Ok so I am confused with how resolution 42 works with applying to allo programs. Let's say I wanted to apply to an allo EM program, how would having to do an AOA internship effect my ability to do so?
Resolution 42 is basically the AOA saying that your ACGME PGY1 year is "AOA approved" and thus you are eligible for licensure in the 4 states that require "AOA approved intern year".
There are some residencies that require a preliminary or transitional intern year before you start that specific residency (at PGY2 level). Some anesthesia residencies start at a PGY2 level and want you to do a prelim/transitional intern year. Dermatology, Radiology, Radiation Oncology, PM&R, Ophtho, etc. starts at a PGY2 level.
In the past (and dependant on the specialty boards such as American Board of Radiology or American Board of PM&R), your osteopathic internship would count towards the intern year requirement so you can jump right into PGY2 residency (say in an ACGME radiology residency). By doing an osteopathic intern year, you automatically are eligible for licensure in the 4 states that requires it without having to go through the process of Resolution 42.
Some boards require an ACGME PGY1 year (such as American Board of Dermatology). In that case, if you do an osteopathic intern year, that does not count so you will have to repeat your intern year at an ACGME PGY1 program (such as prelim medicine, prelim surgery, prelim peds, or transitional year). Now if you don't do an osteopathic intern year but go straight into an ACGME PGY1 year, you will need to petition the AOA (via resolution 42) to review your ACGME PGY1 year for "AOA approval". If your petition is granted, then your ACGME PGY1 year is also "AOA approved" and you are eligible for licensure in the 4 states that requires it. If it is not approve, OR you don't petition for approval, then the only consequence is that you can't be licensed in those 4 states.
This new ACGME proposed rule will affect those who want to do an osteopathic internship and then go straight into a PGY2 ACGME progam. It basically excludes any ACGME program from recognizing your AOA internship. So if you do an osteopathic internship, you have to repeat an ACGME PGY1 internship before you are eligible for that same PGY2 ACGME spot (even if the specialty board recognizes your AOA internship).
In addition, in the past, residents who did an AOA residency and then an ACGME fellowship (for example, an AOA residency in internal medicine, then an ACGME fellowship in Cardiology) would not have been eligible for board certification in cardiology through ABIM, but could have petition the AOA to approve the ACGME Fellowship as "AOA-approved fellowship" and taken the AOBIM (american osteopathic board of internal medicine) Cardiology Boards and be board certified via AOBIM pathway. With this new proposal, that resident would no longer be eligible for the ACGME Fellowship.
This new proposal will not affect those who attend dual accredited intern year program since by default you automatically have completed an ACGME-approved PGY1 year as well as an AOA-approved PGY1 year.
In essence, if this proposal is approved, it will affect two types of applicants
1. applicants interested in residencies that start at the PGY2 level, and are interested in doing an osteopathic internship to satisfy the PGY1 requirement and maintain eligibility for licensure in the 4 states. Essentially those applicants will now have to do an ACGME transitional or prelim internship and go through Resolution 42 if they want to practice in the 4 states that requires AOA approved intern year.
(or you can do an osteopathic internship, then do a prelim PGY1 internship, followed by residency)
2. applicants interested in an ACGME fellowship but are currently doing an osteopathic residency.