DOs Residency Merger with ACGME

[GUH]

OMM wouldn't be. I already addressed that you'd have to be brain damaged to think that why they put that particular ban in place then would happen today. Nowadays CAM is all the rage, we've got MDs doing OMM fellowships, etc. The AMA doesn't ban a physician from advertising any practice unless it us unsafe and proven to be so, for the most part. MDs do everything from acupuncture to hormonal therapy and you think they'll go out of their way to specifically ban OMM in 2016?

Then it shouldn't be too hard for the AMA and ACGME to release statements clarifying that they will not discourage the use of OMM by trained physicians, undergraduate medical training in OMM, or OMM GME programs. Maybe such statements exist but I am unaware of any.

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[Mad Jack]

Then it shouldn't be too hard for the AMA and ACGME to release statements clarifying that they will not discourage the use of OMM by trained physicians, undergraduate medical training in OMM, or OMM GME programs. Maybe such statements exist but I am unaware of any.

There are OMM class taught as electives at some MD schools, the ACGME adopted osteopathic principles into their core principles, and OMM/NMM is now officially recognized as an ACGME residency and fellowship. Wtf more do you need?

 

[GUH]

The California "merger" (degree switch) from 50 years ago? I really wouldn't get too worried about things happening the same way now.

I am concerned that you say it'd be important to have assurances that OMM wouldn't be discouraged. That's not how things work. Modalities are encouraged or discouraged based on evidence, not promises. Once the consistent, rigorous evidence starts to roll in, OMM will stand on its merits. As a proponent of the modality that should excite you.

The historical evidence shows that the AMA has worked hard to push OMM (and DOs) out of existence. They have been unable to do so for a while due to the fact that osteopathic medicine has existed as a separate profession. So it's on them to demonstrate that it is no longer their intention to do so if they want anyone to believe that their stance has changed and that they are willing to take an impartial view of the merits of osteopathic modalities.

 

[GUH]

the ACGME adopted osteopathic principles into their core principles

I was unaware of this. Where can I look it up? A google search for "ACGME core principles" was unsuccessful. I would honestly be glad to see it.

...OMM/NMM is now officially recognized as an ACGME residency and fellowship.

That would definitely be a step in the right direction, although there are no such residencies accredited by the ACGME.

 

[22031 Alum]

The historical evidence shows that the AMA has worked hard to push OMM (and DOs) out of existence. They have been unable to do so for a while due to the fact that osteopathic medicine has existed as a separate profession. So it's on them to demonstrate that it is no longer their intention to do so if they want anyone to believe that their stance has changed and that they are willing to take an impartial view of the merits of osteopathic modalities.

I suppose that's fair, but (unless I'm misinterpreting you) I think you are saying "impartial view" when you mean "immediate acceptance." After all, acknowledging negatives is part and parcel of impartiality- you can't talk about an "impartial view of the merits" only. I think encouraging the use and study of OMM is completely appropriate, but the immediate stamp of approval you want isn't easy to come by.

 

[GUH]

I suppose that's fair, but (unless I'm misinterpreting you) I think you are saying "impartial view" when you mean "immediate acceptance." After all, acknowledging negatives is part and parcel of impartiality- you can't talk about an "impartial view of the merits" only. I think encouraging the use and study of OMM is completely appropriate, but the immediate stamp of approval you want isn't easy to come by.

Not necessarily "immediate acceptance". Just a clear statement that they aren't trying to destroy or push out osteopathy like they have attempted to do in the past. Then they could complete their impartial assessment (to the same extent as they do with other specialties assuming there is such a process) and state their conclusions prior to any further coalescing of the two professions so that both parties know in advance what they'd be getting themselves into. This is reasonable and would lead to a less chaotic outcome than what has happened with the GME takeover, which was pretty much "let's force them into the deal immediately and just wing it".

Again, such a statement is only solicited because of their history. If I had an extensive history of behaving poorly towards you by calling you names or undermining you at work, for example, it would be reasonable for you to want some reassurance from me that I will not do those things anymore before signing a contract agreeing to work with me in the future.

 

[Launcelot]

There are OMM class taught as electives at some MD schools, the ACGME adopted osteopathic principles into their core principles, and OMM/NMM is now officially recognized as an ACGME residency and fellowship. Wtf more do you need?

Interesting, what allopathic schools specifically?

 

[deleted564680]

Also, I definitely agree that the merger is affecting the specialists more than the generalists. Most of you are seeing this as a "greater good" issue.
I would argue that the loss of access to specialties for DOs will harm the greater good. Part of what makes DOs equal, especially in the public eye, is seeing DOs in all specialties and DOs having the ability to go into any specialty. I can't tell you how many times I've heard patients/administrators/random people talk about DOs in a "legitimate" way and back it up by "oh yeah, I've seen a DO neurosurgeon, ortho surgeon, etc."
My concern stems from the fact that DO may mean access to primary care and non-competitive specialties only (outside of a rare elite student). Will it play out this way? I don't know. It's just a concern I have.

 

[Mad Jack]

I was unaware of this. Where can I look it up? A google search for "ACGME core principles" was unsuccessful. I would honestly be glad to see it.
That would definitely be a step in the right direction, although there are no such residencies accredited by the ACGME.

Read your AOA newsletters regarding the merger, my god. Have you no ability to do anything on your own?

 

[GUH]

Read your AOA newsletters regarding the merger, my god. Have you no ability to do anything on your own?

yeah, there is nothing in there about "ACGME core principles"
Are you sure that's what you meant?

 

[Mad Jack]

https://www.aacom.org/news-and-even...opathic-recognition-onmm-program-requirements

yeah, there is nothing in there about "ACGME core principles"
Are you sure that's what you meant?

Both were integrated into the ACGME rules for any program seeking osteopathic recognition, so both are officially supported by the ACGME.

 

[SouthernSurgeon]

I think there's three kinds of DO students:

1- Wanted to be a DO, hard-core DO
2- Wanted to be an MD but will do whatever it takes to be a physician
3- Doesn't give a damn, just wants to be a physician

The 2s tend to split along two lines- the ones that have the massive chip on their shoulder and come off as MD-wannabes, and the ones that go super hardcore DO to overcompensate because they feel like they "owe the profession something for giving them a chance." Both types make me lol, as I'm a #3 myself- idgaf what degree I have, and I objectively honestly believe there is no reason for there to be 2 separate degrees. It's just kind of stupid.

I think the 2b's far far outnumber the 1's, but pretend to be 1's as a part of said overcompensation.

 

[Goro]

Agree with the first, but not not the second. When I ask my students about their career arc, the vast majority tried the MD route first, failed, and accepted that going to a DO school was the realistic way to be a doctor. The people who say at interview "I'm only applying to DO schools" with an earnest look on their faces and passion in their voices are being truthful while dissembling at the same time.

We don't take it personally.

Here's what really counts: At graduation, when there is no need to dissemble, or try to impress fellow students, or massage one's ego, ~90% of our grads say they'd pick our school over an MD school and were satisfied with the training they received. ~5% say they'd prefer MD over DO, and ~5% say they'd not go to med school at all!

These results are consistent year after year.

I think the 2b's far far outnumber the 1's, but pretend to be 1's as a part of said overcompensation.

 

[22031 Alum]

Also, I definitely agree that the merger is affecting the specialists more than the generalists. Most of you are seeing this as a "greater good" issue.
I would argue that the loss of access to specialties for DOs will harm the greater good. Part of what makes DOs equal, especially in the public eye, is seeing DOs in all specialties and DOs having the ability to go into any specialty. I can't tell you how many times I've heard patients/administrators/random people talk about DOs in a "legitimate" way and back it up by "oh yeah, I've seen a DO neurosurgeon, ortho surgeon, etc."
My concern stems from the fact that DO may mean access to primary care and non-competitive specialties only (outside of a rare elite student). Will it play out this way? I don't know. It's just a concern I have.

It strikes me as pretty short sighted to claim that the greater good comes from not changing the status quo, as opposed to going through the uncertain, painful process of truly proving equality. Do you think that 30 years post-merger, after 30 years of being held to all the same standards as MDs, after a complete turnover (likely multiple turnovers) of program leadership nationwide, after decades of attitude changes, DOs would not rise to the occasion? They wouldn't be out there earning those spots that they used to have to depend on special allowances for? If you don't maybe you're not as much a believer in your "profession" as you claim.

(Put "profession" in quotes because the actual profession is medicine.)

 

[deleted731525]

It strikes me as pretty short sighted to claim that the greater good comes from not changing the status quo, as opposed to going through the uncertain, painful process of truly proving equality. Do you think that 30 years post-merger, after 30 years of being held to all the same standards as MDs, after a complete turnover (likely multiple turnovers) of program leadership nationwide, after decades of attitude changes, DOs would not rise to the occasion? They wouldn't be out there earning those spots that they used to have to depend on special allowances for? If you don't maybe you're not as much a believer in your "profession" as you claim.

(Put "profession" in quotes because the actual profession is medicine.)

How likely is it that DO schools get more consistent quality with their clinical education? I feel(perhaps incorrectly) that is the big obstacle that leads to DOs being viewed as "second class" by some programs.

 

[22031 Alum]

How likely is it that DO schools get more consistent quality with their clinical education? I feel(perhaps incorrectly) that is the big obstacle that leads to DOs being viewed as "second class" by some programs.

Well the hypothetical discussion here assumes eventual single accreditation. If that were to happen I think the overall quality control would improve, and take away that argument from the DO-discriminators.

 

[deleted564680]

It strikes me as pretty short sighted to claim that the greater good comes from not changing the status quo, as opposed to going through the uncertain, painful process of truly proving equality. Do you think that 30 years post-merger, after 30 years of being held to all the same standards as MDs, after a complete turnover (likely multiple turnovers) of program leadership nationwide, after decades of attitude changes, DOs would not rise to the occasion? They wouldn't be out there earning those spots that they used to have to depend on special allowances for? If you don't maybe you're not as much a believer in your "profession" as you claim.

(Put "profession" in quotes because the actual profession is medicine.)

I don't know what's going to happen. No one does. I'm just stating that I'm concerned.

We didn't have to merge to raise the quality of our residencies. That could have been done through the AOA.

The reason we had separate residencies was so DOs could actually go into those specialty fields. It protected against the bias on the MD side. Now, if 30 years from now there is no bias then great - merger successful. But what about from now until then?

 

[22031 Alum]

Now, if 30 years from now there is no bias then great - merger successful. But what about from now until then?

A bummer for those caught in the "interim" time, sure. But in time I'd imagine it would be seen as an unfortunate for some, for a time, but beneficial for more, over the long term. When someone like @Mad Jack mentions over and over that they'd welcome the change, I think it's that longer view in mind.

I fully acknowledge that it's easy for me to say things like "think of the long term!" as someone who has no skin in the game.

 

[Mad Jack]

A bummer for those caught in the "interim" time, sure. But in time I'd imagine it would be seen as an unfortunate for some, for a time, but beneficial for more, over the long term. When someone like @Mad Jack mentions over and over that they'd welcome the change, I think it's that longer view in mind.

I fully acknowledge that it's easy for me to say things like "think of the long term!" as someone who has no skin in the game.

Pretty much this. Everyone wants positive change, but no one is willing to sacrifice for it. That's why we've got people that want increased spending on social services or the military or whatever but no one is willing to take a tax increase. Every now and then a generation has to come forward and bite the bullet for the good of their profession/country/cause, to work hard/sacrifice/make difficult changes so that the next generation won't have to. Unfortunately we've become a nation of self-interested people that don't play the long game or think farther ahead than their own immediate future, so you end up with people clinging to the status quo because it's safe and comfortable.

 

[GUH]

https://www.aacom.org/news-and-even...opathic-recognition-onmm-program-requirements

Both were integrated into the ACGME rules for any program seeking osteopathic recognition, so both are officially supported by the ACGME.

Osteopathic recognized programs are required to teach osteopathic principles. That doesn't say anything about the ACGME.

 

[Mad Jack]

Osteopathic recognized programs are required to teach osteopathic principles. That doesn't say anything about the ACGME.

It says that the ACGME approved the teaching of osteopathic principles and practices in ACGME certified programs that want to have an osteopathic focus. That means the ACGME is down with OMM if their programs want to integrate it.

 

[GUH]

It says that the ACGME approved the teaching of osteopathic principles and practices in ACGME certified programs that want to have an osteopathic focus. That means the ACGME is down with OMM if their programs want to integrate it.

It hasn't been done yet to a significant extent but we will see what happens as the GME takeover clock keeps ticking down and programs are forced to apply.

Edit: You're right that it is a good sign that the process has at least started though.

 

[Mad Jack]

It hasn't been done yet to a significant extent but we will see what happens as the GME takeover clock keeps ticking down and programs are forced to apply.

Edit: You're right that it is a good sign that the process has at least started though.

It hasn't been done because most of the formerly osteopathic programs don't even want osteopathic recognition. It's available, and not even the PDs want it. If that's not a sign...

 

[GUH]

It hasn't been done because most of the formerly osteopathic programs don't even want osteopathic recognition. It's available, and not even the PDs want it. If that's not a sign...

That is a side effect of throwing programs under the bus and instituting a system where osteopathic recognition represents just an additional hoop to jump through with minimal discernable benefits. Or perhaps the intended effect. Either way, it remains to be seen whether the new system has the effect of eliminating (or practically eliminating) osteopathic GME. So far the numbers do not prove otherwise.

 

[Mad Jack]

That is a side effect of throwing programs under the bus and instituting a system where osteopathic recognition represents just an additional hoop to jump through with minimal discernable benefits. Or perhaps the intended effect. Either way, it remains to be seen whether the new system has the effect of eliminating (or practically eliminating) osteopathic GME. So far the numbers do not prove otherwise.

And if there is no osteopathic GME, then what purpose will there be in teaching OMM in schools? Then there will be no legitimate reason to have DOs be a separate degree, as they can't continue their education in osteopathic programs.

Boom. That's how it's going to happen.

 

[GUH]

And if there is no osteopathic GME, then what purpose will there be in teaching OMM in schools? Then there will be no legitimate reason to have DOs be a separate degree, as they can't continue their education in osteopathic programs.

Boom. That's how it's going to happen.

So do you believe that osteopathic GME is supposed to die out as an intended effect of the merger?

 

[Mad Jack]

So do you believe that osteopathic GME is supposed to die out as an intended effect of the merger?

It almost certainly will, as almost all programs convert over to ACGME-only. Then DOs will have *gasp* nothing but regular, honest-to-god GME without the leading O.

 

[QueenJames]

If only they could get rid of the COMLEX.... and add a OMM portion to the USMLE for DO students.

Or better yet... Get rid of OMM! lol

 

[Mad Jack]

If only they could get rid of the COMLEX.... and add a OMM portion to the USMLE for DO students.

Or better yet... Get rid of OMM! lol

I can think of rea$on$ they would never want to do that. $omething about control over one'$ profe$$ion, or $omething to that effect.

 

[QueenJames]

I can think of rea$on$ they would never want to do that. $omething about control over one'$ profe$$ion, or $omething to that effect.

Ahh... yeah.. I $ee what you're $ayin'.

 

[jw3600]

Agree with the first, but not not the second. When I ask my students about their career arc, the vast majority tried the MD route first, failed, and accepted that going to a DO school was the realistic way to be a doctor. The people who say at interview "I'm only applying to DO schools" with an earnest look on their faces and passion in their voices are being truthful while dissembling at the same time.

We don't take it personally.

Here's what really counts: At graduation, when there is no need to dissemble, or try to impress fellow students, or massage one's ego, ~90% of our grads say they'd pick our school over an MD school and were satisfied with the training they received. ~5% say they'd prefer MD over DO, and ~5% say they'd not go to med school at all!

These results are consistent year after year.

 

[uworldrelay]

I would def forfeit my degree and get my money back if possible

 

[SLC]

I would def forfeit my degree and get my money back if possible

Didn't score as well on the boards as you hoped, and now you want to pin your failures on the degree type you're earning...sound about right?

 

[deleted731525]

Didn't score as well on the boards as you hoped, and now you want to pin your failures on the degree type you're earning...sound about right?

From his post history it looks like he scored >250

 

[uworldrelay]

Didn't score as well on the boards as you hoped, and now you want to pin your failures on the degree type you're earning...sound about right?

I scored higher than anybody you've ever met and anybody you ever will meet.

 

[deleted564680]

[/QUOTE]

I scored higher than anybody you've ever met and anybody you ever will meet.

Not higher than me

 

[uworldrelay]

Not higher than me [/QUOTE]
yes, even you

 

[Brorthopedic]

I scored higher than anybody you've ever met and anybody you ever will meet.

So, what happened?

 

[deleted564680]

yes, even you

lol

 

[DetectiveAlonzo]

@uworldrelay like a bawwwseeeee.

 

[deleted731525]

So, what happened?

From his posting history it looks like he wanted acgme uro. Judging by how angry he seems I'm guessing he didn't get it.

 

[DetectiveAlonzo]

From his posting history it looks like he wanted acgme uro. Judging by how angry he seems I'm guessing he didn't get it.

Maybe the residents and programs are so tired of seeing dicks that they didn't wanna work with one.

lolz

I keed I keed. You a real one @uworldrelay . You'll match into somewhere worthy of your smarts and intellect brotha. Don't worry. Everything is gonna be alright.

 

[SLC]

Maybe the residents and programs are so tired of seeing dicks that they didn't wanna work with one.

lolz

I keed I keed.

Beat me to it...in my defense I was taking My last NBOME test

 

[DetectiveAlonzo]

Beat me to it...in my defense I was taking My last NBOME test

They can't keep a good man like yourself down.

 

[SLC]

They can't keep a good man like yourself down.

So much OMM, but my COMSAE predicted a 775 so I think I'll be OK

 

[DetectiveAlonzo]

So much OMM, but my COMSAE predicted a 775 so I think I'll be OK

Is OMM a super nuisance that requires constant review or is it something you can cram and call it a day? I plan on taking USMLE and COMLEX but damn... I feel that OMM will be the death of me.

 

[SLC]

Is OMM a super nuisance that requires constant review or is it something you can cram and call it a day? I plan on taking USMLE and COMLEX but damn... I feel that OMM will be the death of me.

Keep the basics sharp and you're usually good to go.

I've been doing an ACGME residency, it's been tough to stay interested in the basics.

 

[DetectiveAlonzo]

Keep the basics sharp and you're usually good to go.

I've been doing an ACGME residency, it's been tough to stay interested in the basics.

Usually after comlex level 3 you are good to go right? No more OMM?

 

[SLC]

Usually after comlex level 3 you are good to go right? No more OMM?

That's my understanding, yeah. I'm not doing an AOA residency so I should be done now.

 

[DetectiveAlonzo]

That's my understanding, yeah. I'm not doing an AOA residency so I should be done now.

good stuff man! congrats! hopefully all goes well for ya!