Good news!

[Goro]

I hate to say "I told you so,", but there was a lot of wailing and gnashing of teeth about this. So, fretting time is over.

Straight from the AOA

After months of discussion, the AOA, along with the Accreditation Council for Graduate Medical Education (ACGME) and the American Association of Colleges of Osteopathic Medicine (AACOM), have agreed to a single accreditation system for graduate medical education (GME) programs in the United States.
A single GME accreditation system will evaluate and provide accountability for the competency of physician residents consistently across all GME programs. This ensures the quality and efficiency of postdoctoral education, while preserving the unique dimensions of the osteopathic medical profession and recognizing its contribution to health care in the U.S.
Under the agreement:

• From July 1, 2015, to June 30, 2020, AOA-accredited training programs will transition to ACGME recognition and accreditation.
• There will continue to be osteopathic-focused training programs under the ACGME accreditation system. Two osteopathic review committees will be developed to evaluate and set standards for the osteopathic aspects of training programs seeking osteopathic recognition.
• DOs and MDs would have access to all training programs. There will be prerequisite competencies and a recommended program of training for MD graduates who apply for entry into osteopathic-focused programs.
• AOA and AACOM will become ACGME member organizations, and each will have representation on ACGME’s board of directors.

The agreement provides the framework for the osteopathic and allopathic communities to prepare future generations of physicians with the highest quality graduate medical education and serve as a unified voice for graduate medical education resources to help mitigate the primary care physician shortage and better serve the public.
As I stated in our joint press release issued today, a single GME accreditation system ensures that all physicians have access to the primary and sub-specialty training they need for the patients they want to serve. For the osteopathic medical profession, the system recognizes the unique principles and practices of DOs and our contribution to the health and well-being of all Americans.
While there is still much to determine over the coming months as far as processes, I am sure many of you have questions. Please visit www.osteopathic.org/acgme for more information.

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[gookies]

Does this basically mean DOs have the same chance of getting into a competitive residency as a MD?

 

[68quebec]

isn't this the greatest news for all DO students? thx goro!

 

[almirbhf]

amazing i wonder if this means that canadians will be able to do AOA residencies and have them recognized as equivalent for Canadian licensure

 

[AlbinoHawk DO]

Does this basically mean DOs have the same chance of getting into a competitive residency as a MD?

In theory, but doubt in reality. I'm happy about this news. I'm eyeing an osteopathic program but was hesitant before due to some international bodies requiring ACGME training.

 

[Jazzy G]

Great news, especially for those of us interested in doing a fellowship after.

 

[Ogmora]

Does this basically mean DOs have the same chance of getting into a competitive residency as a MD?

From the press release:

"Opportunity is created for MD and DO graduates who have met the prerequisite competencies to access any GME program or transfer from one accredited program to another without being required to repeat education. "

So, yes and no. In theory, yes, but no because program directors still have their choice of applicants.

 

[Chillywilly]

So will there also be a unified board exam system instead of taking both USMLE and COMLEX for DOs?

 

[cliquesh]

Does this basically mean DOs have the same chance of getting into a competitive residency as a MD?

I think what will happen in the short term is that the some DO residency programs will be shut down because they cannot meet the acgme's standards. Some of these closed programs will be in competitive fields. Consequently, I think there will be fewer DO surgical specialists than there are currently, at least initially.

 

[Oo Cipher oO]

So will there also be a unified board exam system instead of taking both USMLE and COMLEX for DOs?

No one knows for sure but this agreement does not touch on undergraduate medical education. As long as COMLEX is required for graduation from an osteopathic medical school then all DO students will be required to take it. This may change in the future but I would not expect this to change anytime soon (i.e. prepare to take the COMLEX and possibly the USMLE if you go to a DO school)

 

[CooIBreeze]

So will there also be a unified board exam system instead of taking both USMLE and COMLEX for DOs?

Definitely the question I wanted to know the answer to.

"Many students take both the USMLE and the COMLEX in order to have an option in applying to programs that for one reason or another prefer to see our USMLE scores. Which one should we be taking?
The primary purpose for the COMLEX exam is to assess an osteopathic physician's readiness for licensure to protect the public - that is its primary use. It’s important to remember that state licensing boards exist to protect the public. The AOA and AACOM believe it is the instrument that is best suited to assess readiness of osteopathic physicians in training to move forward in the training and ultimately get licensure.

Many states will allow DOs to gain a license on the basis of having taken the USMLE. The successful passage of the COMLEX exam is accepted for licensure in 50 states for DOs; but for DOs, the USMLE will not get you a license in all 50 states and that again goes back to that issue of protecting the public.

When it comes to applying for residency positions, another purpose of these licensing exams is that residency program directors look at them to help make decisions about interviewing candidates. This is a secondary use of the exam and does not reflect what either the USMLE or COMLEX exams were designed for. The National Resident Matching Program, which matches medical students into ACGME residencies, in its most recent annual report noted that COMLEX was accepted in 79% of their programs.

There are differences in some specialties and from program to program, but the National Board of Osteopathic Medical Examiners, which develops and administers the COMLEX exam, has really gone to great lengths to help program directors on the allopathic side understand what COMLEX scores mean. "



-Unfortunately, this says absolutely nothing so I would assume that some will still have to take the COMLEX and USMLE to be competitive at certain programs.

 

[guylewis]

I'm not sure how to feel about this. feel good on many aspects though a bit worried on others. like how MDs will now be able to apply to AOA spots that were once only refuge for DOs. though the wording "There will be prerequisite competencies and a recommended program of training for MD graduates who apply for entry into osteopathic-focused programs." is slightly vague but if states that MDs have to have OMM knowledge and be tested beforehand, that would make me feel a lot better. this could be a great thing for many reasons though

 

[AlbinoHawk DO]

So will there also be a unified board exam system instead of taking both USMLE and COMLEX for DOs?

Really doubt it. I think that will become the next step. It's probably too risky to move all your students suddenly to USMLE without schools planning ahead.

I'm glad I got in this cycle. I have a feeling osteopathic school applications will explode.

 

[Oo Cipher oO]

I think what will happen in the short term is that the some DO residency programs will be shut down because they cannot meet the acgme's standards. Some of these closed programs will be in competitive fields. Consequently, I think there will be fewer DO surgical specialists than there are currently, at least initially.

I'm not so sure about this. If there is any way to save these programs from being scraped I think both the AOA and ACGME are interesting in making that happen. Those are valuable residency spots being lost! There will be a transitional time where programs can work to meet the new standards but on the whole I think most will be able to make the cut.

 

[Chillywilly]

Definitely the question I wanted to know the answer to.

"Many students take both the USMLE and the COMLEX in order to have an option in applying to programs that for one reason or another prefer to see our USMLE scores. Which one should we be taking?
The primary purpose for the COMLEX exam is to assess an osteopathic physician's readiness for licensure to protect the public - that is its primary use. It’s important to remember that state licensing boards exist to protect the public. The AOA and AACOM believe it is the instrument that is best suited to assess readiness of osteopathic physicians in training to move forward in the training and ultimately get licensure.

Many states will allow DOs to gain a license on the basis of having taken the USMLE. The successful passage of the COMLEX exam is accepted for licensure in 50 states for DOs; but for DOs, the USMLE will not get you a license in all 50 states and that again goes back to that issue of protecting the public.

When it comes to applying for residency positions, another purpose of these licensing exams is that residency program directors look at them to help make decisions about interviewing candidates. This is a secondary use of the exam and does not reflect what either the USMLE or COMLEX exams were designed for. The National Resident Matching Program, which matches medical students into ACGME residencies, in its most recent annual report noted that COMLEX was accepted in 79% of their programs.

There are differences in some specialties and from program to program, but the National Board of Osteopathic Medical Examiners, which develops and administers the COMLEX exam, has really gone to great lengths to help program directors on the allopathic side understand what COMLEX scores mean. "



-Unfortunately, this says absolutely nothing so I would assume that some will still have to take the COMLEX and USMLE to be competitive at certain programs.

No one knows for sure but this agreement does not touch on undergraduate medical education. As long as COMLEX is required for graduation from an osteopathic medical school then all DO students will be required to take it. This may change in the future but I would not expect this to change anytime soon (i.e. prepare to take the COMLEX and possibly the USMLE if you go to a DO school)

You're right. It would make sense that in the future there should only be one single type of board steps. And for MDs that want to do DO residencies, they should have classes that teach OPP/OMT

 

[cliquesh]

I'm not so sure about this. If there is any way to save these programs from being scraped I think both the AOA and ACGME are interesting in making that happen. Those are valuable residency spots being lost! There will be a transitional time where programs can work to meet the new standards but on the whole I think most will be able to make the cut.

They are not valuable if they are garbage. Some AOA residencies cannot be saved. They simply do not have the patient/procedural volume. There's nothing you can do about that.

The merger is a good thing, though. All programs will be at least at a minimum standard, you will be eligible for any fellowship, and there will be only 1 match.

 

[AlbinoHawk DO]

I'm not so sure about this. If there is any way to save these programs from being scraped I think both the AOA and ACGME are interesting in making that happen. Those are valuable residency spots being lost! There will be a transitional time where programs can work to meet the new standards but on the whole I think most will be able to make the cut.

I think there's a zero chance any program will close because the AOA wouldn't have agreed to be hit that hard. If anything, expect those programs to become better because they'll likely pump money into them.

 

[guylewis]

You're right. It would make sense that in the future there should only be one single type of board steps. And for MDs that want to do DO residencies, they should have classes that teach OPP/OMT

This is really something i want to see in order to feel more secure about this merger. otherwise a giant chunk of MDs will be competing for those formerly DO only spots and matching will be getting much tougher for us future DOs

 

[cliquesh]

This is really something i want to see in order to feel more secure about this merger. otherwise a giant chunk of MDs will be competing for those formerly DO only spots and matching will be getting much tougher for us future DOs

There will still be DO program directors with their own biases. I wouldn't worry about it too much.

 

[Elevencents]

So what does this mean for competitive AOA residencies? Will it make it even harder for DO's to match say Ortho since they don't have singular access to AOA residencies and bias will undoubtedly still exist in certain AGCME residencies?

 

[DocEspana]

I was just in the newborn nursery as the only resident there watching 8 little babies and read this and yelled (far too audibly) "HOLY ****".
I've been out of the loop for the last ~4 months or so. Havent heard a peep from anyone since november's national meetings. So this even caught me by surprise and I'm usually the one breaking (or close to breaking) this sort of news.

 

[Skeeks]

They are not valuable if they are garbage. Some AOA residencies cannot be saved. They simply do not have the patient/procedural volume. There's nothing you can do about that.

The merger is a good thing, though. All programs will be at least at a minimum standard, you will be eligible for any fellowship, and there will be only 1 match.

I imagine it would be easier to revamp a current residency than to open new ones. I know nothing, but it seems more logical to find some way to improve flaudering residencies than to scrap them and deal with the shortage till a new one makes it through all the red tape.

 

[NuttyEngDude]

Holy Sweet Jebus!

 

[Postictal Raiden]

Really doubt it. I think that will become the next step. It's probably too risky to move all your students suddenly to USMLE without schools planning ahead.

I'm glad I got in this cycle. I have a feeling osteopathic school applications will explode.

These were my exact words to my wife

 

[Back 5]

 

[Awesome Sauceome]

 

[hv92]

Damn... DO schools are gonna see alot more higher stat applicants now. I only have a 3.4 with grade replacement and haven't taken my MCAT yet This is good news and worrying news for those who aren't in

On the other hand... what does this mean for Caribbean grads?

 

[Nissan GTR]

 

[medschoolbound7]

Finally... It's definitely a great day to be a DO

 

[Awesome Sauceome]

Seriously, I better get in this cycle because people are gonna be flooding in

 

[guylewis]

Damn... DO schools are gonna see alot more higher stat applicants now. I only have a 3.4 with grade replacement and haven't taken my MCAT yet This is good news and worrying news for those who aren't in

On the other hand... what does this mean for Caribbean grads?

sucks to be them

 

[NuttyEngDude]

My cynicism has been abated for at least a week maybe more!!

 

[touchpause13]

 

[TopTomato]

DO schools will definitely see their most competitive year next year

 

[AlbinoHawk DO]

Damn... DO schools are gonna see alot more higher stat applicants now. I only have a 3.4 with grade replacement and haven't taken my MCAT yet This is good news and worrying news for those who aren't in

On the other hand... what does this mean for Caribbean grads?

Only in the hyper competitive pre-med world would a 3.4 be seen as low. I assure you that your gpa won't be the problem for getting into osteopathic programs. You'll just need a good mcat to prove yourself.

 

[DocEspana]

I think there's a zero chance any program will close because the AOA wouldn't have agreed to be hit that hard. If anything, expect those programs to become better because they'll likely pump money into them.

Will none close? No.... thats not true. Some will. but they WONT be in anything competive. Go through any ortho, uro, ophtho, ent, derm, neurosurg program in the AOA and you'll see they are at no risk (would they have to modify random things like add more hours of lecture per week, or add more full time faculty? Sure. but thats not something thats a 'threat to close them down.' its an easy fix if theyre told to do it). Even surgery... I doubt you will find any program that is lacking *if they are willing to add another hospital*. That might seem like a big deal. It's more of a medium deal. There are no shortage of hospitals looking for free labor, especially free surgical labor (making the hospitals cut of the income even higher if they dont have to pay a PA to first assist). But finding one where the attendings want to teach, even a little, can sometimes be the trouble. Plenty of doctors just have no interest in teaching. Still, if you say that they dont do enough procedures or have enough patient load you are mistaking what they do under permissive rules and what they *can* do if they want to. Almost every surgical program out there can easily boost their patient load and procedure variety if the impetus to do so arises.

What will close? Some of the dinkier FM, Peds, IM programs. Because its a harder sell to give more residents in those fields to random nearby hospitals. Residents, despite how productive they may be, are subservient to the attending in these fields. The attending could do just as much (except for procedure-wise) without any residents as he does with tons. So if they need to expand their diversity or patient load they need to find places that actively want residents as FM/IM/Peds residents dont necessarily represent "free" labor since they dont replace a paid position elsewhere.

 

[GypsyHummus]

Well there goes my chance of getting into a DO school with a 26

 

[hv92]

Only in the hyper competitive pre-med world would a 3.4 be seen as low. I assure you that your gpa won't be the problem for getting into osteopathic programs. You'll just need a good mcat to prove yourself.

I appreciate the reply Albino. Thanks and congrats on your acceptance!

 

[AlbinoHawk DO]

sucks to be them

It does and doesn't. Some family med spots on the DO side always remain open. I think at least at the beginning Caribbean will be unfazed, but 6-8 years down the road with the new osteopathic and allopathic schools they'll the begin to feel the squeeze.

 

[La Presse]

Congratulations everyone.

I plan on drinking to this.

 

[touchpause13]

I'm curious how this will affect us class of 2018ers

 

[DocEspana]

It does and doesn't. Some family med spots on the DO side always remain open. I think at least at the beginning Caribbean will be unfazed, but 6-8 years down the road with the new osteopathic and allopathic schools they'll the begin to feel the squeeze.

in anticipation for this Ross has already signed new contracts with hospitals (from back in July 2013) that states hospitals with DO residents and Ross students must have their DO residents teach OMM to the Ross students a certain number of hours per month. Basically they are making the traiditional "make a lecture and call it a day" AOA requirement of their residents into a full on technical session prepping Ross students for AOA residencies.

The hospital i trained in as a 3rd year is one of them.

 

[Mehd School]

As someone who may be interested in something competitive in 2018 ... I'm a bit nervous. Of course this is for the greater good and there will be better patient care in the long run.

The real winners here? FMG's. Dudes just got access to 3000+ residency spots, 900+ that didn't fill this year. DO internships just got competitive.

 

[Hemorrage]

The "downsides" that everyone is talking about such as less surgical spots and so forth deserved to be abolished. This is the right move for our nation and for our education. When all physicians (MD or DO) are trained equally and held to the same standards, theres bound to be less bias and bs in the long term. I also have a good feeling this will help alleviate the physician shortage because now with the combined GME funding, there can be proper allocation and growth of programs where they're actually required.

 

[embracepeace]

HOLY COW. THIS IS FANTASTIC NEWS! Quick question, there was something about sub-specialties out of reach for DOs because they weren't part of an ACGME program. Will this mean that ALL fellowships will be available to DOs (or at least in theory be available) since residencies are going to fall under the purview of ACGME?

 

[bionerd89]

I am so happy and excited about this. After reading how stubborn the AOA was I was pretty skeptical about it actually happening. A least now AOA residencies have to be up to par with ACGME residencies.

 

[Hemorrage]

As someone who may be interested in something competitive in 2018 ... I'm a bit nervous. Of course this is for the greater good and there will be better patient care in the long run.

The real winners here? FMG's. Dudes just got access to 3000+ residency spots, 900+ that didn't fill this year. DO internships just got competitive.

I don't agree. If you look at the match data for IMG's for 2013 you'll see thats not the case- FMG's have a horribly challenging time matching. IMGs (US citizens) are the real winners. They now have a statistically higher chance of being able to go abroad and come back successfully due to the increased number of spots.

 

[Drrrrrr. Celty]

Next step: Get rid of COMLEX

 

[Hemorrage]

HOLY COW. THIS IS FANTASTIC NEWS! Quick question, there was something about sub-specialties out of reach for DOs because they weren't part of an ACGME program. Will this mean that ALL fellowships will be available to DOs (or at least in theory be available) since residencies are going to fall under the purview of ACGME?

That has to be the case. Before the threat was that they would end the ability for students that went to AOA residencies to apply to ACGME fellowships. Under one match i assume everyone would be eligible for all fellowships

 

[Mehd School]

I don't agree. If you look at the match data for IMG's for 2013 you'll see thats not the case- FMG's have a horribly challenging time matching. IMGs (US citizens) are the real winners. They now have a statistically higher chance of being able to go abroad and come back successfully due to the increased number of spots.

I kind of lump IMG and FMG's together because I was in too much of a hurry to make the distinction. But you're right.