Future MD DO merger?

[musicmasta1996]

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So I'm aware that this is probably a touchy issue but I was recently made aware of the merger between MD and DO residency programs. Please correct me if I'm wrong, but the accrediting bodies for MD and DO medical schools are still separate, right? Is there any chance in the coming decades that this changes?

It seems the curriculum is largely the same (as it should if both follow evidence based medicine) with the addition of OMM for DOs. Maybe I am missing something obvious, but doesn't it make sense to just have a single degree/accreditation for all medical schools? If I recall correctly, California has had a serious vendetta against DOs even in the last few decades -- that sentiment and all the usual anti-DO bias seems easily solvable by just absorbing the current DO schools into the existing MD paradigm. I understand it's a politically fraught issue but is there some deeper reason this hasn't happened? I apologize in advance if I have missed something critical.

 

[forumname1]

I haven't followed it too closely but it more than likely boils down to the money like most things. An entire exam and certifying body would be wiped out and a whole lot of guaranteed cash flow (read: tax payer subsidized student loans) to certain people with it.

 

[Isoval]

So I'm aware that this is probably a touchy issue but I was recently made aware of the merger between MD and DO residency programs. Please correct me if I'm wrong, but the accrediting bodies for MD and DO medical schools are still separate, right? Is there any chance in the coming decades that this changes?

It seems the curriculum is largely the same (as it should if both follow evidence based medicine) with the addition of OMM for DOs. Maybe I am missing something obvious, but doesn't it make sense to just have a single degree/accreditation for all medical schools? If I recall correctly, California has had a serious vendetta against DOs even in the last few decades -- that sentiment and all the usual anti-DO bias seems easily solvable by just absorbing the current DO schools into the existing MD paradigm. I understand it's a politically fraught issue but is there some deeper reason this hasn't happened? I apologize in advance if I have missed something critical.

California ironically offered the only time and place in history where DOs could exchange their degrees for MDs in the late 1960s.

The accrediting bodies are separate for medical schools, the same for residencies.

It is likely that there will be some sort of merger before the sun explodes. But don’t hold your breath, you might turn blue and start rotting before that happens.

 

[Goro]

1) but the accrediting bodies for MD and DO medical schools are still separate, right?
2) Is there any chance in the coming decades that this changes?

3) doesn't it make sense to just have a single degree/accreditation for all medical schools?

4) If I recall correctly, California has had a serious vendetta against DOs even in the last few decades --
5) that sentiment and all the usual anti-DO bias seems easily solvable by just absorbing the current DO schools into the existing MD paradigm.
6) I understand it's a politically fraught issue but is there some deeper reason this hasn't happened?

1) Yes
2) We can only hope so, but I probably won't be alive to see it, alas.
3) Yes
4) That was a great story! You have to actually admire the ruthlessness of the CAMA; they nearly extirpated DOs in the state.
5) The old bias against DOs was more doctrinal and that there really once was a Cult of Still. Now the bias is more against the poor clinical education that fair number of DO schools provide. You also assume the LCME and the AOA want DO schools to be absorbed into the LCME framework. This would close at least half of the DO schools
6) Turf and doctrine issues.

 

[907914]

This would close at least half of the DO schools

Why would this close half of DO schools? Are they not held to as high of a standard, or is it just a different standard?

 

[Goro]

Why would this close half of DO schools? Are they not held to as high of a standard, or is it just a different standard?

They don't anything close to the LCME standards. Most of the new branch campuses are in this group.

 

[907914]

They don't anything close to the LCME standards

Do you think this is at a detriment to the students who attend branch campus DO schools?

 

[Goro]

Do you think this is at a detriment to the students who attend branch campus DO schools?

Yes, in terms of specialty choices, and clinical training.

 

[Isoval]

Do you think this is at a detriment to the students who attend branch campus DO schools?

This is why we despise the AOA for churning out new schools constantly. It doesn’t help our case that we’re very competent physicians if the standards continue to decrease year over year.

 

[907914]

This is why we despise the AOA for churning out new schools constantly. It doesn’t help our case that we’re very competent physicians if the standards continue to decrease year over year.

So after the residency merger, have the primary benefactors been MD students who now take over non-OMM former DO residencies as opposed to DO students being considered stronger for MD residencies?

 

[wontonsoup]

This has been talked about for decades. In the late 1990s there was a project started called "Physician 2015" that was attempting to unify MD, DO, and DPM. Immediately, all the separate national, state, local associations as well as specialty societies/academies were generally against it as they would each potentially would lose what independent turf and political influences they had. Podiatry, being the smallest, left first. In some states, such as NY, CA, FL, and especially NJ, they have significant power and entrenchment. The only thing this project eventually led to was the combining of ACGME (MD) and AOA (DO) residencies and that was due to the weakness each side had. MDs needed more slots for more grads and DO had many open slots with fewer hospitals. Hence the marriage of the residency systems.

Interesting DPMs were also included. This is probably a whole 'nother can of worms, but what about DDS/DMDs (i.e. dentists)? They also seem to be a historical anachronism but I suspect they have a pretty powerful lobby.

 

[907914]

Interesting DPMs were also included. This is probably a whole 'nother can of worms, but what about DDS/DMDs (i.e. dentists)? They also seem to be a historical anachronism but I suspect they have a pretty powerful lobby.

Never thought of it this way, but Dentists are to teeth what DMPs are to feet.

 

[wontonsoup]

Never thought of it this way, but Dentists are to teeth what DMPs are to feet.

Yeah, I'm not sure what the curricula are like, but surely dentists and podiatrists are not spending a lot of time on anatomy/physiology/pathology that are not directly related to their area of interest. If that is the case, then any kind of merger would be a loooooot of logistical work to handle. Though I suspect if dentistry were a medical specialty, it would be up there with derm and ophtho in competitiveness given the relatively cush lifestyle and hands-on nature of things. For podiatrists, is there much difference from a foot & ankle fellowship trained orthopedist? To my knowledge, they do full-on surgeries, probably lots of identical or extremely similar cases.

The relative success of dentistry and podiatry also make me wonder about such a different scheme of medical training. If podiatrists and dentists can spend 4 years learning about feet or teeth, respectively, should we consider similar approaches for other relatively modular specialties like ophtho?

 

[907914]

should we consider similar approaches for other relatively modular specialties like ophtho

I don't think so. Can you imagine being a twenty-something with no idea what aspect of medicine you like and needing to apply through 30+ different application systems?

 

[Goro]

So after the residency merger, have the primary benefactors been MD students who now take over non-OMM former DO residencies as opposed to DO students being considered stronger for MD residencies?

Hard to tell. It will probably be a two way osmotic diffusion

 

[907914]

Hard to tell. It will probably be a two way osmotic diffusion

That’s a nice semi-permeable MD/DO membrane you got there.

 

[wontonsoup]

I don't think so. Can you imagine being a twenty-something with no idea what aspect of medicine you like and needing to apply through 30+ different application systems?

Yeah, I mean for most specialties it would be a nightmare. Can't imagine separating general surgery and IM, for example, and it really makes sense there is a common educational pathway for those. But ophtho? Correct me if I'm wrong, but they seem just as anatomically isolated as teeth are. I don't think it would be a great idea (in fact, my naive sense is that it would probably be simpler to just absorb dentistry into medicine), but I think it would be possible to turn ophtho into the new dentistry without causing much or any harm at all.

 

[907914]

Yeah, I mean for most specialties it would be a nightmare. Can't imagine separating general surgery and IM, for example, and it really makes sense there is a common educational pathway for those. But ophtho? Correct me if I'm wrong, but they seem just as anatomically isolated as teeth are. I don't think it would be a great idea (in fact, my naive sense is that it would probably be simpler to just absorb dentistry into medicine), but I think it would be possible to turn ophtho into the new dentistry without causing much or any harm at all.

Imagine if dentistry was absorbed in to medicine. Perhaps it could be combined as an ENT surgical fellowship.

 

[HarmonicConvergence]

Yeah, I'm not sure what the curricula are like, but surely dentists and podiatrists are not spending a lot of time on anatomy/physiology/pathology that are not directly related to their area of interest. If that is the case, then any kind of merger would be a loooooot of logistical work to handle. Though I suspect if dentistry were a medical specialty, it would be up there with derm and ophtho in competitiveness given the relatively cush lifestyle and hands-on nature of things. For podiatrists, is there much difference from a foot & ankle fellowship trained orthopedist? To my knowledge, they do full-on surgeries, probably lots of identical or extremely similar cases.

The relative success of dentistry and podiatry also make me wonder about such a different scheme of medical training. If podiatrists and dentists can spend 4 years learning about feet or teeth, respectively, should we consider similar approaches for other relatively modular specialties like ophtho?

DPM students learn full body medicine at all schools during the didactic years. Just fyi.

 

[gyngyn]

Imagine if dentistry was absorbed in to medicine.

It's called OMFS.