DO schools in PA/MI/OK/FL and TRI requirement

[withoutlyrics]

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I have been reading about the requirement of a traditional rotating internship prior to residency in the above states and it is a cause for concern.. ie. I would not want to extend my years of training further and go through residency training in those states if I am to become a DO, provided that this law is still in use in the near future.

Now, is it a reasonable assumption to make that matching in the state of your medical school is slightly easier -- perhaps because you don't need do away audition rotations, or perhaps because your school is slightly more respected in your state than nationally, or perhaps because some of the state's residency programs have a history of accepting its graduates? Going off of that assumption, should this concern reasonably factor into school selection?

 

[cliquesh]

To practice as an attending physician in PA/MI/OK/FL you need to do an AOA residency, traditional rotating internship, or apply for resolution 42.You can still do an acgme residency/fellowship in those states without doing any of that.

It shouldn't be a factor unless you want to practice in those states.

Additionally, almost everyone who applies for resolution 42 gets it, so it shouldn't really be an issue.

 

[Temperature101]

To practice as an attending physician in PA/MI/OK/FL you need to do an AOA residency, traditional rotating internship, or apply for resolution 42.You can still do an acgme residency/fellowship in those states without doing any of that.

It shouldn't be a factor unless you want to practice in those states.

Additionally, almost everyone who applies for resolution 42 gets it, so it shouldn't really be an issue.

What is that?

 

[cliquesh]

What is that?

AOA Internship Requirement Explained

1) Why should I care?
To receive licensure to practice in all 50 states your internship year must be approved by the AOA. If you do not receive approval, you will not be able to practice in Michigan, Florida, Pennsylvania, or Oklahoma (note: West Virginia used to be on this list but they recently changed this rule).

*

2) How do I get approval?
If you complete an AOA osteopathic residency you have nothing to worry about and will be licensed in all 50 states.

If you complete an ACGME (MD) residency without an AOA-internship year you have to apply for Resolution 42.

*

3) What is Resolution 42?
Resolution 42 is a method to have your ACGME PGY-1 year approved by the AOA. Gaining approval through Resolution 42 will guarantee you licensure in all 50 states.



*

4) What are the requirements to get my internship year approved?
The requirements mostly depend on what rotations you complete during your PGY-1 year. What rotations are required vary depending on your specialty. As an applicant, you have the ability to compare your rotations either to your OGME-1 specialty year or the AOA traditional rotating internship. *

Please browse this pdf to find your specialty and see what is required to receive approval:
http://www.osteopathic.org/inside-a...ng/Documents/resolution-42-core-rotations.pdf

6) Can I be approved if my intern year does not include all of the required rotations?

There is a mechanism for approval if an individual fails to meet the required rotations in their ACGME program. *First, remember a DO MAY gain approval with rotations met in their latter training years. *However, if rotations are not met, an applicant can request a waiver of those rotations from the AOA Program and Trainee Review Council. In order to petition for a waiver a trainee must send in a letter explaining why they are requesting a waiver.

*

7) What if I don't receive approval?
You will be fully licensed to practice in 46 states but cannot practice in Michigan, Florida, Pennsylvania, or Oklahoma. You will not be eligible for osteopathic specialty boards due to lack of an AOA Internship.

*

8) Could my specialty board eligibility be affected?
If you do not complete an AOA-approved internship year you will NOT be eligible for certification through an osteopathic specialty board. However, because you would be participating in an ACGME program, you will still be eligible for certification through an allopathic specialty board.

*

9) Can I receive licensure by taking the USMLE?
You may choose to receive licensure by passing USMLE Step 1, Step2, and Step 3 but you will still have to receive AOA approval of your internship to be licensed in Michigan, Pennsylvania, Oklahoma, and Florida. Additionally you will not be allowed to practice in Oklahoma, Maine, Tennessee, California, or Arizona as they require Doctors of Osteopathy to pass COMLEX Levels 1, 2, and 3 to be licensed.

*

10) What if I want to be licensed in all 50 states but want to go to a program where I will not meet the requirements to receive approval through Resolution 42?
You may complete an osteopathic rotating internship before entering a residency program. This will extend your GME training by one year unless you are then accepted into a residency program as a PGY-2.


*

5) The ACGME program I'd like to go to doesn't include all of the required rotations. What should I do?
Ask the program about the rotations and if there is any flexibility to accommodate the Resolution 42 requirements. Additionally, examine your other PGY years of training to see if you will complete any of the missing rotations. *If the rotations are completed later in training, you can still receive approval of your internship. But it is highly recommended to applicants to complete these rotations in the first year to avoid scheduling conflicts. * *

Ask if anyone has previously applied for Resolution 42 and what they did to get approved (or what caused them to be denied).

You may also contact the AOA to gain better insight and advice. *Contact the AOA Division of Trainee Services at 312.202.8276.

*
"According to AOA records, since 2000, only 4 of 400 applicants for this exception have been turned down, a mere 1% of all applicants." This quote was taken from a 2006 paper.

 

[hallowmann]

I have been reading about the requirement of a traditional rotating internship prior to residency in the above states and it is a cause for concern.. ie. I would not want to extend my years of training further and go through residency training in those states if I am to become a DO, provided that this law is still in use in the near future.

Now, is it a reasonable assumption to make that matching in the state of your medical school is slightly easier -- perhaps because you don't need do away audition rotations, or perhaps because your school is slightly more respected in your state than nationally, or perhaps because some of the state's residency programs have a history of accepting its graduates? Going off of that assumption, should this concern reasonably factor into school selection?

I'm not getting the misinformation floating around. The required TRI in those states doesn't mean you have to do an extra year or something, its the same 1yr internship that every physician must go through. That is their 1st year of residency.

That being said the TRI has special requirements like cliquesh said that may not be included in the ACGME transitional internship, so if you do an ACGME residency, you'll have to be proactive, apply early for Res 42 and probably communicate with the program you are doing your internship at in case there are any discrepencies. From the people I know that have had to apply for Res 42, they said its straightforward enough, and is more or less just paperwork and fees.

 

[withoutlyrics]

Thank you for clarifying and sorry for the confusion. From my understanding, the problem only persists if your ACGME residency program does not satisfy the res 42 requirements, in which case you do have to do an extra year to gain practice rights in PA/MI/OK/FL. What are some specialties that would run into this problem? I was reading that pathology is one. Is that the case? Any others?

(To be sure, I do now understand that the problem can be avoided entirely with AOA residency.)

 

[Major]

Wonder how the merger will affect this rule in those states...?

And I thought Ca had the same rule also?

 

[Drrrrrr. Celty]

9) USMLE can license DOs already?

 

[sylvanthus]

Wonder how the merger will affect this rule in those states...?

And I thought Ca had the same rule also?

If and when the merger actually happens.

 

[Temperature101]

AOA Internship Requirement Explained

1) Why should I care?
To receive licensure to practice in all 50 states your internship year must be approved by the AOA. If you do not receive approval, you will not be able to practice in Michigan, Florida, Pennsylvania, or Oklahoma (note: West Virginia used to be on this list but they recently changed this rule).

*

2) How do I get approval?
If you complete an AOA osteopathic residency you have nothing to worry about and will be licensed in all 50 states.

If you complete an ACGME (MD) residency without an AOA-internship year you have to apply for Resolution 42.

*

3) What is Resolution 42?
Resolution 42 is a method to have your ACGME PGY-1 year approved by the AOA. Gaining approval through Resolution 42 will guarantee you licensure in all 50 states.



*

4) What are the requirements to get my internship year approved?
The requirements mostly depend on what rotations you complete during your PGY-1 year. What rotations are required vary depending on your specialty. As an applicant, you have the ability to compare your rotations either to your OGME-1 specialty year or the AOA traditional rotating internship. *

Please browse this pdf to find your specialty and see what is required to receive approval:
http://www.osteopathic.org/inside-a...ng/Documents/resolution-42-core-rotations.pdf

6) Can I be approved if my intern year does not include all of the required rotations?

There is a mechanism for approval if an individual fails to meet the required rotations in their ACGME program. *First, remember a DO MAY gain approval with rotations met in their latter training years. *However, if rotations are not met, an applicant can request a waiver of those rotations from the AOA Program and Trainee Review Council. In order to petition for a waiver a trainee must send in a letter explaining why they are requesting a waiver.

*

7) What if I don’t receive approval?
You will be fully licensed to practice in 46 states but cannot practice in Michigan, Florida, Pennsylvania, or Oklahoma. You will not be eligible for osteopathic specialty boards due to lack of an AOA Internship.

*

8) Could my specialty board eligibility be affected?
If you do not complete an AOA-approved internship year you will NOT be eligible for certification through an osteopathic specialty board. However, because you would be participating in an ACGME program, you will still be eligible for certification through an allopathic specialty board.

*

9) Can I receive licensure by taking the USMLE?
You may choose to receive licensure by passing USMLE Step 1, Step2, and Step 3 but you will still have to receive AOA approval of your internship to be licensed in Michigan, Pennsylvania, Oklahoma, and Florida. Additionally you will not be allowed to practice in Oklahoma, Maine, Tennessee, California, or Arizona as they require Doctors of Osteopathy to pass COMLEX Levels 1, 2, and 3 to be licensed.

*

10) What if I want to be licensed in all 50 states but want to go to a program where I will not meet the requirements to receive approval through Resolution 42?
You may complete an osteopathic rotating internship before entering a residency program. This will extend your GME training by one year unless you are then accepted into a residency program as a PGY-2.


*

5) The ACGME program I’d like to go to doesn’t include all of the required rotations. What should I do?
Ask the program about the rotations and if there is any flexibility to accommodate the Resolution 42 requirements. Additionally, examine your other PGY years of training to see if you will complete any of the missing rotations. *If the rotations are completed later in training, you can still receive approval of your internship. But it is highly recommended to applicants to complete these rotations in the first year to avoid scheduling conflicts. * *

Ask if anyone has previously applied for Resolution 42 and what they did to get approved (or what caused them to be denied).

You may also contact the AOA to gain better insight and advice. *Contact the AOA Division of Trainee Services at 312.202.8276.

*
"According to AOA records, since 2000, only 4 of 400 applicants for this exception have been turned down, a mere 1% of all applicants." This quote was taken from a 2006 paper.

Thanks... Planning to practice in FL if become a DO... I should keep that in mind though.

 

[cabinbuilder]

9) USMLE can license DOs already?

USMLE is the allopathic board exam, it has nothing to do with licensing for DO's, you take it if you want to be looked at equally when applying to allopathic residency. DO's still have to take the COMLEX to be licensed.

 

[Darthberghen]

Also, you have to pass COMLEX Levels 1 & 2 to graduate from a DO school.

 

[Drrrrrr. Celty]

USMLE is the allopathic board exam, it has nothing to do with licensing for DO's, you take it if you want to be looked at equally when applying to allopathic residency. DO's still have to take the COMLEX to be licensed.

I understand that, but I want to know why it says that a DO can get licensed with USMLE and not practice in 4 states. I.e point 9.

 

[hallowmann]

Thank you for clarifying and sorry for the confusion. From my understanding, the problem only persists if your ACGME residency program does not satisfy the res 42 requirements, in which case you do have to do an extra year to gain practice rights in PA/MI/OK/FL. What are some specialties that would run into this problem? I was reading that pathology is one. Is that the case? Any others?

(To be sure, I do now understand that the problem can be avoided entirely with AOA residency.)

No worries, I've just seen many people lately assume that going DO = having to do more training, and its just not accurate. Really, you only MAY have to do it if you yourself are not proactive, apply early for Res 42, and communicate well with your residency program.

Also, anecdotally: I know 2 DOs working in one of those states in Pathology, who both went to ACGME residencies. Neither had any issue getting approval through Res 42, and neither had to do anything "extra" during residency.

 

[cabinbuilder]

I understand that, but I want to know why it says that a DO can get licensed with USMLE and not practice in 4 states. I.e point 9.

Now I'm confused since you have to take COMLEX to graudate from DO school anyway. I suppose if you get your kicks taking tests then take the 6 exams. Yikes.

 

[cliquesh]

You must take comlex level 1, level 2, and comlex PE to graduate from an osteopathic medical school.

Some state medical boards will give you a license if you take usmle step 1, 2, 3 and usmle CS without taking comlex level 3.

There is no benefit to this unless you truely hate the comlex.

Thank you for clarifying and sorry for the confusion. From my understanding, the problem only persists if your ACGME residency program does not satisfy the res 42 requirements, in which case you do have to do an extra year to gain practice rights in PA/MI/OK/FL. What are some specialties that would run into this problem? I was reading that pathology is one. Is that the case? Any others?

(To be sure, I do now understand that the problem can be avoided entirely with AOA residency.)

Whether you run into trouble or not is program specific. The AOA requires certain pgy1 rotations for each speciality in order to get resolution 42 approved (http://www.osteopathic.org/inside-a...ng/Documents/resolution-42-core-rotations.pdf). Your Acgme internship may fulfill these requirements or it may not. Not all Acgme programs have the same schedules. In my case, my residency fulfills all of the requirements for resolution 42 in regards to anesthesia except for 1 thing (1 month ambulatory family medicine).

I think pathologists get automatic approval.

It's really not a big deal. I wouldn't lose any sleep over it.