You think that they will actually shut DOs out of ACGME programs completely?
Nobody is shutting anybody out of anything (yet). IF this policy takes effect, they are even providing extra time before implementation just to make sure nobody is shut out! Also, if you read the document, it specifically states that it doesn't affect anyone based on medical SCHOOL/DEGREE type.
No what makes is a ****ty exam is that it has short, ambiguous questions. Seriously, how can anyone think that an exam this poorly written is the gold standard merely because it was designed that way by ancient DOs? Did they intend to write a ****ty test? Well then mission accomplished! Doesn't mean it is a good test.
The purpose of COMLEX (similar to usmle) is to assess minimum competence to advance to next stage of training/licensure. So, unless you can show me a valid study that indicates that the style of COMLEX fails to accomplish this goal, it IS the gold standard for osteopathic medical education. Also, without any solid evidence (i.e. controlled study) that somehow COMLEX style is inadequate/bad/or other terms used on SDN, then you can only say that as a student, you personally do not LIKE the style of this exam (btw how students feel about the exam is not a consideration for designing an exam).
Also, It is always good to keep in mind that IF and WHEN you graduate you will have the honor to practice medicine in this country because of all of the battles/hardships these "ancient DOs" had to go through in the past 100+ years (I'm assuming you are a DO student). And as I mentioned in my previous post, once you become an "ancient DO", you can contribute to the profession and come up with a "better" style/exam to assess competence of future students.
1. Can't discriminate against DOs in all hiring decisions or can't discriminate against DOs in the granting of hospital privileges? Isn't the latter what Weiss was about? Hardly informed by the same considerations as those attending the hiring of a first year resident or fellow, is it? Weiss was an anti-trust case, not an employment discrimination case. Are you suggesting that federal anti-trust law, similar to federal employment discrimination law, recognizes "protected classes" of individuals of which DOs are one? Have a case citation for that proposition?
2. Weiss is a 3rd Circuit case from the early 80s, on which the Sup.Ct. denied cert. I don't have the time or interest to Shepardize it. But, even assuming it is still good law, it is not binding outside of the 3rd Circuit (persuasive v. mandatory authority).
3. Since, as you correctly point out, Weiss does not apply to applicants for residency and fellowship positions, it has no relevance to the discussion above from which you quote me in your post.
First of all, a court case is not a law! It is the interpretation of laws (antitrust laws in this case) by the courts. Second, such interpretations do not have expiration dates so it makes no difference if it was the 50s, 60s or the 80s UNLESS there is more recent interpretation from a higher court that contradicts an older interpretation. Third, the fact that it was in the 3rd district does NOT make it invalid in other jurisdictions, although it gives it more weight in the 3rd district. Fourth, if you are a large entity (e.g. a major healthcare facility) that has the potential to monopolize a service (e.g. health services in a region) then you can NOT discriminate against DOs or MDs in your hiring practices solely based on an individual's degree.
Now, admittedly, it would be very difficult to prove such a case and I just wanted to point out the fact that it is not as simple as people make it on SDN.
I agree with your point about anesthesiology. I disagree with your assertion that this is the only field where there is a difference in training quality. Comparing the written requirements of AOA vs ACGME programs is meaningless. AOA programs (in my n=1 experience) are more likely to not actually meet the written requirements and will graduate people anyway, while everyone sort of looks the other way to not make waves. For example, I am skeptical that the upcoming NYCOMEC surgical residency in eastern Long Island (in a 90 bed community hospital) will generate enough case volume to adequately train surgical residents.
This is the issue the ACGME appears to be addressing with the traditional rotating internship. It seems to me to be a formal acknowledgment that the ACGME feels that the AOA internship requirements aren't worth the paper they are written on, and that the graduates are entering advanced residencies with spotty clinical training. Again, in my n=1 experience as an attending in a hospital that sponsors an osteopathic TRI, this is a valid concern. I am continually amazed at how little the interns actually do in terms of patient care in this institution.
My belief is that this action by the ACGME will benefit us as a profession in the end. The AOA, and osteopathic medicine in general, has a history of improvement only after external influences force changes. Consider the Flexner Report - damaging to the profession in the short term by resulting in the closure of the substandard osteopathic schools but keeping the strong ones alive. Or, more recently, the COMLEX-PE, which was established in response to the implementation of USMLE Step 2 CS for MD programs. When the COMLEX-PE was established, many osteopathic schools were forced to take measures beef up their training to meet the new standards (my own school completely revamped their training in physical diagnosis shortly after the new exam was announced). Similarly, I feel that this measure in the long run will help rather than harm us.
I agree with your general ideas regarding OGME and how AOA is dropping the ball. AOA certainly needs to focus a lot more time/effort/resources on improving the quality of all specialties within OGME. They need to STOP opening new schools (possibly close some of them) and focus their energy and efforts on OGME. Not because they are somehow inferior to all ACGME programs*, but because our graduating students are very capable individuals (not that I'm biased or anything, lol) and they deserve to receive the best post-graduate training "in house." Currently this is not an option and AOA is at least partially to blame, IMO
*There are numerous crappy ACGME community programs, especially in primary care specialties, that have much poorer standards/quality. So, the argument that somehow ALL ACGME programs are superior to ALL AOA programs is not valid.
Having said that, you sound very much like any other attending with regards to resident education (regardless of program). This is how the conversation usually goes, "I can't believe the education these residents are receiving these days" and it is always followed by "when I was a resident ..."
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