Can someone educate me on this?

[Raven Feather]

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I know in most states, a while ago, DOs had to do the traditional rotating internship year before residency, right? Now, since then, things have changed. Only, like 5 states currently require this of DOs (for whatever reason). So that being said, since my state that I intend on practicing in does not require that I'm wondering if all osteo residencies are set up to still include that one year or what? Excuse my ignorance on this subject. 😀

 

[bkpa2med]

I can't answer this question, but I would like to know more as well. Which 5 states require this?

 

[Raven Feather]

I can't answer this question, but I would like to know more as well. Which 5 states require this?

I know one is Louisiana, I think Florida...can't remember the rest of the 3. I don't want to do an extra year, since I will not be practicing in any of the 5 states that require it.

 

[Sundarban1]

I know one is Louisiana, I think Florida...can't remember the rest of the 3. I don't want to do an extra year, since I will not be practicing in any of the 5 states that require it.

I thought the rotating year was the same as the traditional interning year and not in addition to your internship year before you begin residency 😕

 

[Doctor Bagel]

the five states are oklahoma, pennsylvania, florida, west virginia and michigan (i think? -- might be ohio). i think that if you do an osteopathic residency, your internship year will be a traditional rotating internship, so you're good on that score. if you do an allopathic residency, sometimes you can do an osteopathic internship, which also meets the requirement. if you go allopathic all the way, you have to get the aoa to approve your internship year, which maybe could be a hassle.

it's a stupid requirement that should be dumped, imo.

 

[Doctor Bagel]

I thought the rotating year was the same as the traditional interning year and not in addition to your internship year before you begin residency 😕

apparently, in some specialties, you might be required to do two internship years, a traditional rotating internship to please the aoa, and a specialty-specific internship. i think this is definitely true with neurology and becomes an issue with psych.

 

[Raven Feather]

I am so freaking confused. I heard or read at some point in time that there are many AOA + ACGME approved programs, like it wasn't that big of a deal as far as approval. Then I get further confused when some MD programs make one do an internship + 3 years and others count it for a 1+2=3 years of residency. So do all DO programs require a total of 4 years after graduating med school?

 

[OSUdoc08]

apparently, in some specialties, you might be required to do two internship years, a traditional rotating internship to please the aoa, and a specialty-specific internship. i think this is definitely true with neurology and becomes an issue with psych.

This is incorrect.

You either do a traditional rotating internship or specialty emphasis internship.

For example:

You can do a traditional PGY-1 internship and then apply to and enter any program as a PGY-2.

You can do a specialty emphasis PGY-1 internship, and remain in the program the following year, continuing as a PGY-2

 

[OSUdoc08]

I am so freaking confused. I heard or read at some point in time that there are many AOA + ACGME approved programs, like it wasn't that big of a deal as far as approval. Then I get further confused when some MD programs make one do an internship + 3 years and others count it for a 1+2=3 years of residency. So do all DO programs require a total of 4 years after graduating med school?

It depends on the residency.

Here is an example:

ACGME emergency medicine residencies: 3 years or 4 years of residency (no internship)

AOA emergency medicine residencies: 1 year of specialty emphasis emergency medicine internship + 3 years of residency

If you do an ACGME residency, then in order to be AOA certified, you must prove that you could not attend an AOA program. This could be a simple as stating that there are no AOA residencies in the same area that you live in the specialty that you want. It is not an automatic approval, especially if you are in the same town as an AOA residency.

 

[Doctor Bagel]

This is incorrect.

You either do a traditional rotating internship or specialty emphasis internship.

For example:

You can do a traditional PGY-1 internship and then apply to and enter any program as a PGY-2.

You can do a specialty emphasis PGY-1 internship, and remain in the program the following year, continuing as a PGY-2

I don't know, I've read about people in neurology especially having problems. Check out the neurology board and do a search to see what I'm talking about. Supposedly, lots of pgy-2 neurology programs don't accept the traditional rotating internship -- they want you do to a specific internal medicine internship. Also, with psych, you have to do an intership that has like six months of psych. I'm not convinced yet that it's not a hassle, especially for two of the top fields that I'm interested in.

 

[OSUdoc08]

I don't know, I've read about people in neurology especially having problems. Check out the neurology board and do a search to see what I'm talking about. Supposedly, lots of pgy-2 neurology programs don't accept the traditional rotating internship -- they want you do to a specific internal medicine internship. Also, with psych, you have to do an intership that has like six months of psych. I'm not convinced yet that it's not a hassle, especially for two of the top fields that I'm interested in.

In the AOA, there are no specialty emphasis internships in neurology. There are specialty emphasis internships in internal medicine, but neurology is NOT a subspecialty of internal medicine.

In the ACGME, neurology is one of those specialties that requires an internship year. This year is linked to the residency program, and no reapplication is needed. That year would be easily approved by the AOA without completing an additional traditional rotating internship.

For psychiatry, there IS a specialty emphasis internship in psychiatry. You would likely not to a tradition internship for this specialty. You would have to do this prior to entering residency with either the AOA or ACGME (if you wanted to be AOA certified.)

 

[Doctor Bagel]

okay, here's a neurology thread discussing it. basically, you can do a dually approved program or try to get aoa approval, which might not happen. either way, though, it sounds like a pita.

http://forums.studentdoctor.net/showthread.php?t=87143&highlight=osteopathic

 

[OSUdoc08]

okay, here's a neurology thread discussing it. basically, you can do a dually approved program or try to get aoa approval, which might not happen. either way, though, it sounds like a pita.

http://forums.studentdoctor.net/showthread.php?t=87143&highlight=osteopathic

If you really want the AOA approval, why not just do an AOA residency?

The reason I'm doing an ACGME residency is because I don't need AOA approval, and this will cut my training by a year.

If you are doing the extra time just for an ACGME residency, what's the point? It's doesn't give you any added benefits.

 

[Doctor Bagel]

For psychiatry, there IS a specialty emphasis internship in psychiatry. You would likely not to a tradition internship for this specialty. You would have to do this prior to entering residency with either the AOA or ACGME (if you wanted to be AOA certified.)

You know, they really need to get rid of the traditional rotating internship for the reasons noted above. For example, why would one attend OSU over OU in a state like Oklahoma with that silly requirement. If you're sure you want to do fp, fine, it's no biggie, but other than that, you might be stuck doing an extra year. At some level, it has to be hindrance to recruiting. If not, it just exacerbates the physician shortage. If I want to be close to my family, I might just practice in Missouri or Arkansas and not Oklahoma just because of that requirement.

Again, why does the osteopathic community in these five states create this problem for all of us?

 

[Doctor Bagel]

If you really want the AOA approval, why not just do an AOA residency?

The reason I'm doing an ACGME residency is because I don't need AOA approval, and this will cut my training by a year.

If you are doing the extra time just for an ACGME residency, what's the point? It's doesn't give you any added benefits.

well, for psych, there just aren't enough osteopathic residencies. i think there are four programs in the country in either michigan or new jersey. the options are pretty d@mn limited. i assume it's the same for neuro, too, but i could be wrong.

so are you not going to be able to practice in oklahoma, either? do you not need aoa approval because you don't care? again, more fuel to my argument above that the osteopathic community in oklahoma is stupid for keeping the requirement.

 

[OSUdoc08]

You know, they really need to get rid of the traditional rotating internship for the reasons noted above. For example, why would one attend OSU over OU in a state like Oklahoma with that silly requirement. If you're sure you want to do fp, fine, it's no biggie, but other than that, you might be stuck doing an extra year. At some level, it has to be hindrance to recruiting. If not, it just exacerbates the physician shortage. If I want to be close to my family, I might just practice in Missouri or Arkansas and not Oklahoma just because of that requirement.

Again, why does the osteopathic community in these five states create this problem for all of us?

Once again, neurology is NOT an extra year of training. If you do an ACGME residency in neurology in Oklahoma or any other state, the AOA will accept the first year of your ACGME residency as the internship year.

With psychiatry, there are NO AOA programs in Oklahoma. Therefore, you will also recieve credit for the first year of ACGME residency.

Therefore, with Neurology & Psychiatry in Oklahoma, you do not need to do an AOA internship year with an ACGME residency. No moving out of state to practice will be needed.

 

[OSUdoc08]

well, for psych, there just aren't enough osteopathic residencies. i think there are four programs in the country in either michigan or new jersey. the options are pretty d@mn limited. i assume it's the same for neuro, too, but i could be wrong.

so are you not going to be able to practice in oklahoma, either? do you not need aoa approval because you don't care? again, more fuel to my argument above that the osteopathic community in oklahoma is stupid for keeping the requirement.

I'm not sure what statements you have made have proved the requirement is "stupid." Please recap, if possible.

You don't need to do an AOA internship with ACGME Psychiatry or Neurology to practice in Oklahoma. What more do you want?

 

[Claymore]

Since you guys mentioned neurology I thought I'd chime in since I'm currently going through the ACGME match. Some programs are linked (meaning all 4 years are included at the same insititution) and others are not (meaning you are on your own to find a separate PGY-1 internship). From my experience it's roughly 50/50. The licensing board for Neurology is somewhat unique in that they actually require you to essentially do a Prelim Medicine year as opposed to say a transitional internship b/c they require a minimum of 6 mos of Medicine and 2 months of Medicine/ER/ICU. Most osteopathic internships are unable to accomodate this emphasis on IM and thus are not an option if you plan on becoming board certified in neurology. Now, whether or not the AOA would just approve an ACGME Medicine internship is another story, but since you will probably not get to fulfill their typical requirements (ie, Peds, Surgery, OB/Gyn, etc) I don't know.

 

[futuredo32]

I live in Michigan and unfortunately(for me) it is one of the five states that require an osteopathic internship year. Ohio is another one of the states. I think it is really confusing and to be honest, I would like to know more about it as well.

 

[Doctor Bagel]

I'm not sure what statements you have made have proved the requirement is "stupid." Please recap, if possible.

You don't need to do an AOA internship with ACGME Psychiatry or Neurology to practice in Oklahoma. What more do you want?

Are you this rude all the time? Just wondering.

The requirement is silly because it sometimes forces people to do an extra year. Claymore's post confirms that it's certainly a possibility that you'll have to if you want to fulfill AOA requirements. It also seems to add another layer of complication to the already stressful residency application thing. Judging by how many posts you see in the osteopathic board and the residency boards, you'll see that the requirement is burdensome. Maybe you can get around, maybe you can't. It is true that some people in fields like neurology have to do an extra year to make the AOA happy, and that's stupid.

I also think it's pretty plausible that this requirement does increase physician shortages in those five states.

 

[Doctor Bagel]

Since you guys mentioned neurology I thought I'd chime in since I'm currently going through the ACGME match. Some programs are linked (meaning all 4 years are included at the same insititution) and others are not (meaning you are on your own to find a separate PGY-1 internship). From my experience it's roughly 50/50. The licensing board for Neurology is somewhat unique in that they actually require you to essentially do a Prelim Medicine year as opposed to say a transitional internship b/c they require a minimum of 6 mos of Medicine and 2 months of Medicine/ER/ICU. Most osteopathic internships are unable to accomodate this emphasis on IM and thus are not an option if you plan on becoming board certified in neurology. Now, whether or not the AOA would just approve an ACGME Medicine internship is another story, but since you will probably not get to fulfill their typical requirements (ie, Peds, Surgery, OB/Gyn, etc) I don't know.

What are your plans, Claymore? Are you going to wind up fulfilling the AOA requirement or just give up on that?

 

[Raven Feather]

If you really want the AOA approval, why not just do an AOA residency?

The reason I'm doing an ACGME residency is because I don't need AOA approval, and this will cut my training by a year.

If you are doing the extra time just for an ACGME residency, what's the point? It's doesn't give you any added benefits.

That's the thing, I'd rather not do an extra year. So if I am practicing in a state without that requirement and am a D.O. and go into ACGME program, it doesn't matter that it is AOA approved or not/that I am AOA certified? With that hinder us later on somehow?

 

[Claymore]

What are your plans, Claymore? Are you going to wind up fulfilling the AOA requirement or just give up on that?

I am going to be practicing in a state that does not require the AOA internship, so I haven't really worried about it too much. If you knew for sure that you wanted to practice in a state that required it, your best bet would probably to match at a program where you are free to do your internship year wherever you want. Then, you could look for internship programs that would satisfy both ACGME Neuro requirements and AOA requirements. This would likely mean a program with a lot of built in elective time, or one that was dually accredited.

Again, since the Neuro licensing board is so particular about what they require, maybe it is possible to get your Medicine internship AOA approved. I really haven't looked into it b/c I'm not looking to practice in the 5 magical states. But I would be kind of surprised, since my internship will be nothing like the typical AOA one.

 

[Claymore]

That's the thing, I'd rather not do an extra year. So if I am practicing in a state without that requirement and am a D.O. and go into ACGME program, it doesn't matter that it is AOA approved or not/that I am AOA certified? With that hinder us later on somehow?

No, it won't hurt you, unless you try to practice in one of those 5 states somewhere down the line.

Keep in mind something like 50% or more graduating DO's do allopathic residencies, so you will be fine.

 

[yasha83]

This talk of different requirements for the AOA and ACGME has me, among others a bit confused. The way I understand it, a typical MD school grad requires a total of 4 years (minimum) residency. From what I understand so far (which isn't that much yet) the first year of such a residency is an internship depending on the requirements of the specialty (neuro for example). My concern is this; should someone decide to do an allopathic ACGME residency (anesthesia for example, which I have always been interested in) I could go straight from med-school to a residency. Would the AOA require someone do an AOA internship for 1 year prior to accepting this ACGME residency? will this internship count for pgy-1? Is AOA approval of traditional ACGME internships common or difficult to obtain? Also, how do the previously mentioned 5 states differ in their treatment of the above issue?

I feel these are the concerns being thrown around in the above posts. would anyone be so kind as to post answers to these issues. I'm sure some of these questions have already been answered by OSUDoc08, among others. but by reposting a thurough reply might help to clarify the issue here

 

[Claymore]

This talk of different requirements for the AOA and ACGME has me, among others a bit confused. The way I understand it, a typical MD school grad requires a total of 4 years (minimum) residency. From what I understand so far (which isn't that much yet) the first year of such a residency is an internship depending on the requirements of the specialty (neuro for example). My concern is this; should someone decide to do an allopathic ACGME residency (anesthesia for example, which I have always been interested in) I could go straight from med-school to a residency. Would the AOA require someone do an AOA internship for 1 year prior to accepting this ACGME residency? will this internship count for pgy-1? Is AOA approval of traditional ACGME internships common or difficult to obtain? Also, how do the previously mentioned 5 states differ in their treatment of the above issue?

I feel these are the concerns being thrown around in the above posts. would anyone be so kind as to post answers to these issues. I'm sure some of these questions have already been answered by OSUDoc08, among others. but by reposting a thurough reply might help to clarify the issue here

Ok, a lot of your confusion stems from the fact that all specialties have different requirements. Some REQUIRE a separate internship, before beginning residency (Neurology and Anesthesiology are examples of these). In this case, your internship is PGY-1 (whether MD or DO) and then you do 3 years of residency. Other specialties do not require a separate internship...Medicine and Family Practice for example. For these, your first year of residency is considered your "internship", although it is just your first year of a continuous 3 year residency (total). So no, you do not have to do 4 years after graduating, many people only do 3.

The easiest thing to do is figure out what specialty it is that you want to do, and then learn the specifics of how to get to that point. There is no cut-and-dry single path that applies to all specialties.

For ACGME anesthesia, after graduating from med school you first do a one year PGY-1 internship. It is my understanding that it can be AOA or ACGME approved and can be either transitional, prelim med, or prelim surg(they are not as picky as Neuro). Following your internship you would then begin 3 years of anesthesia residency, which may or may not be at the same institution where you did your internship. Incidentally, this is the same path that both MD's and DO's would take.

 

[Doctor Bagel]

here's a thread specifically about psych is anyone else out there is interested in it. psych seems easier than neuro if you care about aoa approval because some psych programs actually give you credit for your traditional rotating internship.

http://forums.studentdoctor.net/showthread.php?t=117377&highlight=aoa+internship

 

[yasha83]

Thanks for your help Claymore!!! 🙂

 

[kahoo99]

here's a thread specifically about psych is anyone else out there is interested in it. psych seems easier than neuro if you care about aoa approval because some psych programs actually give you credit for your traditional rotating internship.
http://forums.studentdoctor.net/showthread.php?t=117377&highlight=aoa+internship

But the bottom line is that the AOA approved internship is only relevent in 5 states, yes?

 

[Doctor Bagel]

But the bottom line is that the AOA approved internship is only relevent in 5 states, yes?

Yeah, I'm pretty sure that's the case, so that's good news.

 

[Monty Python]

I know one is Louisiana, I think Florida...can't remember the rest of the 3. I don't want to do an extra year, since I will not be practicing in any of the 5 states that require it.

Au contraire, Pierre. Louisiana legislature recently eliminated this archaic regulation.

http://www.loma-net.org/legislativeupdates.htm


Osteopathic Medicine Achieves Parity in Louisiana

(New Orleans, LA) –The osteopathic profession achieved a critical victory in Louisiana when a rule change by the Louisiana State Board of Medical Examiners (LSBME) established parity between the Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA) and the United States Medical Licensing Examination (USMLE), and between the American Osteopathic Association (AOA) certifying boards and the boards of the American Board of Medical Specialties (ABMS).

“Reaching this definitive victory in Louisiana in 2005 was the result of several years of hard work on the part of the AOA and leaders of the osteopathic medical profession in Louisiana,” said AOA President
Philip L. Shettle, D.O.

The June 20th ruling, granting parity between the AOA certifying boards and the American Board of Medical Specialties (ABMS) boards, by the Louisiana State Board Medical Examiners (LSBME) is the most recent success in a string of osteopathic victories.

“We spent years and years educating the Louisiana medical board about osteopathic medicine,” explains Nancy Bellemare, D.O., president of the Louisiana Osteopathic Medical Association (LOMA) between 1997 and 2005.

The AOA and LOMA worked with the LSBME for several years toward the ruling on May 30, 2001, that amended the Louisiana Medical Practice Act to include both D.O.s with M.D.s in the state’s definition of medical physicians. The next month, the LSBME revised its licensure rules to recognize the AOA’s COMLEX-USA and earlier NBOME qualifying exams.

However, the LSBME ruling was not a complete triumph for the osteopathic profession because D.O.s who passed COMLEX-USA were required to be certified by an ABMS board, until now.

The new rule allows osteopathic physicians in any specialty to present the board proof of passing the COMLEX-USA as the first step toward obtaining full and unrestricted licensure in Louisiana. They no longer need to be ABMS board-certified in order for the COMLEX-USA to be recognized. In addition, as long as they have completed at least one year of post-graduate clinical training in either an AOA program or an Accreditation Council for Graduate Medical Education (ACGME) program within the past 10 years, D.O.s who are licensed in other states will be granted reciprocity in Louisiana.

“Now that restrictions for D.O.s are no longer in place, Louisiana natives who graduate from osteopathic medical schools won’t have any stumbling blocks in their way if they want to return home to practice,” notes Joel Glen Eldridge, D.O, the newly elected president of LOMA.

“The achievement of licensing parity for D.O.s in Louisiana will facilitate growth of the osteopathic profession and increase the availability of quality primary care physicians in underserved and rural areas of the state,” adds Ed Williams, Ph.D., Executive Director of LOMA.

 

[Hoberto]

The five states requiring the AOA-approved internship are Florida, Michigan, Oklahoma, Pennsylvania, and West Virginia.

I found this through the AOA website.

 

[OSUdoc08]

Yeah, I'm pretty sure that's the case, so that's good news.

The internship is only relevant if you are interested in being licensed by the AOA. You are only required to be licensed by the AOA in those 5 states, but you may choose to be licensed in other states due to various reasons, including affiliation with the AOA.

However, I plan to do an ACGME residency in an area where there are no AOA residencies. As a result, I will easily get the AOA certification if I ever make the decision to practice in one of those 5 states.

 

[kahoo99]

Is there a sight that lists AOA residencies?

 

[OSUdoc08]

Is there a sight that lists AOA residencies?

http://opportunities.aoa-net.org/

 

[kahoo99]

thanks

 

[Raven Feather]

This talk of different requirements for the AOA and ACGME has me, among others a bit confused. The way I understand it, a typical MD school grad requires a total of 4 years (minimum) residency. From what I understand so far (which isn't that much yet) the first year of such a residency is an internship depending on the requirements of the specialty (neuro for example). My concern is this; should someone decide to do an allopathic ACGME residency (anesthesia for example, which I have always been interested in) I could go straight from med-school to a residency. Would the AOA require someone do an AOA internship for 1 year prior to accepting this ACGME residency? will this internship count for pgy-1? Is AOA approval of traditional ACGME internships common or difficult to obtain? Also, how do the previously mentioned 5 states differ in their treatment of the above issue?

I feel these are the concerns being thrown around in the above posts. would anyone be so kind as to post answers to these issues. I'm sure some of these questions have already been answered by OSUDoc08, among others. but by reposting a thurough reply might help to clarify the issue here

I think the minimum for most states is 3 yrs I believe, you can find this length of residencies in FP and EM, for example. Can't help you out with the other questions though.

 

[Beau Geste]

I thought after 1 year you were eligible to obtain a GP license, and then the specific residencies/board specialties are a certain length, such as FP = 3 yrs, Rads = 5 years, Neurosurgery = first born.

 

[Raven Feather]

I thought after 1 year you were eligible to obtain a GP license, and then the specific residencies/board specialties are a certain length, such as FP = 3 yrs, Rads = 5 years, Neurosurgery = first born.

I think it all depends on the state.

 

[Beau Geste]

http://en.wikipedia.org/wiki/General_practitioner

I wouldn't take it as gospel, but it's at least a start.

 

[futuredo32]

Does anyone know where on the AOA site to find the specifics on how to apply for a waiver of the AOA intern year?

 

[OSUdoc08]

I thought after 1 year you were eligible to obtain a GP license, and then the specific residencies/board specialties are a certain length, such as FP = 3 yrs, Rads = 5 years, Neurosurgery = first born.

There is no such thing as a GP license. This has been phased out over the years, and no longer exists.

You can be licensed after Step 3 of the boards, but you will not be board certified in anything. The only place you'll probably get hired is a nursing home.

 

[Doctor Bagel]

I think it all depends on the state.

True, but I think one year is the general requirement for most states just for basic licensing. Illinois requires two years, I think -- don't know why I know that one. I guess it used to be totally normal to just do one year, which is why we have the whole silly traditional rotating internship thing. My aunt's ex, an MD, only did one year and worked as a GP in Missouri for ages. I think he didn't have hospital admitting rights anywhere, though, but that could be because of something else. 🙂

 

[OSUdoc08]

True, but I think one year is the general requirement for most states just for basic licensing. Illinois requires two years, I think -- don't know why I know that one. I guess it used to be totally normal to just do one year, which is why we have the whole silly traditional rotating internship thing. My aunt's ex, an MD, only did one year and worked as a GP in Missouri for ages. I think he didn't have hospital admitting rights anywhere, though, but that could be because of something else. 🙂

To have hospital privileges anywhere, you need to be board certified/board eligible in something, or be "moonlighting" while working in a residency program.

Hospitals have quickly phased out allowing physicians in that have not completed a residency, and It would be difficult to find a hospital that allows this, save from extremely underserved areas.

 

[BMW19]

If you are in the military, I am 95% sure you can practice after 1 year as they heavily need GP's. However, I believe you will be practicing in their hospitals or on an Air force base (Ex.).

So If I do a dually accredited program (AOA and ACGME) in one of those five states will I still have to do 1 year intern+ 3 years residency using EM as an example?

What if you just do a residency in one of those states but don't ever want to practice there?

B-

To have hospital privileges anywhere, you need to be board certified/board eligible in something, or be "moonlighting" while working in a residency program.

Hospitals have quickly phased out allowing physicians in that have not completed a residency, and It would be difficult to find a hospital that allows this, save from extremely underserved areas.

 

[Doctor Bagel]

What if you just do a residency in one of those states but don't ever want to practice there?

B-

I think you're technically okay, but I've heard stories of programs in those states wanting people to meet the AOA requirement. Would it affect moonlighting, too? I wouldn't want to do that just on the off chance that I'd fall in love with wherever I was or get really situated and not want to leave.