Bad news about the combined match

[docslytherin]

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hello!

the newest letter is good, but after talking with the academic dean here at KCOM, he stressed that the petition should be short and to the point and that's why the one that i posted earlier was only about 3 paragraphs. the importance in the petition is to stress that it's in the AOA's best interest to establish a joint match. there is no doubt in anyone's mind that it's best for the students, but we need to emphasize that it's in the AOA's primarily. therefore there is no need to discuss it being good for us. to bring that up actually hurts our cause in that the AOA doesn't have a particularly vested interest in what's best for us (as is apparent from their present stance on the issue). the petition should (in my opinion):

1. emphasize the potential for DO students to fill AOA residency spots that are in danger of losing funding

2. emphasize that the students going into an ACGME residency will be doing so to further educate our allopathic colleagues and continue the great strides that past DOs have made to allow our generation to work in environments free of stereotype and animosity toward our education. make sure to emphasize that we will be applying to MD residency spots for which there is not a DO counterpart. i believe that's essential. eliminate the idea that it's competition between residency programs, it's just offering more choices (an MD IM residency in Seattle if there isn't a DO program there for example). we're choosing residency programs based on a number of criteria without regard to whether it's DO or MD. we're choosing the best training for the treatment of our future patients.

3. remind them that we are concerned for the future of the AOA and the survival of osteopathic principles as separate entities. we have a vested interest in the success of not only ourselves, but the organization as well. we are not "abandoning" our osteopathic educations to train at allopathic institutions. in many cases, we are risking a match into an ACGME residency that would have been listed far below some DO programs had we been able to participate in both without penalty.

4. downplay the number of DO students matching into MD programs as first choices (your paragraph on harvard, etc) because the AOA is not concerned with establishing DOs as equal to MDs. they are focused on presenting us as separate modalities. that's why, in my opinion, they're so bitter about the way that the AMA recognizes the AOA. we're not a specialty that needs recognition by MDs. i don't believe that the paragraph will help because of the "old school" animosity that some DOs feel toward the MD establishment.

5. we can't establish the MD hospitals as "the major teaching institutions" in america in the petition. while it might be true, the AOA would argue the label as denegrating to the DO hospitals that train our graduates. to set the MD hospitals above the DO training facilities right off the bat, i think this version of the petition will put the AOA on the defensive. we'll get more flies with honey than vinegar.

6. it has to be short. they're not going to read a petition that is a whole page long with much interest. we have to keep is short and simple and directly to the point.

alright, those are my ideas. i think that at most, the text of the petition needs to be one-third of a page. it has to be something that the AOA can read quickly and something that the people signing it can read quickly. to create something a page long will raise suspicions that those signing it probably don't know everything that they're agreeing to.

 

[docslytherin]

Hey, I think we've hit on a solution for the situations I mentioned above. We can combine & do both!

First, the letter we are reworking can used in both situations - saves time & manpower. In the petition campaign, it can serve as the introduction to what the undersigned petitioners are advocating. This can be divvied up by school & by AOA residency program. I think that not only will there be great strength in the cumulative voices of the med students; but if we can also land a sufficient mass of sigs from DO residents & practitioners - that will substantially add to the force of impact.

Second, same general letter converted to pdf sent out by e-mail to any & all DOs out there willing to sign & return it to the AOA. This way we get folks out of residencies or those who are in AMA programs.

I will certainly volunteer, once the letter is finalized, to send copies to the KCOM SGA, Pres & Dean's office under my signature. Furthermore, I will sniff around Dartmouth, as there are quite a few DOs here and see if some them will sign on too.

dave,

i've been talking to the dean so i'd be happy to present it to him when we get it done. however, you bringing it up to the pres would be great. (he often seems more interested in alumni and their money than current students)

thanks,
john

 

[TCOM-2006]

hi everyone--

**good discussion about the joint match. there are a lot of issues that have been brought up, but i first just want to clear up some mis-information that has been posted on what exactly occured at the AMA meeting last week. to summarize:

--neither the AOA nor the AMA (nor their student components) has taken an official position on this issue by passing policy in their respective HODs. both bodies are still studying the issue.
--the resolution at the AMA-MSS level was referred for study.
--the resolution at the AMA-HOD level was voluntary withdrawn by the author of the resolution before he bacame aware of the letter from the AOA president.

here's the basic timeline (and full story).

**pre-june 2004:

--a resolution calling for broad NRMP reform ("national residency matching program" which has been referred to the "allopathic" or MD" match in previous posts) ***including combining the AOA/NRMP matches*** was introduced and passed in the CMA-MSS ("california medical association - medical student section"). it was then introduced and passed by the CMA-HOD ("house of delegates"). the resolution was then forwarded by the CMA-MSS to the AMA-MSS Assembly ... and was also forwarded from the CMA-HOD to the AMA-HOD.

**june 2004 (the AMA annual meeting):

--2 copies of the resolution appeared - one in the MSS handbook, and one in the HOD handbook. both of these were referred. the MSS version was referred to the "MSS governing council", with report due back at the december,2004 meeting ... and the HOD version was referred to the AMA board of trustees with report due back at the june, 2005 meeting. as i mentioned, these twin resolutions have many aspects to them, but in resolved #2, point #9 - they both say:

..."The Osteopathic Match should be incorporated into a single all-students Match; and be it further RESOLVED"...

--for full text for the MSS version follow the link, click "final actions" and see resolution #8:
http://www.ama-assn.org/ama/pub/category/12944.html
--for full text for the HOD version follow the link, click
http://www.ama-assn.org/ama/pub/category/12460.html

**pre-july, 2004:

--meanwhile, on the AOA side of things, the Maine Osteopathic Association passed a resolution supporting a joint match, and forwards it to the AOA-HOD. some of the UNE-COM students said they had no idea their state osteopathic association was going to do this (i'm not sure who wrote the resolution). can anyone from UNE-COM tell me how this started?

**july, 2004 (the AOA-HOD annual meeting):

--the AOA-HOD considers the issue (my understanding is that there was mixed support and opposition to the resolution), and it was eventually referred for study and report back by July 2005. the resololved clauses state:

..."RESOLVED, that the AOA endorses the concept of a joint match for the military, osteopathic and allopathic medical professionals; and, be it further

RESOLVED, that the AOA will assist the COPT in effecting the implementation of a joint match for the class of 2006."...

**november, 2004 (the AOA meeting):

--the AOA-HOD only meets once per year (july) while the AMA-HOD meets twice per year (june and december). this is the AOA's non HOD meeting - but students groups (ie SOMA and COSGP) still meet. at this meeting, the student from Touro who has been very involved with this issue and is involved with the AMA, presented the issue to the AOA student leadership. COSGP, who showed general support for a joint match - but did not take any official action, agreed to research the issue, including gathering the feedback from all osteopathic students.

**pre-december, 2004:

--the student from Touro gets word that the AMA-MSS report on resolution #8 (the "omnibus", introduced by the CMA-MSS) will **not** be ready for consideration at the december AMA-MSS meeting. it's not clear why the report is not ready. so - the day before resolutions are due - this individual submits another (seperate) resolution which just calls for the only calls for a joint-match to the MSS assembly *and* directly to the AMA-HOD.

--i personally advised this individual to *withdraw* the resolution that was submited directly to the HOD, and that individual agrees to do so. the resolution was not withdrawn by the AMA - it was withdrawn (and can only be withdrawn) by the original author. and - it was withdrawn *before* i, or this individual became aware of the letter that was sent from the AOA president.

--why did i advise withdrawl of the resolution?
#1: the issue was already being studied by the AMA (via the previous "omnibus" resolution). it probably would have been voted down - not because people were necessarily against it - but because it would be seen as redundant, and a bypass of the study that the HOD had already called for.
#2: resolutions to the AMA-HOD are almost never introduced by an individual - they are almost always taken through another voting body first, so this would lessen its chance for passing for this reason.
#3: the resolution could have - and needs to be - stronger.

**december, 2004 (AMA meeting):

--by this point, the HOD resolution had already been withdrawn, but the MSS resolution was still in play. feelings for the resolution was virtually universal support from DO students, and either full support from our MD student friends, or confusion/unclarity on how this will effect the match as a whole (i did not hear of any MD students who were outright opposed to the idea). because it's a complex issue, and it was difficult to fully explain everything - the resolution was referred for study with report back at the june 2005 meeting. for some reason (and the letter might have had an impact here), the MSS reference committee recommended against apoption - but this was extracted, and i personally moved for referral - which was almost unanimously supported by the MSS assembly.it will likely be combined with the other resolution passed in june 2004, for one big report to come back to the MSS in June 2005.

**feb 2005:

--COSGP will be meeting and will likely vote on this issue. as i mentioned, there is a general (but as of yet - unofficial) support for the joint match. ***make sure to contact your student government president, and SOMA leadership, and tell them how you feel about the issue***.

**june 2005:

--AMA-MSS and AMA-HOD will meet, and reports on the issue will be up for consideration.

**july 2005:

--AOA-HOD will meet, and a report will be considered.

####it's VERY important to understand the full story on what's going on, so it this can carefully guide our future actions to achieve the best possible outcome. i will post more soon, on some other issues that have been brought up - and how i would advise that we move forward with the issue####

bl

 

[brahms]

when registering for the nrmp match, we were given a survey about how we felt about making changes to the match. most of the questions involved eliminating the "scramble" and implementing a second post-match round in its place. one of the questions in the survey asked if we felt there should be a combined match. i didn't really understand the issue because i don't know much about the osteopathic application process, so i asked other (allopathic) students how they voted on this issue. they all voted no, stating they didn't think it was fair that osteopathic students could enter allopathic residencies but not vice versa. this doesn't make sense either because the question doesn't ask about barring DO's from applying to allopathic residencies. i don't really have a point except to say that is seems a lot of confused and misinformed people may have influenced the outcome on not having a single match.

 

[JohnDO]

docslytherin, excellent post.

TCOM-2006, thanks for posting that! So what do you suggest aside from contacting the SG presidents and SOMA. Should we let this play out before we write letters?

 

[Thousandth]

It seems that after the above post by brahms that another aspect of this that should be approached is to educate the MD students as to how the matching for DO students already works along with explaining the benifits to them of a combined match. I think this should be done regardless of whether or not we wait for the vote next june.

I am not sure how to do this the sheer volume of MD students means we need to target a few points of contact that can diseminate the info to their respective groups. I would think there could be a couple of ways. Send out a mass email to all of the schools Dean of Students asking for them to distribute it to the students or we could go thru the respective student government presidents. Any other ideas would help.

 

[Lee]

This effort has my full support. PM me if you need any assistance!

 

[docslytherin]

when registering for the nrmp match, we were given a survey about how we felt about making changes to the match. most of the questions involved eliminating the "scramble" and implementing a second post-match round in its place. one of the questions in the survey asked if we felt there should be a combined match. i didn't really understand the issue because i don't know much about the osteopathic application process, so i asked other (allopathic) students how they voted on this issue. they all voted no, stating they didn't think it was fair that osteopathic students could enter allopathic residencies but not vice versa. this doesn't make sense either because the question doesn't ask about barring DO's from applying to allopathic residencies. i don't really have a point except to say that is seems a lot of confused and misinformed people may have influenced the outcome on not having a single match.

i think this should be addressed by each school's AMA-MSS chapter. perhaps they could organize a letter-writing campaign to explain the process to other members of the AMA HOD to explain why it's so important for us to have the joint match.

as it stands now, we (DOs) can enter MD residencies for reasons mentioned earlier (equally qualified, more spots than applicants, less "red tape" than FMGs, etc). MDs are not allowed to enter DO residencies because they don't learn OMM and because there aren't enough funded spots for all the DO grads, much less if we start letting MDs in who want to learn OMM. i actually think it would be a good idea to let MDs into the programs eventually so as to further incorporate OMM into the "mainstream" but right now the logistics are just not there. it may seem unfair, but DOs are in MD programs at the request of residency directors. perhaps with the advent of dually accredited programs we'll see more MD exploration of OMM (or maybe less DO utilization of it, who knows).

i don't think i clairified anything in this really... it's 2am and i have a cardiology exam in 5.5hrs and studying is wearing me out... all of the ECGs are starting to look alike

sorry to ramble if i didn't make anything clearer to the allopaths here wondering why we're complaining about the AOA.

 

[PACtoDOC]

I think the main thing to do now is
1) finalize a short letter that addresses the main reasons why we as students desire a joint match
2) continue to find one rep per school to make this effort work at their respective school.

Can anyone help here in organizing a rep from each school? It could be as simple as a petition attached to the letter, posted on a school bulletin board and then collected later. It need not be overly complex.

I am not in favor of passing this through student government as the only means of making this effort heard. I feel that the AOA should receive these signatures outside of student government AS WELL to show that this effort is bigger than that. I plan to seek the advice of my SGA, but regardless of their input, the signatures are going to be collected and sent. The AOA has already shown that it will unilaterally determine what is best for us without consulting our SGA's before making an important decision that affects us. So they are the ones we have to take this directly to. I personally don't want to wait 6 months for some quaint meeting between COSGP's and AOA leaders where everyone smiles and sits around drinking coffee and discusses what TV show a DO might show up on as a character. The time is right to be heard my friends.

 

[delicatefade]

Like I said, I am available for CCOM when a final petition or letter is available. I can distribute and collect signatures here.

 

[AwesomeO-DO]

sorry if this Q has already been answerd, but: if there is a combined match, will MD grads have access to DO residency spots?

 

[JMC_MarineCorps]

sorry if this Q has already been answerd, but: if there is a combined match, will MD grads have access to DO residency spots?

NEVER! They are neither skilled nor versed in the sacred art and ritual of bone voodoo and witchcraft.

 

[Thousandth]

Ok well I have taken on my own previous sugestion and will move foward with trying to contact as many allopathic students as possible to garner support for the combined match.

I am curious though what is the main reason that we don't allow allopaths into our osteopath residencies? It seems to me that it would be something worthwhile to look into. It seems to me that the potenial benifits would be an increase in quality of our residencies, better union between the two groups (DO/MD), and that all the residencies would get a much higher fill ratio. If our residencies are no less than the allo ones then whats the difference?

 

[stoic]

I am a future (starting next year) allopathic student with a strong interest in osteopathy.

If you guys need an MD liason, I'd be happy and honored to serve that function.


On other note, if they combine matches, I really think that MD students should have access to DO GME spots. I'll elaborate later... but right now dinner awaits.

 

[Bookworm]

I think the main thing to do now is
1) finalize a short letter that addresses the main reasons why we as students desire a joint match
2) continue to find one rep per school to make this effort work at their respective school.

Can anyone help here in organizing a rep from each school? It could be as simple as a petition attached to the letter, posted on a school bulletin board and then collected later. It need not be overly complex.

I am not in favor of passing this through student government as the only means of making this effort heard. I feel that the AOA should receive these signatures outside of student government AS WELL to show that this effort is bigger than that. I plan to seek the advice of my SGA, but regardless of their input, the signatures are going to be collected and sent. The AOA has already shown that it will unilaterally determine what is best for us without consulting our SGA's before making an important decision that affects us. So they are the ones we have to take this directly to. I personally don't want to wait 6 months for some quaint meeting between COSGP's and AOA leaders where everyone smiles and sits around drinking coffee and discusses what TV show a DO might show up on as a character. The time is right to be heard my friends.

so far our volunteers for distribution: (if i have missed someone, please feel free to add to the list)


PACtoDOC-UNT HSC/TCOM
delicatefade-CCOM
bookworm-UMDNJ SOM
elysium - TUCOM NV
Thousandth - DMU
jhug - AZCOM
docslytherin - KCOM

since a lot of our 1st and 2nd year colleagues are finishing up for the semester, i think a reasonable self imposed deadline for a final draft should be the first week of Jan. it should be reasonable to collect signatures during the first week back from break.

thanks to everyone for their suggestions on the letter.
i will be able to work on it on Wed, but in the meantime if anyone wants to post a version that combines/shortens/finalizes the petition, it would be greatly appreciated.
Look forward to your postings...

 

[no-see-um]

On other note, if they combine matches, I really think that MD students should have access to DO GME spots. I'll elaborate later... but right now dinner awaits.

I agree with that statement, as someone who would be going the osteopathic route. I believe that the matches should be combined, but I think that it is harder, then, to justify residencies that are exclusive to allopathic students who respect osteopathic medicine enough to want to do an osteopathic residency . If there is going to be a barrier broken down, I think it should be broken down bidirectionally. That should be the goal, in my opinion.

 

[DrMom]

On other note, if they combine matches, I really think that MD students should have access to DO GME spots. I'll elaborate later... but right now dinner awaits.

This has actually been proposed and discussed on my AOA committee. 🙂

There are definitely issues about how to make up for the lack of OMM training, but there are DOs out there in favor of this & promoting the idea.

 

[dr. deez]

On other note, if they combine matches, I really think that MD students should have access to DO GME spots. I'll elaborate later... but right now dinner awaits.

I agree with this statement... and would be willing to help as well.
-D-

 

[jhug]

I personally don't want to wait 6 months for some quaint meeting between COSGP's and AOA leaders where everyone smiles and sits around drinking coffee and discusses what TV show a DO might show up on as a character. The time is right to be heard my friends.

in atlanta (AMA meeting a couple weeks ago) we talked about this...i was actually really impressed with how many MD's are interested in learning more about OMM...anyway, i think what it comes down to is that allo's aren't covered (liabililty wise) in DO residencies...something to do with accreditation (?)
as part of the osteopathic promotions committee in the OC (osteo caucus) of the AMA we are looking to have break-out sessions to show off different techniques and we want to have a display of which schools provide rotations in omm for allo's at our next meeting (june) in chicago.

 

[OldManDave]

dave,

i've been talking to the dean so i'd be happy to present it to him when we get it done. however, you bringing it up to the pres would be great. (he often seems more interested in alumni and their money than current students)

thanks,
john

John;

In my humble opinion, I think that both of us approaching them, you as an involved & motivated student & me as an alumnus, will put forth the most efficacious approach. Besides, they all know me very well - worked extensively with them all. Hopefully...maybe...that'll count for something.

 

[OldManDave]

sorry if this Q has already been answerd, but: if there is a combined match, will MD grads have access to DO residency spots?

I have to be perfectly honest, but I think this will be a critically important step that needs to be undertaken - but will be opposed vehemently by the AOA. As DrMom points out, the number of DOs in leadership postions with opening minds is growing. They need our (DOs & DO students) support to underwrite what they are trying to accomplish. Popular concensus, poltical savvy & broad-based involvement are the only ways to overcome what has become unjustifiably entrenched as status quo for the AOA.

There is a massive amount of inertia to overcome - call it tradition. So, grasping for the entire pie at once will do nothing but get our hands slapped. However, if we are smart & take this one step at a time - broad, sweeping changes are instituted only one step at a time to remain palattable - these are obtainable goals.

 

[stoic]

So what good would having MD's in DO residencies DO? Consider this: presumably MD's in DO residencies would need to learn some remedial OMM. I know some DO's go on and on about how hard learning OMM is, but I honestly don't believe it. What I've heard from students and physicians personally is the the dramatic stuff - the only methods most DO's use - can be taught without 2 years of constant training. Perhaps seminars twice a month for the first year or two of training, or something like that.

Doing this could actually help to legitimize OMM in the eyes of other physicians. After all, if MD's start learning and using OMM, then it's going to become a more and more accepted treatment modality (not because more MD's are using it, but because more physicians are using it). This sort of situation might actually provide a chance to offer speciality specific training in OMM so that the most useful techniques are emphasized to the practitioners who need them most, regardless of degree.

 

[jgrady]

Great thread folks. I hope an action plan (letter or whatever) gets finalized so we can use all this energy for something positive.

As for the questions about why DO residencies would be benefited by a combined match, I have a few responses:

1) Many DO's that would list DO residencies as #2, 3 or 4 for match seem to go allo and forego any chance of a DO spot in order to try for their first choice(s). Combined match would keep a lot more DOs "in system". (I have no idea how many DOs fall into this category, but believe it's a good percentage.)

2) A correllary to the above is that DO residency programs are likely to get happier, more satisfied residents. For example, they wouldn't be stuck with DOs who only chose their program because they couldn't pick allo programs for their 3rd or 4th choices.

3) DO residency programs would have compete on a level playing field. The good ones would prosper, and the bad ones would improve or be mercifully ended. Good ol' Econ 101 market dynamics.

4) As already mentioned, MDs might be able to fill vacancies. I suppose that would also include qualified IMGs.

That's all I can think of at the moment. Time to go study Gross...

 

[brahms]

MDs are not allowed to enter DO residencies because they don't learn OMM

I'm just curious...do DO's use OMM in the osteopathic dermatology or radiology programs? Let's say MD's were allowed to apply osteopathic, I can tell you, it ain't the FP residencies they would go after.

After reading more thoroughly through this thread, I don't understand why any allopathic student would be in support of a combined match. They have nothing to gain and their chances of obtaining their top choice residencies will certainly be diminished with the large influx of DO students coming into the systemif such students are ranked higher by the programs. If any allopathic student bothered to read the email updates from their school's AMA delegate (most delete them without reading them), I am sure they would be strongly opposed. I hardly believe the earlier post that said most allopathic students supported a combined match. I am not trying to be antagonistic towards your efforts and I certainly don't want to make the application process any tougher than it is, I'm just giving an allo point of view. Anyway, the AMA doesn't listen to allo students, as evidenced by the required $1000 USMLE step 2 clinical skills exam that students fought tooth and nail.

 

[docslytherin]

John;

In my humble opinion, I think that both of us approaching them, you as an involved & motivated student & me as an alumnus, will put forth the most efficacious approach. Besides, they all know me very well - worked extensively with them all. Hopefully...maybe...that'll count for something.

dave,
that would certainly be fantastic. i wasn't trying to imply that you shouldn't, i'm sorry if it came across that way. if you have contacts with other alumni, that would help as well!! dean slocum (academic dean now) is very supportive of the idea and has been helping me immensely.

john

 

[docslytherin]

I'm just curious...do DO's use OMM in the osteopathic dermatology or radiology programs? Let's say MD's were allowed to apply osteopathic, I can tell you, it ain't the FP residencies they would go after.

After reading more thoroughly through this thread, I don't understand why any allopathic student would be in support of a combined match. They have nothing to gain and their chances of obtaining their top choice residencies will certainly be diminished with the large influx of DO students coming into the systemif such students are ranked higher by the programs. If any allopathic student bothered to read the email updates from their school's AMA delegate (most delete them without reading them), I am sure they would be strongly opposed. I hardly believe the earlier post that said most allopathic students supported a combined match. I am not trying to be antagonistic towards your efforts and I certainly don't want to make the application process any tougher than it is, I'm just giving an allo point of view. Anyway, the AMA doesn't listen to allo students, as evidenced by the required $1000 USMLE step 2 clinical skills exam that students fought tooth and nail.

what i would wonder about is whether MDs would have to fulfill the 1 year rotating internship (including an OMM rotation) prior to beginning a DO radiology or derm residency.

 

[Shinken]

Brahms raises a good point. Allopathic students will not go for the combined match (they won't gain anything, and stand to lose residency spots). Right now, they also stand to lose residency spots, but at least some DO grads will be dropped from the allo match if they match osteo first.

Also, I don't think that opening osteo residencies to MD grads is going to do anything whatsoever. My reasons: (1) I don't think there's any *competitive* MD grad out there dying to go to a DO residency and (2) most likely the only MD grads applying to DO residencies will be the less competitive ones (including IMGs). Any DO program director will give preference to DO grads before any less-competitive MD grad.

I believe the only way the AOA (and the AMA) will be convinced that a combined match is in the best interest of both professions is if the osteo and allo match happen on the same day but osteo students have to rank DO programs above MD programs in their rank list. That way, the same situation that we have today applies (if you match DO first, you don't get your MD choices). If you want a combined match so that you can use DO programs as a backup in case you don't get an MD spot, good luck convincing the AOA to approve your case.

 

[stoic]

I'm just curious...do DO's use OMM in the osteopathic dermatology or radiology programs? Let's say MD's were allowed to apply osteopathic, I can tell you, it ain't the FP residencies they would go after.

I don't know if DO's use OMM in their derm and rads programs. One interesting aspect of allowing MD's into DO residencies is the potential for IMG participating. The shear infux of applicants from interested US MD's and IMG's might be enough to really bail out a lot of DO programs that are not filling year after year.

After reading more thoroughly through this thread, I don't understand why any allopathic student would be in support of a combined match.

one reason would be so that they could potentially (maybe not at first, but eventually) learn some OMM. A lot of MD's are interested in the practice and right now there are a lot of options for those who want to learn

another reason, and this one should be important to you and everyone else, is that it would increase the quality of DO programs. and this is your concern, because the physicians who train in them are your future coworkers and healthcare providers.

They have nothing to gain and their chances of obtaining their top choice residencies will certainly be diminished with the large influx of DO students coming into the systemif such students are ranked higher by the programs.

Not true. As it stands right now, DO students who want allo spots just forgoe the DO match altogether. In this sense you'd be competing against the same people you are now. Right now something like 65% of DO's do MD GME. This number would likely not change much by combining the matches.

Also, a eventual end of this would like be the ability of MD's to match into DO programs.

I'm just giving an allo point of view.

Incorrect, you're giving and individual allopath's view. Here's another allopaths view: combine the matches.

 

[brahms]

what i would wonder about is whether MDs would have to fulfill the 1 year rotating internship (including an OMM rotation) prior to beginning a DO radiology or derm residency.

if the traditional internship were in lieu of the already required transitional year/preliminary year for these advanced programs, then i think some MD's might be interested in applying for the more competitive fields. i don't think many MD's would pursue osteo programs anyway. i was just making the point that allo seniors could be hurt by a combined match while gaining nothing in return.

 

[PACtoDOC]

One thing allopaths might want to consider is that allopathic residencies have been signing DO applicants prior to the match through a loophole in the process. This reduces the number of seats available for MD's in their own programs, especially in primary care where DO's are actively recruited. The joint match ends this practice and DO's would have to wait and match like every MD would.

 

[jgrady]

After reading more thoroughly through this thread, I don't understand why any allopathic student would be in support of a combined match. They have nothing to gain and their chances of obtaining their top choice residencies will certainly be diminished with the large influx of DO students coming into the systemif such students are ranked higher by the programs.

From my biased position, I think you have it wrong. For many of the reasons the combined match is good for DO residencies (that I outlined a few posts ago) the combined match isn't going to hurt allopaths applying for their match.

It would probably be a non-event since we already can and do apply to their programs. But it has the potential of keeping many DOs in osteo residencies if they don't get their top allo choices.

Moreover, this has the potential of leading to a single Board score for applications. As first year, I'm no expert on COMLEX vs. USMLE. But I can see a single match leading to a single Boards test (USMLE) with OMM being a supplemental or add-on test DOs have to take. Allos would almost certainly see a level playing field (no COMLEX scores vs. USMLE scores) as a benefit.

 

[DrMom]

Just an FYI: there already are MDs asking to be in primary care osteo residency slots. Some of these want in because of location, others want to learn OMM. Granted, they don't flock there in large #s, but they do exist.

 

[brahms]

Incorrect, you're giving and individual allopath's view. Here's another allopaths view: combine the matches.

sorry if i offended. i didn't say i was giving "the" allopathic view. i am not pretending to be an expert on the issue. i actually voted in support of the combined match in the NRMP survey, although i think my only rationale at the time was that it would allow a couples match for folks from two different schools, and i have a few inter-disciplinary couples friends. otherwise, i would have just flipped a coin.

 

[docslytherin]

Brahms raises a good point. Allopathic students will not go for the combined match (they won't gain anything, and stand to lose residency spots). Right now, they also stand to lose residency spots, but at least some DO grads will be dropped from the allo match if they match osteo first.

Also, I don't think that opening osteo residencies to MD grads is going to do anything whatsoever. My reasons: (1) I don't think there's any *competitive* MD grad out there dying to go to a DO residency and (2) most likely the only MD grads applying to DO residencies will be the less competitive ones (including IMGs). Any DO program director will give preference to DO grads before any less-competitive MD grad.

I believe the only way the AOA (and the AMA) will be convinced that a combined match is in the best interest of both professions is if the osteo and allo match happen on the same day but osteo students have to rank DO programs above MD programs in their rank list. That way, the same situation that we have today applies (if you match DO first, you don't get your MD choices). If you want a combined match so that you can use DO programs as a backup in case you don't get an MD spot, good luck convincing the AOA to approve your case.

as it stands now, we (DOs) can already get into MD residency programs, so there's really nothing to lose that hasn't already been "lost." DO students can't only list DO spots first because there are not nearly enough spots for all of the graduates and the MD programs want us in their programs so they won't like that either...

i think the AMA would support the joint match and will support if the AOA decides to do so. from the way it sounds, the motion to approve it was sent to committee at the AMA only because the AOA hasn't come out in support of it yet.

 

[brahms]

Not true. As it stands right now, DO students who want allo spots just forgoe the DO match altogether. In this sense you'd be competing against the same people you are now. Right now something like 65% of DO's do MD GME. This number would likely not change much by combining the matches.

What I meant was the large influx of DO's coming from the DO expansion schools. I was referring to Fantasy Sports much earlier post. Incidentally, one of the DO schools in my state nearly doubled the size of its first year class this past year. The percentage of DO's doing MD GME would have to increase, esp with DO residencies being shut down. With this surge of DO applicants submitting their ROL's as #1 allo, #2 osteo, do you feel allo students would still support a combined match? You could argue that more DOs will fill DO programs with the combined match, but I think most students will still be leary.

 

[stoic]

sorry if i offended. i didn't say i was giving "the" allopathic view. i am not pretending to be an expert on the issue. i actually voted in support of the combined match in the NRMP survey, although i think my only rationale at the time was that it would allow a couples match for folks from two different schools, and i have a few inter-disciplinary couples friends. otherwise, i would have just flipped a coin.

no offense taken 👍

i'm just passionate about this issue 🙂

I think it would be good for everyone involved and work to further close any rifts between allopaths and osteopaths.

 

[docslytherin]

What I meant was the large influx of DO's coming from the DO expansion schools. I was referring to Fantasy Sports much earlier post. Incidentally, one of the DO schools in my state nearly doubled the size of its first year class this past year. The percentage of DO's doing MD GME would have to increase, esp with DO residencies being shut down. With this surge of DO applicants submitting their ROL's as #1 allo, #2 osteo, do you feel allo students would still support a combined match? You could argue that more DOs will fill DO programs with the combined match, but I think most students will still be leary.

if we can set this up, we hope there will be fewer DO residency programs shutting down. that's one of the main goals of this. when DO grads are foregoing their option of applying to these DO programs because of the possibility of matching somewhere they don't want, they are also eliminating the possibility of matching into a DO program they might like.

for example... say i want to rank the following programs:

DO programs: IM-1, IM-2, and IM-3
MD programs: IM-4, IM-5, IM-6 and IM-7

and i want to do so in this order:
1. IM-5 (MD)
2. IM-2 (DO)
3. IM-4 (MD)
4. IM-1 (DO)
5. IM-6 (MD)
6. IM-3 (DO)
7. IM-7 (MD)

if i can only choose 1 match process, then i'm going to choose the MD match because there are more options and are ranked higher on my overall list than DO programs. however, if i can apply to a combined match, i have the opportunity to get into 6 programs before i get to the bottom of my list and 3 of those would not eliminate an MD grad from his/her choice. what this does is actually create LESS competition between DO and MD students for the same residencies, assuming that DO students are going to apply for DO residencies.

also, the more DO students we have interested in applying to DO residencies, the more likely these spots will fill and continue to be funded.

a combined match won't eliminate anymore MD students from MD residencies. since most (65% quoted above) of the DO grads are actually not listing any DO residency programs, it seems logical that if we stop penalizing them for considering the DO programs, more will apply to them, thereby opening up more MD spots.

if anyone should be fighting this, i would think that the MD residencies would be. they're the ones who stand to lose something here.

 

[Thousandth]

What I meant was the large influx of DO's coming from the DO expansion schools. I was referring to Fantasy Sports much earlier post. Incidentally, one of the DO schools in my state nearly doubled the size of its first year class this past year. The percentage of DO's doing MD GME would have to increase, esp with DO residencies being shut down. With this surge of DO applicants submitting their ROL's as #1 allo, #2 osteo, do you feel allo students would still support a combined match? You could argue that more DOs will fill DO programs with the combined match, but I think most students will still be leary.

There are quite a few of us in the DO community who are opposed to this expansion of class size and school opening without the residencies to support them. I personally feel that the schools who have opened "branch" campuses after only being in existence for a few years themselves are mainly after more $$ rather than trying to promote osteopathy. This also holds for schools who have increased their class size by a large amount (the doubling of a class size). We as osteopaths need to kick the AOA in the ass to halt this and take care of the current shortage problems rather than cause more.

As far as the combined benift issues you have brought up, docslytherin and myself have addresed this several times. His above post clearly shows the most obvious imeadiate benifits. I think the main issue is that allopathic students really dont know the mechanics of how osteopaths fit into the current match process. This is an issue that I am trying to take on.

 

[brahms]

Thank you for your explanation, docs. Sorry if y'all had to beat me over the head to make me understand. I had a knee-jerk reaction which I think many others will have, but hopefully they will understand the bigger picture as you've presented it.

Signing out-
brahms

 

[docbill]

Just an FYI: there already are MDs asking to be in primary care osteo residency slots. Some of these want in because of location, others want to learn OMM. Granted, they don't flock there in large #s, but they do exist.

A few thoughts... which I would love some info/feedback on.

Overal it would be great if MD can do DO residencies. BUT... if the argument is that OMT can be learned in a few weeks, that would give more support to combining the two branches of medicine.

Also, would DO spots be filled with IMG... that would be a problem on its own. Cause then the residencies would also be taged as a less competitive not as worthy as Allo. Would the head of a DO residency still prefer a DO over an MD... YES.. but what if no DO selects that program. That position is now in risk of being shut down.... they would be forced to take an IMG or not as qualified MD applicant just to keep the spot open.

I would assume that ALLO admin would love to have DO students since they are trained in the US... and have no need to evaluate qualification etc... no problems with VISA requirements (except for some Canadians Ehhhh!)

 

[JohnDO]

This isn't really related to the combined match, but shouldn't we be equally concerned and as passionate about the AOA approving new schools without having adequate osteopathic GME, and then excommunicating osteopathic physicians (essentially) who go to allopathic insitutions for their residency? I find this absolutely horrifying.

We really need to push both of these issues hard because they are going to affect us all.

 

[delicatefade]

Here is some news from CCOM - I made an announcement in class about the campaign and spoke with our class president. We are going to set up a lunch time meeting with our dean (probably after Winter Break) to feel out her opinion on the joint match issue as well as to present our opinion.

Once the final petition/letter is ready we will be mobilizing to involve those in our class who support the issue.

 

[donvicious]

We're going to pass around the petition at COMP as soon as we get back next semester.

docslytherin, could you PM me with the final draft?

 

[OldManDave]

dave,
that would certainly be fantastic. i wasn't trying to imply that you shouldn't, i'm sorry if it came across that way. if you have contacts with other alumni, that would help as well!! dean slocum (academic dean now) is very supportive of the idea and has been helping me immensely.

john

I did not take it as such - was merely emphasizing that I felt a 2-pronged attack would be better. I used to sit on the alumni board as well...might even send a letter through the alumni office to them too.

 

[OldManDave]

This isn't really related to the combined match, but shouldn't we be equally concerned and as passionate about the AOA approving new schools without having adequate osteopathic GME, and then excommunicating osteopathic physicians (essentially) who go to allopathic insitutions for their residency? I find this absolutely horrifying.

We really need to push both of these issues hard because they are going to affect us all.

I don't recall the specifics, but this was a fairly heated topic while I was in med school too. At that time, KCOM expended a little, NYCOM & UHSCOM (or whatever the hell it is now) expanded massively and there was talks of new schools in FL & GA. When I started first year, there were something like 2000 DO students per year w/ only 1200 to 1500 FUNDED PGY1 slots...you have to watch those DO programs as many advertise numbers of slots that are not even funded & only exist in the ether. With all of these new schools & news of several DO programs closing - Jesus, how large is the imbalance today?

Regarding AOA vs AMA approval of new schools. As I recall, the AMA has a pretty tight reign on the process of adding new schools. However, the AOA, obviously, is pretty much a cheap date. I think that they think proliferation of schools = proliferation of DOs & increased influence for the DO world. In actuality, it appears unprofessional, reckless & greedy in my humble opinion & in the eyes of quite a few others as well.

However, as I cautioned this movement before - these are all noble & worthy causes - but in politics, movement towards reform must be executed in a step-wise fashion. If we approach the AOA with a massive rewrite of all that is DO - as well intention & correct as we perceive it - they will only react with derision & assume a defensive posture.

To achieve our goals, we must focus on a precise target first. Once that initial mini-goal is obtained, we have not only made progress, but earned the respect of the leadership. In turn, they will be much more likely to listen in the future. All of this hinges upon presenting this in the most professional, mature & in as positive a light for the AOA as is feasible.

My $0.02 worth...

 

[Malph]

A few thoughts... which I would love some info/feedback on.

Overal it would be great if MD can do DO residencies. BUT... if the argument is that OMT can be learned in a few weeks, that would give more support to combining the two branches of medicine.

Also, would DO spots be filled with IMG... that would be a problem on its own. Cause then the residencies would also be taged as a less competitive not as worthy as Allo. Would the head of a DO residency still prefer a DO over an MD... YES.. but what if no DO selects that program. That position is now in risk of being shut down.... they would be forced to take an IMG or not as qualified MD applicant just to keep the spot open.

I would assume that ALLO admin would love to have DO students since they are trained in the US... and have no need to evaluate qualification etc... no problems with VISA requirements (except for some Canadians Ehhhh!)

From my understanding there are IMGs in DO programs right now--in New York. I am not sure if elsewhere?

Also, as the author of the resolution at the AMA, let me say that the President's letter had nothing to do with the withdraw of the resolution. As a point of fact, I was asked by the Student section to give them time to speak to the issue knowledgeably. The same resolution was referred for report in the AMA Medical Student section. This will produce resolutions that will hit the AMA-HOD sometime in the near future.

I would also like to say for the record that I am a 100% true believer in the principles I have learned as an Osteopath and that the combined match is an effort to aid distribution of students and not to merge the professions.

Thanks again for all your talk on this list serve.

 

[Malph]

I think "The DOs: Osteopathic Medicine in America" should be required reading before anyone applies to DO school. In case you forget, the AMA did screw the AOA and the osteopathic profession in general for decades. It's not surprising that there's still some sentiment in the AOA that prevents too much "amalgamation" with what used to be the sworn enemy of osteopathic medicine.

Are you on a military scholarship? You can thank the AOA for that. The AMA fought tooth and nail to prevent DOs from becoming military physicians. Would you like to work in an allopathic hospital? Thank the AOA. If the AMA has had its way, DOs wouldn't even be allowed to become licensed much less allowed employment or even privileges in allopathic hospitals.

I'll be honest with you; I also wanted the combined match. However, I understand perfectly why the AOA decided not go through with it. The profession wants to remain unique and separate but strategically tries to remain "competitive" as much as it can without becoming too absorbed by the larger AMA organization. Truth be told, if I was president of the AOA I would also vote to not combine the matches, even though that would make me very unpopular with many students.

I think as a profession we need to work to improve the Osteopathic Medical world instead of trying to become more like Allopathic medicine. And I totally disagree with JMC: $60 to trade our DO for an MD is *not* an upgrade. If anything, it would be a lateral move.

I think people are missing the point about a combined match. It has NOT ONE THING to do with the profession merging nor losing any identity! It has to do with fair student distribution in a geographically unequal process.

 

[docbill]

From my understanding there are IMGs in DO programs right now--in New York. I am not sure if elsewhere?

- Are these IMGs that completed their medical studies in X country did the USMLES and then are doing a AOA residency.

Or

Are these IMGs, medical graduates from another country, but decided to return to medical school and register at NYCOM in there Emigre Physician program (a 3 year DO program for IMGs, which recognizes there previous work and reduces the program by one year). In this program they still have to learn OMT and have to prepare for boards. Then apply to AOA residency.
This catagory would not be considered IMGs.

 

[H0mersimps0n]

Hey everyone great posts! Finals just ended so I started reading through the forums again and I actually sat down and read all 8 pages of this I'm so interested in it.

First, I'm going to see how the petition turns out then contact one of my LECOM class reps (who has in's in a big way with the admin here) and see if we can pull some strings...

There was a poster around page two that brought up Gevitz book, I assume his new version (what a lazy B-****- only two new chapters and I spent $ on it when I already had the first version-- FYI - if you have the first version- read the extra two chapters at the bookstore and leave). BUT anyway, Gevitz does make a point that the profession needs to maintain certain levels of autonomy to keep from being swallowed by the AMA. This I can understand. BUT, I don't think a combined match is in any way leading us down that path. More on that for another day...

I also thought that since I'm adding my worthless two cents on this very worthwhile topic that I'd use my own observations to make some points.

The AOA leadership needs to be younger. Never in my life have a seen a group of grown men and woman hold onto something so tightly as they do this hatred for MD's. My fiancee is a first year at an MD school (I’m MSII LECOM) and she's told everyone under the sun about me and osteopathic medicine and not once has it been met with a negative comment. The AOA is fighting invisible battles with itself when it comes to us younger generations.

I agree with all those who speak of this combination residency improving the quality of osteopathic medicine residencies. As with nearly everything QUALITY not quantity should be the focus of the AOA. But no, we'd rather write letters to TV shows, reject proposals to improve quality and think that the best way to beat the competition is to belittle them.

So what do I think the AOA really needs to do for us to survive?(wow off topic) No doubt competition in residencies will force changes in quality that sorely need to happen. Research? You bet, we now live in a society that understands proven research = legitimacy (even if that's not always true). Admission committee's at COM's need to recruit students that are very familiar with scientific method and stastics (because I've seen some horrendous things done with osteopathic research that makes me cringe). Finally, embrace our difference with the allopathic profession without being all defensive and insecure about it.

Also I question my membership to the AOA but I understand the pts made and will stay on for now. I'm definitely joining the AMA soon to maintain perspective and understand the issues on the table for them too.

Any kind of couples/combined matches MD/DO would make my day and anything I can do, just let me know.

DrMOM FOR AOA PRES!!

 

[Malph]

- Are these IMGs that completed their medical studies in X country did the USMLES and then are doing a AOA residency.

Or

Are these IMGs, medical graduates from another country, but decided to return to medical school and register at NYCOM in there Emigre Physician program (a 3 year DO program for IMGs, which recognizes there previous work and reduces the program by one year). In this program they still have to learn OMT and have to prepare for boards. Then apply to AOA residency.
This catagory would not be considered IMGs.

I am unsure of this. I was not even aware of this until about three months ago and have not fully researched it in detail. Since you are there maybe you can further answer this qustion for us in greater detail?

On a second note, the idea that combining the match would be helpful for couples has crossed my mind. This will only be true, at this time for those applying to NRMP programs and not AOA.

Which brings me to my next point. There may be many reasons why at this time MDs cannot enter AOA programs, but one that I am aware of are state licensure restrictions:
For instance, in California the California Medical Board states that an MD should attend and ACMGE or a Canadian program to qualify for state licensure.

I understand that this may not be true for all states, but I am in the process of checking each state for this information.