Darn those 5 states...

Discussion in 'Medical Students - DO' started by Stillwell, Apr 22, 2002.

  1. Stillwell

    Stillwell Member

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    Well, at least three, because I am pretty sure I won't practice in OK or WV. But as for PA, FL, and MI, does anyone have any speculation as to whether the Osteopathic internship requirement for these states will end soon? Or, will it expand to other states in the future?

    If not where can I find out? I e-mailed someone at the AOA but no response :(

    Just one more thing to think about as I start to prepare for residency apps.

    Thanks for any help - -
     
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  3. Tammy

    Tammy Senior Member

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    What is the internship requirement?
     
  4. melancholy

    melancholy 1K Member

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    I "think" you have to have done an AOA-approved internship in order to practice in any of those states...

    Someone please correct me if I'm wrong.. this is only what I vaguely remember.
     
  5. Tammy

    Tammy Senior Member

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    That's interesting. So you can't do an allopathic residency? I'll definitely have to check into this further as Florida is a definite possibility for me following med school. My step-daughters (almost anyway) live in Panama City, so we'd like to move closer to them.

    If anyone has more information on this, please post!!!

    - Tammy
     
  6. Sugar72

    Sugar72 Senior Member

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    The way I understand it is that you can do an allopathic residency, but you have to do an approved one year osteopathic rotating internship in addition to your residency in order to be licensed to practice in those states.
     
  7. Tammy

    Tammy Senior Member

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    Do internships pay or treat you any better than residencies? :D
     
  8. GoForIt

    GoForIt Senior Member

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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif"> Do internships pay or treat you any better than residencies? </font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">The answer is both NO

    As an intern, they want you to do different things each month for something like $35000 a year (depends on different hospital). Hence, you may be doing IM one year and then OB/GYN the next month etc. There will be a lots of on call days.

    As an a resident, you will be doing things you like to specialize for a little more money, may be a couple thousand dollars more each year.
     
  9. John DO

    John DO A.T. Still Endowed Chair

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    I am surprised that you are opposed to the rotating internship--it is what sets DOs apart and is beginning to be copied by many MD schools (such as University of Oklahoma). The concept of a rotating internship is to expose the physician to all areas of primary care and limited areas of common practice so that ALL physicians, regardless of specialty, is first and foremost a fully capable PHYSICIAN, rather than just a specialist.

    With this internship requirement in place universally, a patient can rest assured that his cardiologist understands the systemic implications of his treatment and that his Ophthalmologist can understand issues concerning areas other than the eye. It makes sure that we are all equal before we specialize.

    I think it should be more enforced in both schools of medicine, because anything that could make us better physicians should be welcomed, rather than discarded because the money isn't good enough. Heck, $35,000/year is a lot more than i make as a student!!
     
  10. med student

    med student Senior Member

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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by John DO:
    <strong>I am surprised that you are opposed to the rotating internship--it is what sets DOs apart and is beginning to be copied by many MD schools (such as University of Oklahoma). The concept of a rotating internship is to expose the physician to all areas of primary care and limited areas of common practice so that ALL physicians, regardless of specialty, is first and foremost a fully capable PHYSICIAN, rather than just a specialist.

    With this internship requirement in place universally, a patient can rest assured that his cardiologist understands the systemic implications of his treatment and that his Ophthalmologist can understand issues concerning areas other than the eye. It makes sure that we are all equal before we specialize.

    I think it should be more enforced in both schools of medicine, because anything that could make us better physicians should be welcomed, rather than discarded because the money isn't good enough. Heck, $35,000/year is a lot more than i make as a student!!</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">The whole point of medical school is to expose you to all the different fields of medicine during your third and fourth years so why do it again as an intern. In a way it may make you not as good as a doctor when you come out of residency because you lost that year of specilized training.
     
  11. jrich15

    jrich15 Member

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    I also don't agree with a rotating internship. Specialties such as radiology, opthamology, etc. are required to do rotating internship as part of their residency. I believe it is called a transition year in allopathic residencies (feel free to correct me if I am wrong). Cardiologist must also be certified in internal medicine or pediatrics. Most often a cardiologist will do a residency in IM or peds then a fellowship in cardiology. The idea is great for family practice docs and EM. I don't think a peds doc or internist would necessary benefit from it. I know I wouldn't want a internist delivering my wife's baby just because he had a extra rotation in ob-gyn. Plus it adds a year to your residency if you don't fast track or go to an osteopathic residency. But this is just my opinion.
     
  12. GoForIt

    GoForIt Senior Member

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    John DO

    I just answer the question posted by someone regarding 1. treatment between being intern and resident, and 2. salary difference between intern and resident. I believe my answers are pretty much factual.

    I believe you might have put words in my mouth:

    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">I am surprised that you are opposed to the rotating internship--it is what sets DOs apart and is beginning to be copied by many MD schools (such as University of Oklahoma)
    </font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">I did not say, nor did I infer that I oppose to rotating intership, did I?????

    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif"> rather than discarded because the money isn't good enough. Heck, $35,000/year is a lot more than i make as a student!!</font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">I do not know how much you make as a student, nor do I care.

    I hope I make myself clear.
     
  13. Detroit Mick

    Detroit Mick The Supinator

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    I have mixed feelings concerning the internship year particularly being from Michigan and most likely practicing here. I have heard there are ways of substituting the requirement but it is all hearsay at this point. On the other hand, I think it will provide greater insights into IM, OB/GYN, FM & General Surgery that one doesn't get as a student. Since some specialty programs call for a rotating first year anyways, I have heard of DO grads doing their rotating AOA internship during that first year. I am sure it will all work out in the end. :D
     
  14. HARRIETtheSPY

    HARRIETtheSPY Junior Member

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    Actually, the deal is you CAN do an allopathic residency, the catch is it has to have an AOA approved first year. As for pay and the way you're treated, you are still a resident; pay and respect are about even across the board. Expect to make about $35,000/yr no matter where you go or what you do.
     
  15. Sweaty Paul

    Sweaty Paul Senior Member

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    Greeneyedmonster,

    Actually it is Resolution 42 and you all can see the exceptions to it on the AOA web page at:

    <a href="http://www.aoa-net.org" target="_blank">www.aoa-net.org</a>

    Look around a little there and you will find it. The previous posters are correct, you can do an Allopathic Residency (ACGME)in any of the 5 states that currently require an AOA rotating internship, however, if you want to practice in one of those 5 states you must have AOA accreditation for having completed Traditional Osteopathic Intership.

    Resolution 42 allows an individual, who meets some incredibly draconian standards, to get their ACGME accredited residency accredited by the AOA. Even then, those choosing to get AOA approval have extra work to complete the AOA accreditation.

    I respectfully disagree with John DO, however, I think the way of the rotating internship is the way of the dinosaur as employed by the osteopathic profession. Instead of being used as a teaching tool it is used as a method of acquiring cheap labor. Currently there will be an estimated 2700 students who will be graduated this spring of osteopathic medical schools. There are only 2500 Rotating internship spots available and only 1989 of those spots are paid.

    I also agree that many of the ACGME residencies currently require their first year residents to do a rotating internship style instruction, so what besides the OMT is the Osteopathic Student in an ACGME residency losing? The only conclusion that I come to again is cheap labor, so why not give dual accreditation?...b/c the profession is dependant upon cheap labor even though they don't have enough rotating internships available (paid/unpaid) to take care of all of the graduates...and we're adding two more schools.

    The answer is simple...dual accreditation with a weekend of CME hours required on manipulation/yearly, open the AOA with all privledges to any student graduated from an osteopathic institution, and watch the conroversy over the rotating internship fade into the sunset.

    Sweaty Paul
     
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  17. HARRIETtheSPY

    HARRIETtheSPY Junior Member

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    Amen Paul!

    I understand that the AOA doesn't want to do things the AMA way for fear of losing our distinct identities as DOs, but the only thing they are accomplishing is frustrating a lot of students. It is becoming harder for me to feel the loyalty I should feel toward my profession because of all the limitations imposed on me. I CHOSE to go to a DO school because of their history of acceptance of women in medicine and diversity. However, I sometimes wish I had saved myself a load of cash and struggle and gone to my state school.
     
  18. Sweaty Paul

    Sweaty Paul Senior Member

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    Harriet,

    Now see the dilemma, we both see the problem, however, if we don't stay involved with the process (i.e. bcm members of the AOA) we can't fix anything. It is a nasty thing, however, it almost forces you/me, if we have a social conscience, to try to get involved. Wonder if the rotating internship would be so bad...

    Got to study for boards and worry about this later.

    Sweaty Paul
     
  19. FroDO

    FroDO New Member

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    Sweaty Paul et al,

    Please let me know where you're getting your infomation regarding practice rules for "those 5 states."

    You state:
    "....if you want to practice in one of those 5 states you must have AOA accreditation for having completed Traditional Osteopathic Intership."

    Since Oklahoma is speculated to be one of these 5 states please see the quote below from the Oklahoma Osteopathic Act regarding licensure and practice:

    (a) Licensure by Board required. It is the general requirement in the State of Oklahoma that practitioners of osteopathic medicine and surgery be licensed by the State Board of Osteopathic Examiners. (b) Temporary license. The Osteopathic Medicine Act does not authorize the Board to issue a temporary license for any purpose. (c) Postgraduate training. One year of postgraduate training is a requirement for licensure. This experience must be in the form of a rotating internship or its equivalent, in an accredited internship or residency program acceptable to the Board. To be deemed equivalent to a rotating internship and, acceptable to the Board, a program must provide the following: (1) The program must provide the following core experience: (A) One (1) month - General Practice (B) Two (2) months - General Internal Medicine (C) One (1) month - General Surgery (D) One (1) month - Obstetrics/Gynecology (E) One (1) month - Pediatrics (2) This core experience must be supplemented by three (3) months of Selectives and three (3) months of Electives, accounting for a total of twelve (12) months. A Selective may be defined as any core category or Emergency Medicine. An Elective may be any category of experience chosen by the intern or resident. (3) If an applicant has completed an ACGME accredited residency training program and become specialty board eligible or attained specialty board certification, the Board may consider this standing as equivalent training.

    Please pay particular attention to this last line. Nowhere does it state that Oklahoma requires an "AOA-approved" internship, therefore why would Resolution 42, 19, or others even apply in this case? People interested in practicing in those other 4 states may want to review state licensing laws there as well.

    From my experience in OK, I've seen DO's routinely enter ACGME residencies right out of med school and have no problem getting a license to practice in OK, regardless of whether the AOA approves or not. The key phrase here is "rotating internship," which means the first year of residency is spent rotating in the specified fields. Ultimately the power lies with the state boards, not the AOA.
     
  20. Sweaty Paul

    Sweaty Paul Senior Member

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    FroDO,

    Hey, cool handle. (Is 'handle' the correct terminology in cyber-space? I am a child of the late '70's and '80's and during a portion of that time CB's and 'handles' were very cool).

    In any event FroDO you are correct licensing does come down to the state boards and their requirements. I also agree that each state board should be contacted to determine their interpretation of the law. I did not intend to comment on state law, I was reporting the information that I have gotten from the AOA concerning the rotating internship and licensure in 5 states.

    Further my comments on Resolution 42 were so people would learn where to find it and what its ramifications, at least within the AOA meant if they applied for and recieved recognition for an ACGME Residency exception. Also, there are some other considerations when thinking about the topic of the rotating internship. If you do not do an AOA approved Rotating Internship, you are unable to be head of any academic department at an Osteopathic Institution; this includes being a Dean.

    I am not saying that everyone wants to go into academic med at an osteopathic medical school. However, I think it is a shame to have the doors closed to osteopathic students who chose to augment their continued training in an environment outside of the traditional osteopathic training pardigm. I also think that by having these exclusionary policies we, as a profession, may be losing potential members of the AOA who could add lots to the osteopathic profession if they didn't feel spurned by
    their profession.

    Anyway, just a couple pennies of my thoughts. Perhaps once boards are completed we can check with members of the various state licensing boards where the Rotating internship requirements are in question and we can post that info here to help all osteopathic students figure out what they need to do to make an intelligent decision for themselves on the topic.

    Sweaty Paul
     
  21. FroDO

    FroDO New Member

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    Sweaty Paul,

    Glad you agree. I have also heard this rumor that not completing an AOA-approved internship may bar one from higher posts within the osteopathic academic environment. However, I also have doubts about this information and would like to see something official. If this were the case, then are PhD's, JD's, DDS's also barred from higher academic positions? This doesn't seem to be the case at my school - OSU-COM. And, aren't there other osteopathic schools out there that have had non-DO deans at one time or another?

    Best of luck on your boards. They're not as scary as others would have you believe.
     
  22. Sweaty Paul

    Sweaty Paul Senior Member

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    FroDO,

    It was my understanding that the "Department Heads" issue is for clinical departments only. I am sure there are ways around it, how one writes an organizational flowchart may facilitate 'exceptions' to be made. Again, my information is coming from the AOA, however, I'll put this issue on my "to be checked on once boards are completed" list. I'll contact the AOA and then I'll post the response here for everyone's perusal. As for individual states; we'll need to create a list of specific question to have answered and get volunteers to contact the state medical boards in the five states that allegedly don't license D.O.'s without a Rotating Internship. Once we get the answers we can post that information here to allow others to get the real story.

    Sweaty Paul MS-II
    KCOM
     

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