ACGME response to failed merger

[DrNightMoves]

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Everyone is making this out to be waaaay bigger than it is. I mean for one, I cant remember any article or correspondence from either side that included the word "merger". Unification of GME people. It would have made the process of applying to residency programs SLIGHTLY EASIER for DO grads, nothing more. You still have every door open to you that you would have if the "merger" went through, you just have to take an extra test and in some cases take an extra year.

 

[DocEspana]

Thanks for the response. I know you've been quite involved in medical politics on the so I was curious as to what bothered you the most about the whole situation. Aside from the AOA internship/residency--> ACGME residency/fellowship issues that started the merger talks in the first place, what if any consequences to you foresee for current DO students? I try to be optimistic and stuff, and downplay any worry, but like a lot of us I'm hoping the ACGME doesn't take its frustration with the AOA out on individual DOs and DO students.

Specifically? That the AACOM and AOA both sent representatives that were supposed to represent their membership to the table. These representatitves agreed on a deal. And for MONTHS... MONTHS... they could have reported back (the MOU in june was almost no different from the one in november 2012, from what Im told) to their home organization and gotten feedback. For MONTHS they did nothing, knowing that the board of trustees for one and the HoD for the other was coming up in mid and late june. They gave themselves one attempt to pass it rather than months to get it nailed out.

but that naive believe that the AOA and AACOM would listen to the best suggestions of the hand picked representation on the matter isn't what bothers me. Its that the comments I heard from people on the inside were that the AOA HoD, in particular, ripped this apart as treason and spitting on AT Still's grave and made up fallacious assumptions about how the MOU must have been reached through arm twisting and blackmail. Which is what happens when you leave a group of a couple hundred people almost completely in the dark and then tell them they have to give it an up or down vote immediately, with no information on how the matter up to this point was feverishly debated already and no choice to modify the document at all with any further debate they have. They will reject it. Its the nature of parlimentary politics. But to do so with on the record remarks that equate to nothing more than fearmongering assumptions (and they stated they were assumptions, but stated in a way where unless you paid attention to the disclaimer, it sure sounded like a declarative sentence of what actually happened).

It is, as I have always said it is, the AOA is self-propogating. In order to move high enough to have a voice, you need to either 1) drink the kool-aid or 2) be independently worthy within the political community. No one rises up the ranks who says anything but the AOA is the world's greatest organization, unless they are politically relevant for other reasons. And the ones who are politically relevant for other reasons (actual elected officials, relevant in the AMA, chairs of osteopathic specialty societies) are FAR outnumbers by the AOA zealots who rise from the lower levels. The level headed students I know in SOMA don't generally get to be the voting members at the HoD, its the "wierd" ones who extra electives in OMM and pay to attend a cranial clinic who get those voting membership spots. The "future" won't solve this. Ask any older DO out there now who is even slightly involved in advocacy, they will tell you that they thought their generation would be the one which changed it. It didnt.

As for fellowships. It was shelved for the time being. Will it be unshelved? No clue.

I wonder if PDs even care about this, or will care about this when they pick/rank their next set of interns. My guess is no, unless that PD was actually involved in the talks directly.

Could unintentionally turn into a lucky app cycle for IMGs.

They won't care. Its exactly as you say, unless they are directly involved in the ACGME going ons they will only have a passing idea of how this worked out, no specific knowledge. And no specific animosity.

In all reality its probably going to be no different for DOs, and as with every year, it will be harder for IMGs

yup. Politics of a (big picture) mostly irrelevant thing doesn't change the math of it all. Too many students, plus a much bigger bias for out of country than different degree = not much changes in that dynamic.

 

[DocEspana]

Everyone is making this out to be waaaay bigger than it is. I mean for one, I cant remember any article or correspondence from either side that included the word "merger". Unification of GME people. It would have made the process of applying to residency programs SLIGHTLY EASIER for DO grads, nothing more. You still have every door open to you that you would have if the "merger" went through, you just have to take an extra test and in some cases take an extra year.

No. Merger has been used. And unification. And solitary accreditation system.

And your evaluation of the difference it would have made is dramatically undervaluing the impact. But you are right about one thing: people are making this out to be much bigger than what it is. Politically its egg on the AOA's face. It's disgraceful. But it changes little for the student body and everything remains at, more or less, status quo.

 

[NurWollen]

Specifically? That the AACOM and AOA both sent representatives that were supposed to represent their membership to the table. These representatitves agreed on a deal. And for MONTHS... MONTHS... they could have reported back (the MOU in june was almost no different from the one in november 2012, from what Im told) to their home organization and gotten feedback. For MONTHS they did nothing, knowing that the board of trustees for one and the HoD for the other was coming up in mid and late june. They gave themselves one attempt to pass it rather than months to get it nailed out.

but that naive believe that the AOA and AACOM would listen to the best suggestions of the hand picked representation on the matter isn't what bothers me. Its that the comments I heard from people on the inside were that the AOA HoD, in particular, ripped this apart as treason and spitting on AT Still's grave and made up fallacious assumptions about how the MOU must have been reached through arm twisting and blackmail. Which is what happens when you leave a group of a couple hundred people almost completely in the dark and then tell them they have to give it an up or down vote immediately, with no information on how the matter up to this point was feverishly debated already and no choice to modify the document at all with any further debate they have. They will reject it. Its the nature of parlimentary politics. But to do so with on the record remarks that equate to nothing more than fearmongering assumptions (and they stated they were assumptions, but stated in a way where unless you paid attention to the disclaimer, it sure sounded like a declarative sentence of what actually happened).

It is, as I have always said it is, the AOA is self-propogating. In order to move high enough to have a voice, you need to either 1) drink the kool-aid or 2) be independently worthy within the political community. No one rises up the ranks who says anything but the AOA is the world's greatest organization, unless they are politically relevant for other reasons. And the ones who are politically relevant for other reasons (actual elected officials, relevant in the AMA, chairs of osteopathic specialty societies) are FAR outnumbers by the AOA zealots who rise from the lower levels. The level headed students I know in SOMA don't generally get to be the voting members at the HoD, its the "wierd" ones who extra electives in OMM and pay to attend a cranial clinic who get those voting membership spots. The "future" won't solve this. Ask any older DO out there now who is even slightly involved in advocacy, they will tell you that they thought their generation would be the one which changed it. It didnt.

As for fellowships. It was shelved for the time being. Will it be unshelved? No clue.




They won't care. Its exactly as you say, unless they are directly involved in the ACGME going ons they will only have a passing idea of how this worked out, no specific knowledge. And no specific animosity.



yup. Politics of a (big picture) mostly irrelevant thing doesn't change the math of it all. Too many students, plus a much bigger bias for out of country than different degree = not much changes in that dynamic.

No. Merger has been used. And unification. And solitary accreditation system.

And your evaluation of the difference it would have made is dramatically undervaluing the impact. But you are right about one thing: people are making this out to be much bigger than what it is. Politically its egg on the AOA's face. It's disgraceful. But it changes little for the student body and everything remains at, more or less, status quo.

Thanks for the info, DocEspana... I think I can speak for a lot of us when I say we really appreciate your contributions to this forum.

 

[Imnoglbln]

It's the absolute hypocrisy of the AOA that bothers me. They said they were presented a "take it or leave it" deal, when in reality the ACGME incorporated a very-last-minute request to "go the extra mile."

This means that the AOA flatout LIED.

And yes, the risk here is for the students, not the AOA, such as President Buser and his subordinates. The old AOA guard that never took the Comlex, nor the USMLE, and who were grandfathered into medicine are now holding their students hostage. Most of them are/were FM/OBYGN/Primary care docs who are now deciding the fate of all DO students who wish to attend wonderful academic centers, largely only accessible through ACGME.

The risk is clearly to loose fellowships for AOA IM residents. That could literally kill IM for osteopathic medicine. There could and will be such sanctions, the ACGME is providing 60% of all DO students with residencies, why shouldn't they have 60% of the say in their education?

 

[salutations]

Thanks for the info, DocEspana... I think I can speak for a lot of us when I say we really appreciate your contributions to this forum.

 

[dozitgetchahi]

The risk is clearly to loose fellowships for AOA IM residents. That could literally kill IM for osteopathic medicine. There could and will be such sanctions, the ACGME is providing 60% of all DO students with residencies, why shouldn't they have 60% of the say in their education?

There seems to be a lot of misunderstanding on this.

For most specialties, your chances of matching a (desirable) ACGME fellowship after attending an AOA residency program are somewhere between 'slim' and 'none'. Yes, a handful of people do it every year, but it's rare. It's really no big loss in this respect because very few people actually pull it off.

What it does affect more directly are the people who want to apply to AOA internships before going on to ACGME advanced residency positions.

 

[Imnoglbln]

What's "desirable" always differs on the person. Location doesn't matter that much for a relatively short fellowship.. and having ACGME fellowship options is huge because most people who do IM also want to do a fellowship.

 

[Deceptacon]

There seems to be a lot of misunderstanding on this.

For most specialties, your chances of matching a (desirable) ACGME fellowship after attending an AOA residency program are somewhere between 'slim' and 'none'. Yes, a handful of people do it every year, but it's rare. It's really no big loss in this respect because very few people actually pull it off.

What it does affect more directly are the people who want to apply to AOA internships before going on to ACGME advanced residency positions.

this is the first i've heard this, i always thought it was relatively easy to land a fellowship after residency regardless of whether it was acgme or aoa. do you mean to say it would be near impossible to land acgme gi/cards after an aoa residency? or that it would be hard to land ANY fellowship in huge academic centers?

 

[SurgeDO]

There seems to be a lot of misunderstanding on this.

For most specialties, your chances of matching a (desirable) ACGME fellowship after attending an AOA residency program are somewhere between 'slim' and 'none'. Yes, a handful of people do it every year, but it's rare. It's really no big loss in this respect because very few people actually pull it off.

What it does affect more directly are the people who want to apply to AOA internships before going on to ACGME advanced residency positions.

i hear of this happening a lot...at least in surgery.

 

[cbrons]

So close...

The real party is going to be when the Federation of State Medical Boards get's together next. The MD and DO reps from every state in the US will get together all at once. I'd pay money to be there.

Not sure why you think such a meeting would be explosive. Those state level bureaucrats have little to do with med-ed afaik and couldn't care less about much more than their individual state-level concerns.

 

[JGimpel]

Not sure why you think such a meeting would be explosive. Those state level bureaucrats have little to do with med-ed afaik and couldn't care less about much more than their individual state-level concerns.

You don't think getting a bunch of DOs and MDs in a room after this big an insult has been dealt by one party to the other would have any lasting effects on the relationship as a whole?

The membership of the FSMB, to be more specific, is of members of the AMA and AOA medical boards, one's that will field a great deal of the complaints and be directly involved in how Residents and GME graduates get licensed and this merger was about...the options for Residents and GME graduates when they are finalizing their education. You can't be licensed as a physician or have your fellowship recognized by the state that you want to practice in unless you follow their exact guidelines. They make the standards for what happens with your USMLE/COMLEX 3 score and the ability to get a license in their individual states.

http://www.fsmb.org/m_usmlestep3.html

The FSMB is also the body that sponsors the FVCS, where all of the information about you, your education and any disciplinary action is stored. It will eventually be mandatory to participate in it and the FSMB holds the keys to this information.

http://www.fsmb.org/fcvs.html

Another way that they affect MDs and DOs is that they also record all of the GME programs that were shut down and, if the merger would have gone through, they would be responsible for making sure that the affected doctors would have established records while they find other programs.

http://www.fsmb.org/fcvs_closedprograms.html

I hope that this is more clear. The bureaucrats got us into this mess and have little chance of getting us out of it. The FSMB has a large amount of oversight into the careers of every physician in the United States, and many of their members are some of the same people that participated in the talks, either behind the scenes or actually in the meetings.

Everyone's definitely entitled to their opinion. Mine is that with this latest slap in the face, tempers in and around the AOA and AMA membership are going to be pretty tense and the effects will be seen for a while. That's not too far of a stretch, is it? And yes, it would be great entertainment to watch what is said and done at those meetings between the different groups.

 

[cbrons]

You don't think getting a bunch of DOs and MDs in a room after this big an insult has been dealt by one party to the other would have any lasting effects on the relationship as a whole?

IMO probably not. I would be surprised if they even heard of the incident .

 

[SpecterGT260]

Let's not forget the reason the unified accreditation was proposed in the first place. The ACGME had them by the balls.

it seriously just burns my short and curlies every time I read this.... not because I disagree but because of how much flak I took when I said it at the get go.

So with this failed deal, does this mean the issues with DOs going into fellowships are going to be a thing now?

 

[SpecterGT260]

Everyone is making this out to be waaaay bigger than it is. I mean for one, I cant remember any article or correspondence from either side that included the word "merger". Unification of GME people. It would have made the process of applying to residency programs SLIGHTLY EASIER for DO grads, nothing more. You still have every door open to you that you would have if the "merger" went through, you just have to take an extra test and in some cases take an extra year.

The reason this unification was conceived was that the ACGME was implementing a rule that would keep non-ACGME trained residents out of its fellowships. This means no more DO cardiologists (as well as a slough of other specialists).

I smelled an implosion back when the JAOA started publishing articles stating that osteopathic physicians were simply better than their MD counterparts.

 

[Dr Yiot]

The reason this unification was conceived was that the ACGME was implementing a rule that would keep non-ACGME trained residents out of its fellowships. This means no more DO cardiologists (as well as a slough of other specialists)

they can do an ACGME IM residency and then apply cards.

 

[SpecterGT260]

they can do an ACGME IM residency and then apply cards.

Yeah, you're right. That was sloppy of me. It basically makes the AOA programs much more undesirable as the AOA has very few fellowships and no money to make any. The deal will reduce the number of DO specialists and make it harder for any given DO to specialize in general.

 

[Dr Yiot]

Yeah, you're right. That was sloppy of me. It basically makes the AOA programs much more undesirable as the AOA has very few fellowships and no money to make any. The deal will reduce the number of DO specialists and make it harder for any given DO to specialize in general.

agreed it will make specializing more difficult but with this new law if you want a fellowship you better go ACGME IM

 

[dozitgetchahi]

this is the first i've heard this, i always thought it was relatively easy to land a fellowship after residency regardless of whether it was acgme or aoa. do you mean to say it would be near impossible to land acgme gi/cards after an aoa residency? or that it would be hard to land ANY fellowship in huge academic centers?

Yes.

And if you don't believe me, head on over to the IM forum and ask the same question.

ACGME GI/cards are often tough to match even coming out of decent mid-tier allo programs; it's even tougher for grads of allo community progs. Applicants from AOA progs aren't going to get the time of day in anything other than the noncompetitive specialties, and even then a successful match is very uncommon because AOA grads cannot be ACGME subspecialty boarded (and no program wants to match people that are never actually going to pass boards).

It's not that common with surgery either.

 

[SpecterGT260]

Yes.

And if you don't believe me, head on over to the IM forum and ask the same question.

ACGME GI/cards are often tough to match even coming out of decent mid-tier allo programs; it's even tougher for grads of allo community progs. Applicants from AOA progs aren't going to get the time of day in anything other than the noncompetitive specialties, and even then a successful match is very uncommon because AOA grads cannot be ACGME subspecialty boarded (and no program wants to match people that are never actually going to pass boards).

It's not that common with surgery either.

not *nearly* impossible. The resolution was to bar non-ACGME residents from ACGME fellowships. So an AOA resident would be ineligible.

 

[dozitgetchahi]

not *nearly* impossible. The resolution was to bar non-ACGME residents from ACGME fellowships. So an AOA resident would be ineligible.

I'm talking about the situation as it stands right now.

 

[MedGrl@2022]

(and no program wants to match people that are never actually going to pass boards).

It's not that common with surgery either.

Are you saying that if you don't get an ACGME residency you can't pass fellowship boards?

 

[Imnoglbln]

Are you saying that if you don't get an ACGME residency you can't pass fellowship boards?

The proposal was to not allow AOA residents to do an ACGME fellowship.

I don't think this proposal has been passed but but it's more likely than ever now that the AOA has taken a **** on their students.

 

[MedGrl@2022]

The proposal was to not allow AOA residents to do an ACGME fellowship.

I don't think this proposal has been passed but but it's more likely than ever now that the AOA has taken a **** on their students.

This is because the AAMC is concerned about the quality of the AOA residencies right? What can/should the AOA do to improve these residencies? In addition, if a DO goes into a ACGME residency then they should be able to do an ACGME fellowship if the new rule were to pass. Is this correct?

 

[Imnoglbln]

if a DO goes into a ACGME residency then they should be able to do an ACGME fellowship if the new rule were to pass. Is this correct?

Yes. Bottom line still is, if you want to be a doctor and can't get into MD then go DO.

 

[CDI]

Yes. Bottom line still is, if you want to be a doctor and can't get into MD then go DO.

You might get stoned for that comment. DOs are about to picket out front your lawn.

 

[JGimpel]

You might get stoned for that comment. DOs are about to picket out front your lawn.

I'm sure many of us are getting stoned to cope with this tragedy.

 

[DocEspana]

I'm sure many of us are getting stoned to cope with this tragedy.

I lost my appetite after the web conference. But this helped me get it right back.

In all seriousness, the biggest reason why we don't need medicinal marijuana is because there has yet to be any conclusive study showing that synthetic THC is not more effective, or non-inferior (though there is at least one that does show a more moderate impact with smoked marijuana in a situation where you would want a more subtle impact, its not of clinical significance only anecdotally interesting)

 

[Dharma]

I lost my appetite after the web conference. But this helped me get it right back.

In all seriousness, the biggest reason why we don't need medicinal marijuana is because there has yet to be any conclusive study showing that synthetic THC is not more effective, or non-inferior (though there is at least one that does show a more moderate impact with smoked marijuana in a situation where you would want a more subtle impact, its not of clinical significance only anecdotally interesting)

Focus upon and isolation of the so-called active constituent amongst an intricate mix of potentially synergistic compounds sounds a bit too simplistic. Everyone's yelling THC, while in the shadow's of delta-9, we find CBCs, amongst other playas.

http://www.ncbi.nlm.nih.gov/pubmed/20619971

http://www.ncbi.nlm.nih.gov/pubmed/21749363

Major thread derailing there... do I smell Phish playing someplace?

 

[DocEspana]

Focus upon and isolation of the so-called active constituent amongst an intricate mix of potentially synergistic compounds sounds a bit too simplistic. Everyone's yelling THC, while in the shadow's of delta-9, we find CBCs, amongst other playas.

http://www.ncbi.nlm.nih.gov/pubmed/20619971

http://www.ncbi.nlm.nih.gov/pubmed/21749363

Major thread derailing there... do I smell Phish playing someplace?

While you are right, in that it is a complex synergy.... It appears that the other active ingredients actually mellow the THC, diminishing (some) of its impacts. In some cases that's better than isolated THC, but generally isolated THC is superior for what we want it to do therapeutic. So isolated synthetic THC does generally outperform smoked herb in most studies seeking actual therapeutic outcomes (sometimes significantly, sometimes without significance).

My source is the very recent medscape article on it. Was just reading it last Thursday. It is chock full of sources on the matter.

 

[group_theory]

Stay On Topic Please

 

[BurghStudent]

I have a related question. Can residents in AOA programs take the allopathic equivalent board certification exams? I.e. become a FACS instead of or in addition to FAOCS? I ask because I've often seen in ACGME fellowship applications that board certification (not necessarily AOA vs ACGME residency) is what matters in terms of eligibility.

 

[Bacchus]

I have a related question. Can residents in AOA programs take the allopathic equivalent board certification exams? I.e. become a FACS instead of or in addition to FAOCS? I ask because I've often seen in ACGME fellowship applications that board certification (not necessarily AOA vs ACGME residency) is what matters in terms of eligibility.

I know you most definitely can if you're in a dually accredited program. I'm required to take the ABFM in addition to the ABOFM.

 

[The kitchen sink]

Are you saying that if you don't get an ACGME residency you can't pass fellowship boards?

Regarding the new prosposal: what if you are an DO resident in an ACGME residency and you have only taken step 2 ck and are looking to apply to ACGME fellowships, are you still allowed to?

 

[DocEspana]

Regarding the new prosposal: what if you are an DO resident in an ACGME residency and you have only taken step 2 ck and are looking to apply to ACGME fellowships, are you still allowed to?

If you are applying this cycle yes. Rules don't go into effect until next years application cycle.

If not, then no*, as you need all four step exams to get a fellowship.

*= I would not rely on being an extraordinary candidate, but if there ever was a time to let extraordinary candidates slip through, it will be then first few years of this change.

Please note: most surgical fellowships (and specialty surgery) are neither aoa nor acgme so this wont apply to them. "Medicine" like fields are highly acgme fellowships though.

 

[NurWollen]

If you are applying this cycle yes. Rules don't go into effect until next years application cycle.

If not, then no*, as you need all four step exams to get a fellowship.

*= I would not rely on being an extraordinary candidate, but if there ever was a time to let extraordinary candidates slip through, it will be then first few years of this change.

Please note: most surgical fellowships (and specialty surgery) are neither aoa nor acgme so this wont apply to them. "Medicine" like fields are highly acgme fellowships though.

Do you foresee a flood of DO students going for ACGME residencies, thereby increasing competition? Or do you think that the DO students who are qualified for ACGME residencies already go for ACGME residencies? Is it possible that highly-qualified DO students who might previously have gone AOA in order to match a highly competitive field (e.g optho, ENT, etc.) might now go ACGME instead, even if it means matching a less competitive specialty?

 

[NontradCA]

If you want an ACGME fellowship, go to an ACGME residency....

 

[DocEspana]

Do you foresee a flood of DO students going for ACGME residencies, thereby increasing competition? Or do you think that the DO students who are qualified for ACGME residencies already go for ACGME residencies? Is it possible that highly-qualified DO students who might previously have gone AOA in order to match a highly competitive field (e.g optho, ENT, etc.) might now go ACGME instead, even if it means matching a less competitive specialty?

The ones who can get to acgme already are.

The ones who want the specialty fields are going aoa and have no reason to go to acgme.

I'd think there is no change at all in application trends.

 

[DocEspana]

If you want an ACGME fellowship, go to an ACGME residency....

Correct. Though I would encourage people to actually look up what acgme fellowships actually are. I've heard some stories about DO surgeons, orthos, emergency med docs, and radiologists going and being worries about this. They shouldn't be.

IM docs, FMs, pediatricians, pathologists? Yes.

 

[The kitchen sink]

Correct. Though I would encourage people to actually look up what acgme fellowships actually are. I've heard some stories about DO surgeons, orthos, emergency med docs, and radiologists going and being worries about this. They shouldn't be.

IM docs, FMs, pediatricians, pathologists? Yes.

Okay just to understand this fully. I am applying for ACGME IM this upcoming cycle so if everything goes well I will start an ACGME residency in July 2014. I have taken:
Comlex 1, 2, pe
Step 2 ck

Here is my main q: With that being said, will i be able to apply to acgme fellowships with that when the time comes which may be sometime around 2017?
Or
Do i have to take step 1, 2cs and 3 to be able to apply?

Thanks

 

[malformation]

Okay just to understand this fully. I am applying for ACGME IM this upcoming cycle so if everything goes well I will start an ACGME residency in July 2014. I have taken:
Comlex 1, 2, pe
Step 2 ck

Here is my main q: With that being said, will i be able to apply to acgme fellowships with that when the time comes which may be sometime around 2017?
Or
Do i have to take step 1, 2cs and 3 to be able to apply?

Thanks

There is absolutely NO USMLE requirements from the ACGME if you complete an ACGME residency for fellowship placement (you don't even have to take step 1/2, as far as ACGME is concerned). Obviously my statement implies nothing about the individual residency/fellowship program requirements. It is merely what ACGME requires (or in this case doesn't require).

As the proposal is currently written, the USMLE rule/policy is ONLY for folks who have NOT completed an ACGME residency and want to go into an ACGME fellowship.

 

[group_theory]

Regarding the new prosposal: what if you are an DO resident in an ACGME residency and you have only taken step 2 ck and are looking to apply to ACGME fellowships, are you still allowed to?

If not, then no*, as you need all four step exams to get a fellowship.

*= I would not rely on being an extraordinary candidate, but if there ever was a time to let extraordinary candidates slip through, it will be then first few years of this change.

Okay just to understand this fully. I am applying for ACGME IM this upcoming cycle so if everything goes well I will start an ACGME residency in July 2014. I have taken:
Comlex 1, 2, pe
Step 2 ck

Here is my main q: With that being said, will i be able to apply to acgme fellowships with that when the time comes which may be sometime around 2017?
Or
Do i have to take step 1, 2cs and 3 to be able to apply?

Thanks

Malformation is correct. DocEspana misread the ACGME proposal

http://www.acgme.org/acgmeweb/Portals/0/PDFs/CPR_Eligibility.pdf

Page 7. The requirements for USMLE [III.A.2.b (3)] falls under III.A.2.b, which deals with fellow eligibility exception. There is no proposal for residents in ACGME residencies to complete USMLE for ACGME fellowship eligibility.


So if you are a DO in an ACGME IM residency program, with only COMLEX scores, under this new proposal, you are eligible for ACGME IM fellowship programs.

If you are a DO in an AOA IM residency program, with COMLEX and USMLE scores (all 3 steps), under this new proposal, you (and the fellowship program) will have to petition the RRC for that ACGME specialty to get approval (and demonstrate to the RRC that you satisfy the exceptionally qualified applicant as set forth in page 7-8)