AOA and ACGME merge!!

[spartan9]

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But in the short term, absent new restrictions that are not in place as part of this agreement, the IMG wave will flow over the AOA residencies.


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I see. Well my understanding is that current ACGME programs as well as AOA programs being absorbed by ACGME and effectively becoming ACGME programs WILL have restriction of IMG percentages. I'm not saying eliminated, just restricted, which as I previously mentioned was the initial impetus for the ACGME revamp to begin with and there is no reason to think those restrictions don't still exist and the FAQ merely states that IMGs can enter what are going to be "osteopathic focused" ACGME programs, which was always the case the major overhaul is the restricted amounts of IMGs allowed to enter in any ACGME program. For me thats who really is taking the hit on this deal is NON American trained medical students, which quite frankly is how it should be IMO.

 

[hallowmann]

...That said, this is a neutral for US MDs and a net gain for DOs. It just saddens me that an organization like COCA can get away with irresponsible behavior in opening tons of new medical schools when the AOA didn't have enough residency spots for them. This alone proves that the DO community doesn't really care about the DO philosophy, because they don't care about sending more than half of their graduates to the "dark side." I mean, Liberty University (aka dinosaur fossils are a lie put in the ground by the devil and the world is 6k years old) has a ******* DO school. DeVry University has a DO school. Do you really think these students are competing with even the lowest tier of MD graduates? Of course not. Most DOs will still be less competitive than MDs across the board. What this does is alleviate the burden on the AOA for taking a fat dump on the DO brand.

First off, if you have a problem with COCA, I wouldn't really then say that the whole "DO community" doesn't care. Also, while I don't agree with the constant expansion of DO schools, COCA has added new requirements for accreditation including affiliated GME training sites and a >98% GME placement for DO graduates. Plus, just last year, AOA added something around 1000 new residency slots (closer to 200-300 a year realistically).

Secondly, what DO school is owned by DeVry? The only for-profit US medical school (although this may change given the recent for-profit MD school applicants to the LCME and the LCME's recent change in policies with regards to for-profit schools), RVU-COM, is owned by one guy. Now he happens to be the same guy who owned AUC, the Caribbean MD school, before he sold it to DeVry, but no US medical school (DO or MD) is owned by DeVry.

Also, lets be realistic, the only people DO expansion is really hurting are the IMGs/FMGs. Now unless DO schools suddenly double in their admissions to the point that the >6000+ spots currently going to IMGs/FMGs dissappear, that's not changing anytime soon. Now I'm not for neverending expansion of DO schools, and I'm certainly for increasing GME numbers, but lets not act like the recent DO expansion (which I believe is still less numerically than the 30% projected US MD class size/school expansion meant to take place from 2006-2016) is ruining medicine.

 

[BurghStudent]

Remember this?

http://news.providencejournal.com/breaking-news/2012/04/ri-house-commit-1.html

 

[TheFuture_22]

Well, there are some well known ACGME residencies that are basically crap but they still exist. Of course, AMDs avoid them like the plague precisely because they are crap. So by itself, ACGME is not a precise measure of quality.

That said, this is a neutral for US MDs and a net gain for DOs. It just saddens me that an organization like COCA can get away with irresponsible behavior in opening tons of new medical schools when the AOA didn't have enough residency spots for them. This alone proves that the DO community doesn't really care about the DO philosophy, because they don't care about sending more than half of their graduates to the "dark side." I mean, Liberty University (aka dinosaur fossils are a lie put in the ground by the devil and the world is 6k years old) has a ******* DO school. DeVry University has a DO school. Do you really think these students are competing with even the lowest tier of MD graduates? Of course not. Most DOs will still be less competitive than MDs across the board. What this does is alleviate the burden on the AOA for taking a fat dump on the DO brand.

DeVry does not own a DO school. Rather, they own two MD schools. Get your facts straight please.

 

[ulikedaggers]

First off, if you have a problem with COCA, I wouldn't really then say that the whole "DO community" doesn't care. Also, while I don't agree with the constant expansion of DO schools, COCA has added new requirements for accreditation including affiliated GME training sites and a >98% GME placement for DO graduates. Plus, just last year, AOA added something around 1000 new residency slots (closer to 200-300 a year realistically).

Secondly, what DO school is owned by DeVry? The only for-profit US medical school (although this may change given the recent for-profit MD school applicants to the LCME and the LCME's recent change in policies with regards to for-profit schools), RVU-COM, is owned by one guy. Now he happens to be the same guy who owned AUC, the Caribbean MD school, before he sold it to DeVry, but no US medical school (DO or MD) is owned by DeVry.

Also, lets be realistic, the only people DO expansion is really hurting are the IMGs/FMGs. Now unless DO schools suddenly double in their admissions to the point that the >6000+ spots currently going to IMGs/FMGs dissappear, that's not changing anytime soon. Now I'm not for neverending expansion of DO schools, and I'm certainly for increasing GME numbers, but lets not act like the recent DO expansion (which I believe is still less numerically than the 30% projected US MD class size/school expansion meant to take place from 2006-2016) is ruining medicine.

I agree with most of this. However, comparing MD expansion to DO expansion is apples to oranges. To my knowledge, MD expansion will primarily be class-size increases whereas DO expansion has been opening of new schools. Accepting more students to a school that otherwise has everything in place (curriculum, faculty, administration, etc) is not as risky as creating a new school altogether.

 

[SouthernSurgeon]

DeVry does not own a DO school. Rather, they own two (OFFSHORE) MD schools. Get your facts straight please.

I included a rather important distinction that you left out.

I agree with most of this. However, comparing MD expansion to DO expansion is apples to oranges. To my knowledge, MD expansion will primarily be class-size increases whereas DO expansion has been opening of new schools. Accepting more students to a school that otherwise has everything in place (curriculum, faculty, administration, etc) is not as risky as creating a new school altogether.

Almost ten years ago now there was a big push from the LCME/AMA to expand the number of seats at US MD schools. I believe the figure they were targeting was an overall 20% expansion. A lot of schools, once they saw how that expansion was impacting them (and the fact that no new residencies were opening up) quickly backed off of that after an initial exuberant period of expansion.

Now there are actually a number of new MD schools opening in the next few years, which is a very new phenomenon - from ~1985 to 2005 there were only I think 2 new MD schools that opened, and none from 1985-2000.

 

[Psai]

DeVry does not own a DO school. Rather, they own two MD schools. Get your facts straight please.

Lol because Caribbean schools are the same as USMD amirite?

 

[TheFuture_22]

Lol because Caribbean schools are the same as USMD amirite?

I wasn't trying to say they were the same.

 

[Beth_W737]

As I said in another thread, there are some great DO schools that are better than some mid-low tier MD programs. There are also some not so great programs. Mine has a large OPTI including fellowships in GI, cards, ID, hem/onc. I chose to do an AOA program because I was applying for EM which gets more and more competitive, I'd rather definitely match than risk not matching. A lot of my very strong friends and classmates feel the same. For me this matters for fellowship, I'm really relieved I'll have more options open.

 

[Trogghunter]

As I said in another thread, there are some great DO schools that are better than some mid-low tier MD programs. There are also some not so great programs. Mine has a large OPTI including fellowships in GI, cards, ID, hem/onc. I chose to do an AOA program because I was applying for EM which gets more and more competitive, I'd rather definitely match than risk not matching. A lot of my very strong friends and classmates feel the same. For me this matters for fellowship, I'm really relieved I'll have more options open.

Just saying, but graduating from a 'low tier' or brand new school will give you a much better shot in the match than pcom, tcom, msucom, ccom with a similar/less stellar app.
If you do ER at a current AOA program, you better make sure that it's up to snuff for when the acgme comes by to review, or it'll get cut if the hospital doesn't comply to 1) >6 students/yr 2) a certain faculty/resident ratio.

 

[DrEnderW]

If you do ER at a current AOA program, you better make sure that it's up to snuff for when the acgme comes by to review, or it'll get cut if the hospital doesn't comply to 1) >6 students/yr 2) a certain faculty/resident ratio.

ACGME requires >6 students per PG year?

That would preclude essentially 100% of current AOA competitive residencies. That volume of residents wouldn't even be feasible at those programs if the spots were funded. Interesting to see what will happen on that front.

 

[spartan9]

Just saying, but graduating from a 'low tier' or brand new school will give you a much better shot in the match than pcom, tcom, msucom, ccom with a similar/less stellar app.
If you do ER at a current AOA program, you better make sure that it's up to snuff for when the acgme comes by to review, or it'll get cut if the hospital doesn't comply to 1) >6 students/yr 2) a certain faculty/resident ratio.

As I have stated previously I think these broad generalization are inaccurate and overstated in my opinion. People are going to be judged as individuals and by individuals. Whoever is evaluating you is going to look at the quality of your character and the quality of your application and your willingness to learn and be taught. Ultimately you are going to be judged on those things regardless of where you come from. I think this massive discrepancy between quality students from either MD or DO backgrounds is vastly overstated. If it were that significant I wouldn't know as many people as I do who came out of DO school and matched into competitive ACGME fields. Once again I'm not saying that is the case as a whole for DO students, but the point is still clear, which is that a quality applicant is a quality applicant and the opposite is also true. Your allopathic vs. osteopathic background is not going to outweigh the aforementioned qualities of an individual, or lack thereof.

 

[Beth_W737]

My EM has 6-7 straight EM residents plus 2 EM/IM. And lots of faculty, we are at my schools teaching hospital system. I think ours is safe

 

[Elisabeth Kate]

I agree with most of this. However, comparing MD expansion to DO expansion is apples to oranges. To my knowledge, MD expansion will primarily be class-size increases whereas DO expansion has been opening of new schools. Accepting more students to a school that otherwise has everything in place (curriculum, faculty, administration, etc) is not as risky as creating a new school altogether.

There are many new MD schools opening up.

 

[Elisabeth Kate]

ACGME requires >6 students per PG year?

That would preclude essentially 100% of current AOA competitive residencies. That volume of residents wouldn't even be feasible at those programs if the spots were funded. Interesting to see what will happen on that front.

Pretty sure this is only a requirement for ER, not all ACGME residencies.

 

[ulikedaggers]

I included a rather important distinction that you left out.



Almost ten years ago now there was a big push from the LCME/AMA to expand the number of seats at US MD schools. I believe the figure they were targeting was an overall 20% expansion. A lot of schools, once they saw how that expansion was impacting them (and the fact that no new residencies were opening up) quickly backed off of that after an initial exuberant period of expansion.

Now there are actually a number of new MD schools opening in the next few years, which is a very new phenomenon - from ~1985 to 2005 there were only I think 2 new MD schools that opened, and none from 1985-2000.

There are many new MD schools opening up.

Any estimate of how many students the new schools (MD and DO) will be taking each year?

 

[rjgennarelli]

I think the biases against DOs by MD PDs will still be there, and DO PDs (who have never had MD students to deal with) will bias against MDs.

I agree with, but I am sure the AOA/ACGME will try to find a way to work around this.

According to their web site they already have ~9300 residency programs and through this merge they gain ~1000 DO residency programs, of which who knows how many are going to be up to their standards and not placed on probation...I really don't see the point.

The differences between the residency educational requirements are actually not that far off. Differences between the programs according to William Gifford, MD from MSU:

https://scs.msu.edu/media/GME/2011-06/Comparison of AOA and ACGME Educational Requirements.pdf

Finally someone saying something of relevance rather than conjecture. One of the biggest reason these talks got underway is because of the FOREIGN and OFF SHORE trained medical students who were taking ACGME residency spots and leaving American trained students without slots or reducing the number of slots in areas of interest. That issue was impetus for these talks from the very beginning and was the primary issue that led ACGME to investigate limiting and/or restricting non American trained students from taking ACGME residencies. With all this MD DO back and forth it seems to me like shooting at the wrong target.

How do you know this? What is your source?

Training program in what, exactly? I missed this on my first read through but this sounds like rubbish to me. You mean to tell me MD grads who match into former DO programs for urology, peds, etc. are going to have to undergo additional training? Presumably this would be in OMM or something (which is fraudulent and non-evidence-based and shouldn't be forced on DO students much less MD students), but could there be more that would be required?

You wouldn't be willing to go through a crash course in OMM/OPP if you really wanted to get into orthopaedic surgery?

Many DOs are already applying for allopathic residencies but in certain specialties, they face an enormous bias. Yes, this will create more competition for MDs but programs (provided they become more inviting toward DOs) now have a better pool of applicants. MDs can also apply for osteopathic programs as well for specific reasons such as location.

There are many excellent DO residencies but there is a huge number of DO residencies that shouldn't be accredited. The ACGME standards will weed out the terrible residencies.

It will not create anymore competition for MDs. 55% of DOs match ACGME as it is. It will likely not change by very much.

I'm not sure I agree with this. I'm not exactly sure of the numbers, but aren't there something like 5k DO graduates per year and 2900 AOA residency spots per year? That means there are already ~2000 DOs going to ACGME programs (obviously excluding DOs who do not match at all). I assume that most of those 2k are strong applicants who were confident enough to forego the AOA match. Now if we look at this purely statistically, half of all applicants are average or below average, so that's 2500. Assuming, again, that most of the 2000 ACGME matching DOs are strong applicants, that leaves only 500 "new" strong applicants in the MD program pool. It also adds 2500 "new" average to below average applicants.

Flawed logic. The general idea for DOs (at least at my school) is to stay away from certain allopathic specialties that have not necessary "opened up" to DOs at this point. Usually they are the more competitive ones: orthopedic surgery, neurosurgery, radiology, ophthalmology. Thus many of the more "competitive" applicants will stay away from the NRMP. For internal medicine, non-OMM based FM, peds etc. It is the general consensus to apply allopathic as these specialties are easier to get into, and are more willing to accept DOs (and usually have them).

 

[ulikedaggers]

You wouldn't be willing to go through a crash course in OMM/OPP if you really wanted to get into orthopaedic surgery?

Is OMM on step 3? I know that SDN says most DOs don't use OMM in their practice, but do all DOs need to keep up with OMM to pass their boards? Or does OMM only get tested for those DOs who want to practice (and bill) it?

Flawed logic. The general idea for DOs (at least at my school) is to stay away from certain allopathic specialties that have not necessary "opened up" to DOs at this point. Usually they are the more competitive ones: orthopedic surgery, neurosurgery, radiology, ophthalmology. Thus many of the more "competitive" applicants will stay away from the NRMP. For internal medicine, non-OMM based FM, peds etc. It is the general consensus to apply allopathic as these specialties are easier to get into, and are more willing to accept DOs (and usually have them).

Point taken, but there is a difference between competitive applicants and applicants wanting to go into competitive specialties. Sure, someone who matches into ortho would probably be competitive for IM, but they aren't applying for IM so they aren't adding to the "competitive applicant" pool for IM.

 

[Elisabeth Kate]

It will not create anymore competition for MDs. 55% of DOs match ACGME as it is. It will likely not change by very much

That's the IMG match rate. It's in the 70 something for DOs in the ACGME.

 

[rjgennarelli]

That's the IMG match rate. It's in the 70 something for DOs in the ACGME.

What I meant was ~50-55% of graduating DOs will match into an allopathic residency. 40-45% will match into an aoa residency. ~2% will not match at all. Around 95-98% of DOs will match on the first attempt.

It is about 54% for IMGs (at least this is what I read about IMGs).

 

[HarryPlopper]

It will not create anymore competition for MDs. 55% of DOs match ACGME as it is. It will likely not change by very much.

Overall the increased competition may not be significant, but can you be sure that this will not be the case for highly coveted specialties like derm and ortho? Many DOs going into these fields stick mainly with AOA because their chances in ACGME are slim. Ideally the merger will increase the chances of DOs getting into ACGME ROAD specialties and thus creating more competition for MDs.

 

[BurghStudent]

Overall the increased competition may not be significant, but can you be sure that this will not be the case for highly coveted specialties like derm and ortho? Many DOs going into these fields stick mainly with AOA because their chances in ACGME are slim. Ideally the merger will increase the chances of DOs getting into ACGME ROAD specialties and thus creating more competition for MDs.

One thing to clarify, because I've been drawing the same conclusions. How do we know this will effect DO bias at all on the ACGME side especially in competitive specialties? I'll wager it will still be as hard for DOs to get into ROAD or Nsurg/Ortho/ENT etc, after the merger, even with similar USMLE scores.

 

[ninjacowboy]

http://www.buzzfeed.com/ninjacowboy/8-signs-that-celebrate-the-aoaacgmeaacom-merger-irad

 

[GangaMaster]

http://www.buzzfeed.com/ninjacowboy/8-signs-that-celebrate-the-aoaacgmeaacom-merger-irad

Were you on drugs when you made that?

 

[Mad Jack]

Were you on drugs when you made that?

You know you your life has taken a wrong turn of some sort when GangaMaster, of all people, is criticizing your posts.

 

[rjgennarelli]

Overall the increased competition may not be significant, but can you be sure that this will not be the case for highly coveted specialties like derm and ortho? Many DOs going into these fields stick mainly with AOA because their chances in ACGME are slim. Ideally the merger will increase the chances of DOs getting into ACGME ROAD specialties and thus creating more competition for MDs.

That is correct but I would like to clarify that the reason is not because there are not competitive enough DO applicants, but because the bias against DOs in these particle fields has not yet been shed. Thus, a DOs chances of being accepted into allo ortho, for example, no matter how good of an applicant they are, are next to none. Thus, the DO match is preferred over the MD match.

About the chances of DOs getting into ACGME "ROAD" specialties after the merger: Do not forget two things: the MD bias is most likely not going anywhere soon regardless of the merger. I assure you that my OMS classmates and I are very cognizant of this.

Additionally, MDs will have gained access to several quite good "ROAD" positions, and in some hot areas. It is unclear if DO PDs will be likely to hold a bias against MD applicants; however, I am willing to bet that it is less likely than vice versa (MD PDs continuing to hold bias against DO applicants).

One thing to clarify, because I've been drawing the same conclusions. How do we know this will effect DO bias at all on the ACGME side especially in competitive specialties? I'll wager it will still be as hard for DOs to get into ROAD or Nsurg/Ortho/ENT etc, after the merger, even with similar USMLE scores.

Unfortunately I believe this to be true. You can't change peoples' minds with policy. I believe the AOA and ACGME will attempt to find a way to work around this. Who knows what they will come up with.

If anyone wants more information about the merger please see this link for the faq: http://www.aacom.org/news/latest/Pages/SingleGME_FAQs.aspx

 

[SouthernSurgeon]

One thing to clarify, because I've been drawing the same conclusions. How do we know this will effect DO bias at all on the ACGME side especially in competitive specialties? I'll wager it will still be as hard for DOs to get into ROAD or Nsurg/Ortho/ENT etc, after the merger, even with similar USMLE scores.

I don't think it will have any impact.

 

[Mad Jack]

That is correct but I would like to clarify that the reason is not because there are not competitive enough DO applicants, but because the bias against DOs in these particle fields has not yet been shed. Thus, a DOs chances of being accepted into allo ortho, for example, no matter how good of an applicant they are, are next to none. Thus, the DO match is preferred over the MD match.

About the chances of DOs getting into ACGME "ROAD" specialties after the merger: Do not forget two things: the MD bias is most likely not going anywhere soon regardless of the merger. I assure you that my OMS classmates and I are very cognizant of this.

Additionally, MDs will have gained access to several quite good "ROAD" positions, and in some hot areas. It is unclear if DO PDs will be likely to hold a bias against MD applicants; however, I am willing to bet that it is less likely than vice versa (MD PDs continuing to hold bias against DO applicants).



Unfortunately I believe this to be true. You can't change peoples' minds with policy. I believe the AOA and ACGME will attempt to find a way to work around this. Who knows what they will come up with.

If anyone wants more information about the merger please see this link for the faq: http://www.aacom.org/news/latest/Pages/SingleGME_FAQs.aspx

The ROAD doesn't exist anymore. Anesthesia and radiology will probably be moderately competitive at best in the very near future due to substantial changes in both fields.

 

[rjgennarelli]

The ROAD doesn't exist anymore. Anesthesia and radiology will probably be moderately competitive at best in the very near future due to substantial changes in both fields.

I was just using it as an example referring to more "competitive" specialty programs.

 

[Mad Jack]

I was just using it as an example referring to more "competitive" specialty programs.

I am just doing my part to kill the ROAD mythology.

 

[ninjacowboy]

http://www.buzzfeed.com/ninjacowboy/big-news-mds-and-dos-make-sweet-medical-love-irad

http://www.buzzfeed.com/ninjacowboy/osteopathic-medicine-does-exist-irad

 

[Psai]

http://www.buzzfeed.com/ninjacowboy/big-news-mds-and-dos-make-sweet-medical-love-irad

http://www.buzzfeed.com/ninjacowboy/osteopathic-medicine-does-exist-irad

It is readily apparent that you are not an attending. Stop posting these unfunny pictures.

 

[HarryPlopper]

One thing to clarify, because I've been drawing the same conclusions. How do we know this will effect DO bias at all on the ACGME side especially in competitive specialties? I'll wager it will still be as hard for DOs to get into ROAD or Nsurg/Ortho/ENT etc, after the merger, even with similar USMLE scores.

We don't really know until we see several classes of MDs and DOs enter residencies after the merger.

I do believe that change will occur in time as PDs become more familiarized with DOs or until those PDs are replaced. How fast this will be is up in the air.

 

[BurghStudent]

We don't really know until we see several classes of MDs and DOs enter residencies after the merger.

I do believe that change will occur in time as PDs become more familiarized with DOs or until those PDs are replaced. How fast this will be is up in the air.

I agree. At the very least, this merger has been an education for me and my class about osteopathic medicine. I'm sure every MD school in the country is talking about this.

 

[Law2Doc]

Overall the increased competition may not be significant, but can you be sure that this will not be the case for highly coveted specialties like derm and ortho? Many DOs going into these fields stick mainly with AOA because their chances in ACGME are slim. Ideally the merger will increase the chances of DOs getting into ACGME ROAD specialties and thus creating more competition for MDs.

I think you might be underestimating what the CVs of the grads of top allo schools going into derm, optho, ortho look like. To some extent having their own residencies sheltered some top DOs from trying to compete with the absurdly high board scores and extensive number of research publications some of the more competitive specialties see from their "average" allo applicants. Now to get those spots they will have to hope for built in biases of osteo PDs and the low hurdle of needing a couple week rotation to learn OMM. I predict this merger is better for the DO grad applying in a noncompetitive field but a much harder road if you are osteo and want something competitive, at least in the short term. But there really was no choice here -- allo programs were growing at a rate that would have otherwise boxed DOs out of most allo residencies. Now they are part of the combined group that will box out the IMG/FMG crowd in a few years. So it was a capitulation-- a hostile takeover of a small business by a much larger one. But it was more needed by the osteopathic world than the allopathic, and surrender terms were set accordingly. At the end, there will now be no MD or DO distinction or bias, which is a good thing. But those in top osteo programs now might feel some pains of moving from being big fish in small ponds to a very small fish in a big one. Osteo programs often don't have the research opportunities or the top USMLE scores so the closed door residencies they had first crack at might now go to the research heavy guy at an Ivy who otherwise couldn't get derm.

 

[SouthernSurgeon]

I think you might be underestimating what the CVs of the grads of top allo schools going into derm, optho, ortho look like. To some extent having their own residencies sheltered some top DOs from trying to compete with the absurdly high board scores and extensive number of research publications some of the more competitive specialties see from their "average" allo applicants. Now to get those spots they will have to hope for built in biases of osteo PDs and the low hurdle of needing a couple week rotation to learn OMM. I predict this merger is better for the DO grad applying in a noncompetitive field but a much harder road if you are osteo and want something competitive, at least in the short term. But there really was no choice here -- allo programs were growing at a rate that would have otherwise boxed DOs out of most allo residencies. Now they are part of the combined group that will box out the IMG/FMG crowd in a few years. So it was a capitulation-- a hostile takeover of a small business by a much larger one. But it was more needed by the osteopathic world than the allopathic, and surrender terms were set accordingly. At the end, there will now be no MD or DO distinction or bias, which is a good thing. But those in top osteo programs now might feel some pains of moving from being big fish in small ponds to a very small fish in a big one. Osteo programs often don't have the research opportunities or the top USMLE scores so the closed door residencies they had first crack at might now go to the research heavy guy at an Ivy who otherwise couldn't get derm.

Yup.

It will actually be interesting to see what these DO programs do about interviews. Because they are all of a sudden going to have a flood of applications from top-of-their class MD students with stats and research out the wazoo. But these students are almost certainly going to view the DO programs as safeties. So the programs are going to have to be very picky about how they approach interview selection.

 

[SouthernSurgeon]

I agree. At the very least, this merger has been an education for me and my class about osteopathic medicine. I'm sure every MD school in the country is talking about this.

I was doing a career counseling/interest group thingy for M1s-M2s this week and none of them had heard a thing about it.

 

[Law2Doc]

I was doing a career counseling/interest group thingy for M1s-M2s this week and none of them had heard a thing about it.

This is very new, and not something people early in med school are following. There's no reason for them to care until late in M3 when they start seriously thinking about residency.

 

[Daodejing]

I agree. At the very least, this merger has been an education for me and my class about osteopathic medicine. I'm sure every MD school in the country is talking about this.

Every student in every MD school in the country is (thankfully) not on sdn.

 

[SouthernSurgeon]

This is very new, and not something people early in med school are following. There's no reason for them to care until late in M3 when they start seriously thinking about residency.

I just meant that I think the SDN population is far more aware of all things DO than the average med student. There were kids at my school who didn't know what DO was.

So while the merger is big news here and at DO schools, I suspect (and at least at my program confirmed) that the public awareness of it is rather low at least in comparison

 

[hallowmann]

I agree with most of this. However, comparing MD expansion to DO expansion is apples to oranges. To my knowledge, MD expansion will primarily be class-size increases whereas DO expansion has been opening of new schools. Accepting more students to a school that otherwise has everything in place (curriculum, faculty, administration, etc) is not as risky as creating a new school altogether.

Thats not entirely accurate. While many schools expanded their classes, there were also many new MD school openings in the last 10 years, including LIJ-Hofstra, TCMC, Cooper-Rowan U, UCR (previously a 2 yr branch, but now established a 4 yr program), Quinnipiac, CMU, Florida International U, Florida Atlantic U, UCF, Oakland U, and Texas Tech El Paso.

In the last decade, I believe there have been 12 new MD schools that have opened and something like 15 new DO schools. Not positive about the numbers, but its something close to that.

A few people involved in a couple MD schools told me that the reason the MD expansion that was originally meant to be ~30% expansion slowed to 20% wasn't about residencies, but rather finances/the economy (but obviously that was their side of it).

 

[BurghStudent]

I was doing a career counseling/interest group thingy for M1s-M2s this week and none of them had heard a thing about it.

Interesting. I'm sure that eventually, at least, AMA chapters will start talking about it. I guess it shouldn't be surprising that many students have no idea about the merger, but also about osteopathic medicine in the first place. If there is a group of people that need to be educated fast, it's pre-health advisers. That's why I love SDN.

 

[HarryPlopper]

I think you might be underestimating what the CVs of the grads of top allo schools going into derm, optho, ortho look like. To some extent having their own residencies sheltered some top DOs from trying to compete with the absurdly high board scores and extensive number of research publications some of the more competitive specialties see from their "average" allo applicants. Now to get those spots they will have to hope for built in biases of osteo PDs and the low hurdle of needing a couple week rotation to learn OMM. I predict this merger is better for the DO grad applying in a noncompetitive field but a much harder road if you are osteo and want something competitive, at least in the short term. But there really was no choice here -- allo programs were growing at a rate that would have otherwise boxed DOs out of most allo residencies. Now they are part of the combined group that will box out the IMG/FMG crowd in a few years. So it was a capitulation-- a hostile takeover of a small business by a much larger one. But it was more needed by the osteopathic world than the allopathic, and surrender terms were set accordingly. At the end, there will now be no MD or DO distinction or bias, which is a good thing. But those in top osteo programs now might feel some pains of moving from being big fish in small ponds to a very small fish in a big one. Osteo programs often don't have the research opportunities or the top USMLE scores so the closed door residencies they had first crack at might now go to the research heavy guy at an Ivy who otherwise couldn't get derm.

I think you bring up good points. I can understand that allopathic CVs of applicants are most likely going to be better than the osteopathic counterpart, if not due to resources and opportunities, then by sheer number. I also strongly agree with the growing pains of the shift from "big fish in small pond" to "small fish in big pond" for osteopathic residencies. I do hope that the AOA does preserve a good number of seats for the most competitive residencies for DOs.

 

[ninjacowboy]

It is readily apparent that you are not an attending. Stop posting these unfunny pictures.

What is wrong with these social media articles? I think it would be great for the public to know more about the DO profession.

P.S. I am an attending. 😉 Your bias is showing.

 

[Law2Doc]

... I do hope that the AOA does preserve a good number of seats for the most competitive residencies for DOs.

They shouldn't and won't, at least not after the first match or two. They are going to try to compete for the best applicants they can get (whether MD or DO) just like everyone else because if they don't, they will lock themselves in as the low end derm etc program. The fastest way to change that perception is to integrate fully, and train allo grads. If the allo applicant is willing to jump through the OMM hurdle and has the objectively better CV, he will win the spot. If the osteopathic residencies are giving spots to people not as objectively strong because they are DO, that's going to be viewed by ACGME as a violation of the merger terms, and I suspect such a PD won't have a long tenure.

 

[ulikedaggers]

I agree. At the very least, this merger has been an education for me and my class about osteopathic medicine. I'm sure every MD school in the country is talking about this.

Nope, not mine. And many of my classmates actually know DO schools exist.

 

[SnowDoggy44]

Here is the relative growth, by positions available, of some of the major specialty categories from the ACGME perspective assuming the AOA programs would all meet standards for accreditation:
Trad/Trans Rotating Internship - 55% growth
Family Medicine - 29% growth
Emergency - 15.4%
Orthopedics - 15%
Gen Surg - 11.7%
Internal Medicine - 9.7%
Neurosurgery - 7.8%
Urology - 7.6%
ENT - 6.5%
OB/GYN - 6.2%
Psychiatry - 3.6%
Ophthalmology - 3.6%
Pediatrics - 2.6%
IM/EM combined - 59%

Anesthesiology - 2.8% (amongst PGY-1 grant programs), 1.8% overall
PM&R - 11.6% (amongst PGY-1 granting programs), 3% overall
Dermatology - 12.1% (amongst PGY-2 granting programs), 11% overall
Neurology - 5.8% (amongst PGY-1 granting programs), 3.0% overall
Diag Radiology - 20.7% (amongst PGY-1 granting programs), 2.9% overall
Pathology - 0% 🙁

 

[GUH]

They shouldn't and won't, at least not after the first match or two. They are going to try to compete for the best applicants they can get (whether MD or DO) just like everyone else because if they don't, they will lock themselves in as the low end derm etc program. The fastest way to change that perception is to integrate fully, and train allo grads. If the allo applicant is willing to jump through the OMM hurdle and has the objectively better CV, he will win the spot. If the osteopathic residencies are giving spots to people not as objectively strong because they are DO, that's going to be viewed by ACGME as a violation of the merger terms, and I suspect such a PD won't have a long tenure.

Then will it be viewed by ACGME as a violation of the merger terms if allo programs continue to enforce blanket bans (written or unwritten) against DO's?

 

[Makati2008]

Then will it be viewed by ACGME as a violation of the merger terms if allo programs continue to enforce blanket bans (written or unwritten) against DO's?

That's a very good question. Do you have any insider information law2doc to prove your theory?

 

[Law2Doc]

Then will it be viewed by ACGME as a violation of the merger terms if allo programs continue to enforce blanket bans (written or unwritten) against DO's?

There will be pressure on both sides to look at numbers and CVs rather than the MD/DO distinction. I'm not sure that works in DOs favor for anything competitive, since few osteo programs have the same kind of research opportunities, etc. As an allo derm program you would still take the people with top board scores and solid derm research/pubs, and so at least initially That would be mostly allo grads. But now the borderline derm applicant from allo will be allowed to take a crash course in OMM and let his board scores and research snare him an osteo spot. It won't really work in reverse.

remember which side needs this merger more. Osteo was going to get squeezed out of all allo residencies in the next few years. They basically caved on the separate residency issue and came back to the table to avoid this. They got swallowed up by a much larger and more powerful organization -- it wasn't a Merger of equals. And this hugely helps the DO grad to get into a noncompetitive field. Now an allo program can consider DO grads freely without worrying how their peer programs or perspective med school applicants will view them for not being allo oriented. If I was an osteo grad going into a primary care field this merger would be awesome news. If I was a DO going into derm, I'd feel screwed.