency programs in competitive specialties are required to meet defined quotas of DO's in their programs.

Quotas? Seriously?

 

[VA Hopeful Dr]

There are far fewer AOA than ACGME specialty slots, and many more MD graduates than DO graduates. Even if just a small fraction of those MD's take up what are now the few spots in competitive specialties reserved for DO's, it could have a very significant impact on the chances a DO has for matching into such specialties.

I would be fine with merging if and only if ACGME residency programs in competitive specialties are required to meet defined quotas of DO's in their programs.

Fine, then DO residencies must do the same.

Do you honestly think, as has been said earlier, that if a merger went through that all of the DO programs would just up and start taking MD students willy-nilly? The same discrimination that happens in MD program would happen in the other direction for DO programs.

 

[Deceptacon]

There are far fewer AOA than ACGME specialty slots, and many more MD graduates than DO graduates. Even if just a small fraction of those MD's take up what are now the few spots in competitive specialties reserved for DO's, it could have a very significant impact on the chances a DO has for matching into such specialties.

I would be fine with merging if and only if ACGME residency programs in competitive specialties are required to meet defined quotas of DO's in their programs.

you should be able to land a residency based on your academic merits.

 

[as1212559]

Quotas...

Ich don't think so.

 

[evilbooyaa]

There are far fewer AOA than ACGME specialty slots, and many more MD graduates than DO graduates. Even if just a small fraction of those MD's take up what are now the few spots in competitive specialties reserved for DO's, it could have a very significant impact on the chances a DO has for matching into such specialties.

I would be fine with merging if and only if ACGME residency programs in competitive specialties are required to meet defined quotas of DO's in their programs.

You can't have your cake and eat it too. If you want equal opportunity, then there can't be quotas. If you want equal opportunity (but with PD bias towards MD in ACGME residencies, and bias towards DO in AOA residency), there can't be quotas.

 

[BinderClip]

There are far fewer AOA than ACGME specialty slots, and many more MD graduates than DO graduates. Even if just a small fraction of those MD's take up what are now the few spots in competitive specialties reserved for DO's, it could have a very significant impact on the chances a DO has for matching into such specialties.

I would be fine with merging if and only if ACGME residency programs in competitive specialties are required to meet defined quotas of DO's in their programs.

This sentiment may (and a very weak "may" at that) if programs were run by computers. (Un)fortunately, they are not. They are run by human program directors who have biases. DO program directors at top institutions will want to see where the top applicants in their pool stand, presumably just as the ACGME would.

Furthermore, emphasized applicant traits tend to vary between programs. Interview considerations, for instance, can be generally divided between auditioning at top AOA programs and meeting the average scores of previous applicants at top ACGME programs. Do you really think that PD's of competitive programs were hankering for MD grads all of this time?

Now I'm curious what the underlying reason for your quotas argument is. What are you worried about, in particular? That your application isn't as "competitive" as a MD? That the ACGME will somehow consume all of the AOA programs and leave DO grads with nothing? This is not an attack on you, I'm genuinely curious as to what this defensive move has to offer you in particular.