Here is what annoys me about the failed GME merger...

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jayoh

turning mountains into molehills
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So I don't post here very often, but I feel like this is an interesting topic to discuss. I've been reading about the proposed GME accreditation merger for a while, and I was fairly shocked to hear that the AOA/AACOM said no thanks.

I'm applying this year to both MD/DO because I want to be a doctor. I dont care about OMM, and I don't believe that the DO philosophy is actually any different in reality. I think that both MD and DO schools train excellent physicians, and that's what I want to be a part of.

So here's what annoys me about the AOA/AACOM stance on this issue:

The AOA blatantly doesn't have the GME sports available to support the number of DO grads. Not by a loooong shot. Everything is cool as long as DO's can go to ACGME residencies, though. So 60% of DO grads go to ACGME residencies, and all is good. So how can they make a decision to remain separate from the ACGME-- and get a standing ovation -- for defending the hardcore DO principles in their GME when they don't even have the capacity to train half of the DO graduates? Havent they already "lost" like 60% of grads to ACGME because they don't even have room for them? They want to preserve the DO-ness for the minority of students that they have room for?

How is comlex viability even a negotiation point anyways?

And as if it somehow helps matters, why am I reading all this nonsense about how they're working hard to increase AOA residency spots? Like they're going to catch up to ACGME soon or something? AOA has like 1100 programs? ACGME has what, 10,000?

I guess this all just makes me question whether or not I should even apply to DO schools. Seems like common sense would dictate unifying GME, opening more doors, etc... But the powers that be are more concerned with making DO's more separate, and I guess that is not what I would want if I went to a DO school.

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Hmm, I see your point and I would lean in favor of the merge (for obvious reasons).
 
I agree and I hope DO students and especially residents can chime in.

My biggest concern that should be more important than the merger is the number of schools opening (and from relatively weak schools). There should be a 5 - 10 year moratorium on new schools because I feel that we have enough.

AOA should be focusing much more on increasing GME funding for their own programs (especially from larger hospitals) and perhaps having more spots for the more competitive specialities (for instance, there's only ~14 neurosurg spots from the AOA, which is just ridiculous).

But oh well, we should definitely preserve that "DOness" :thumbdown:
 
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I agree and I hope DO students and especially residents can chime in.

My biggest concern that should be more important than the merger is the number of schools opening (and from relatively weak schools). There should be a 5 - 10 year moratorium on new schools because I feel that we have enough.

AOA should be focusing much more on increasing GME funding for their own programs (especially from larger hospitals) and perhaps having more spots for the more competitive specialities (for instance, there's only ~14 neurosurg spots from the AOA, which is just ridiculous).

But oh well, we should definitely preserve that "DOness" :thumbdown:

It is already being mentioned in the osteopathic medical student forum.

This is pure ******edness on part of the AOA. They are currently increasing the amount of osteopathic schools but there are not enough osteopathic residency spots as it is for their own.

At least osteopathic students can still apply for ACGME residencies, if there is anything we should still be thankful for.
 
I've been reading through a lot of these posts, and I don't want to sound like an ignoramus. Can someone explain what this means to a potential DO like myself? As a DO applying for residency, you can do AOA or ACGME, and the merger was supposed to make it so there is no longer a distinction right? Now since it failed, we can still apply for both, so what is the problem with still doing an AOA residency? I guess I just don't follow this kind of stuff as closely as I should.
 
I've been reading through a lot of these posts, and I don't want to sound like an ignoramus. Can someone explain what this means to a potential DO like myself? As a DO applying for residency, you can do AOA or ACGME, and the merger was supposed to make it so there is no longer a distinction right? Now since it failed, we can still apply for both, so what is the problem with still doing an AOA residency? I guess I just don't follow this kind of stuff as closely as I should.

The problem with doing an AOA residency is that one would be barred from the majority of ACGME fellowships in the current system that we have. There are very few AOA fellowships as it is and so if the excess of osteopathic students who have done a AOA residency want to further specialize they would need to do a ACGME fellowship. There in lies the problem.

Here is a link to a thread with more details on it.

http://forums.studentdoctor.net/showthread.php?t=1021547

Read seranade and K31's response since they truly show what was at stake here.
 
It's not really that big of a deal. Especially not at the premed level.
 
Yeah, I just think that as a pre-med considering the DO route, it makes me feel like the AOA's ultimate goals are to fully separate the DO path rather than bring it closer to the MD route. Which is not something I want to be a part of
 
Yeah, I just think that as a pre-med considering the DO route, it makes me feel like the AOA's ultimate goals are to fully separate the DO path rather than bring it closer to the MD route. Which is not something I want to be a part of

That's obviously not the ultimate goal. They just don't want anything to change, that's all.
 
Yeah, I just think that as a pre-med considering the DO route, it makes me feel like the AOA's ultimate goals are to fully separate the DO path rather than bring it closer to the MD route. Which is not something I want to be a part of

It will likely change soon, I think. The people that are currently in power at the AOA faced a lot of discrimination when they were training and they still think there is a war between DOs and MDs. The people who trained in the late 1990s were really the first group of DOs who didn't face massive discrimination, so I think once these people get into positions of power the AOA will become more reasonable.
 
Yeah, I just think that as a pre-med considering the DO route, it makes me feel like the AOA's ultimate goals are to fully separate the DO path rather than bring it closer to the MD route. Which is not something I want to be a part of

AOA is hardly representative of what real DOs want.

If only DO med students and residents would drag the AOA administrators into the streets and do what needs to be done.
 
It will likely change soon, I think. The people that are currently in power at the AOA faced a lot of discrimination when they were training and they still think there is a war between DOs and MDs. The people who trained in the late 1990s were really the first group of DOs who didn't face massive discrimination, so I think once these people get into positions of power the AOA will become more reasonable.

Interesting, so do you all think that the newer generation of DOs have similar feelings about not necessarily wanting to be considered different?
 
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Interesting, so do you all think that the newer generation of DOs have similar feelings about not necessarily wanting to be considered different?

I think it's a relatively recent phenomenon. A decade or two ago the Caribbean was a viable option and you really could work hard at the time and land yourself a decent residency. As have been mentioned before, despite the shortcomings of the AOA's recent positions, DO is being seen less as a school for quacks and as a viable alternative equal to Allo schools in curriculum and provides a great opportunity for people to practice medicine. So the AOA has done a lot more then we give them credit for even if they just want to keep the "separate but equal mentality" but it will take time for that to change as well.
 
No one here knows what was in the MOU. So stop your complaining, because for all we know there was some real risks in the MOU that served to harm DOs indirectly. Or maybe you are right and that the current AOA leadership is out of touch.

The point is, you don't know, so complaining isn't going to solve anything. If you have such big issues with the leadership, then get involved and work your way up and make change.

Its understandable that our generation wants instant gratification, but things in the real world are full of politics and decision making that doesn't always please everyone. If you want to have your way, and it isn't already happening, then its up to you to make change. Nothing happens overnight either.
 
I just don't want to feel like I'm hamstrung when it comes to residency. I know it really only boils down to certain surgical specialties and some of the more research intensive specialties, but a rockstar DO should be able to compete with rockstar MD's for spots.

Disclaimer: I am an uninformed premed, so this opinion is formulated based on what I have read here.
 
I just don't want to feel like I'm hamstrung when it comes to residency. I know it really only boils down to certain surgical specialties and some of the more research intensive specialties, but a rockstar DO should be able to compete with rockstar MD's for spots.

Disclaimer: I am an uninformed premed, so this opinion is formulated based on what I have read here.

As of now the situation for residency is no different than if you were already a DO student, or a DO graduate.
 
Interesting, so do you all think that the newer generation of DOs have similar feelings about not necessarily wanting to be considered different?

I think the AOA will always advocate for a separation between the 2 degrees, but the next generation will be more willing to intermingle with our MD colleagues. However, with that said, I think Acgme trained DOs are excluded from leadership roles in the AOA, so I don't except the AOA to drastically change in upcoming years.

This merger issue is not a huge deal and it probably won't impact that many students/residents. The people who will be hurt the most will be aoa trained surgeons because, as of now, it's pretty common to go from an aoa surgery residency to an Acgme fellowship. But, besides surgery, very few fields will be affected.
 
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Someone in the osteopathic forum wrote that the merger supposedly was going to be used by the acgme as a step towards accrediting foreign residencies later...That was the motive. If that were to happen, the us job market would become flooded with foreign trained doctors and hurt US grads.
 
Yeah, I just think that as a pre-med considering the DO route, it makes me feel like the AOA's ultimate goals are to fully separate the DO path rather than bring it closer to the MD route. Which is not something I want to be a part of

Well then get yourself into an MD school. Or go to DO school and then get yourself into an ACGME residency. If you live in a state where an osteopathic internship is required for licensure as a DO, move to one where it isn't.

Somehow I think it's going to be a long time before the leadership of osteopathic medical organizations (ie organizations that you probably will only sit here complaining about and not try to get involved in closely enough to even begin to try to make changes to the way things are now) say that they are anything less than 'separate but equal' and willingly give up their power to the ACGME, LCME, etc.

The # of osteopathic medical school spots vs # or osteopathic residency slots issue would be valid if allopathic residencies were to stop accepting DOs (which is not the case).
 
No one here knows what was in the MOU. So stop your complaining, because for all we know there was some real risks in the MOU that served to harm DOs indirectly. Or maybe you are right and that the current AOA leadership is out of touch.

The point is, you don't know, so complaining isn't going to solve anything. If you have such big issues with the leadership, then get involved and work your way up and make change.

Its understandable that our generation wants instant gratification, but things in the real world are full of politics and decision making that doesn't always please everyone. If you want to have your way, and it isn't already happening, then its up to you to make change. Nothing happens overnight either.

That's a good point, maybe it really was a bad deal and they were wise not to accept it.

Well then get yourself into an MD school. Or go to DO school and then get yourself into an ACGME residency. If you live in a state where an osteopathic internship is required for licensure as a DO, move to one where it isn't.

Somehow I think it's going to be a long time before the leadership of osteopathic medical organizations (ie organizations that you probably will only sit here complaining about and not try to get involved in closely enough to even begin to try to make changes to the way things are now) say that they are anything less than 'separate but equal' and willingly give up their power to the ACGME, LCME, etc.

The # of osteopathic medical school spots vs # or osteopathic residency slots issue would be valid if allopathic residencies were to stop accepting DOs (which is not the case).

Yeah, I mean that is one of my points, that it makes me less inclined to want to go DO. I will still apply, since nothing has really changed, though. Just making a point, throwing it out on the internets, and wondering if there is anyone who agrees/disagrees with my sentiments about it. That's all.


I should probably also mention that it was unwise of me to say that the decision annoys me, as much as I just disagree with it. I don't mean to come across like I'm "sitting back and complaining", as much as just making conversation. I just think it's an interesting discussion point-- and as an admittedly near-sighted pre-med, I wanted to see the GME merged. I'm not trying to "solve anything" either. :)
 
It's not really that big of a deal. Especially not at the premed level.

I think it is a factor worth considering when weighing options of whether or not to apply to DO schools. I wouldn't completely disregard this decision by the AOA. It's going to be a pretty big deal for applicants in about 5 or so years if residency spots (mainly in certain specialties) stay stagnant while new schools (MD and DO) open up.
 
Someone in the osteopathic forum wrote that the merger supposedly was going to be used by the acgme as a step towards accrediting foreign residencies later...That was the motive. If that were to happen, the us job market would become flooded with foreign trained doctors and hurt US grads.

You really have no idea what you're talking about. The reference you're making is completely out of context.
 
I think it is a factor worth considering when weighing options of whether or not to apply to DO schools. I wouldn't completely disregard this decision by the AOA. It's going to be a pretty big deal for applicants in about 5 or so years if residency spots (mainly in certain specialties) stay stagnant while new schools (MD and DO) open up.

Again, this does not affect residencies.
 
I think it is a factor worth considering when weighing options of whether or not to apply to DO schools. I wouldn't completely disregard this decision by the AOA. It's going to be a pretty big deal for applicants in about 5 or so years if residency spots (mainly in certain specialties) stay stagnant while new schools (MD and DO) open up.

How so? If anything it's better for DOs because MDs can't apply to AOA programs as opposed to what would have happened.
 
It's fun when people use 3rd hand knowledge from internet forums to formulate their opinions, I encourage a lot of you to do your own research into things pertaining to your future(or current) educations. While it is politics and somethings are unclear(to the informed and uninformed alike), it would help stop spreading misinformation if more people are actually current in the topics they like to weigh in on.
 
You really have no idea what you're talking about. The reference you're making is completely out of context.

No I was actually pretty much repeating a point that was made by somebody in that forum (dozitgetchahi)
 
How so? If anything it's better for DOs because MDs can't apply to AOA programs as opposed to what would have happened.

I agree with this.
I'd rather match into a specialty I want and only have to compete against DO's then to have to deal with competing against US and foreign MD's for what are currently DO-only spots. I'm glad the merger failed although it is a bummer about fellowships. But if you really want an ACGME fellowship, you still have the option of going to an ACGME-accredited residency.

A lot of the DO students on SDN really just want to be MD's and don't care at all about osteopathic medicine, so anything that undermines the AOA is good in their eyes.
 
About the AOA cancellation uproar:

Pre Medical Student: Why do we hate them Dad?

SDN: Because we have to hate them.

Pre med: They didn't do anything wrong

SDN: Because they are the heroes the DOs deserve, but not the one they need right now. So we'll hate them, because they can take it. Because the AOA are not heroes. They are silent guardians and the watchful protector of mid level competitive residencies like Ortho and General surgery in the osteopathic world. The dark DOs.
 
No I was actually pretty much repeating a point that was made by somebody in that forum (dozitgetchahi)

Like I said, repeating things you heard elsewhere on the internet.

I don't disagree with some of the words you put, but the context is completely wrong. Which is why I would encourage you to go actually read about that specific topic yourself.
 
So if you do an AOA residency there is absolutely no way of doing a fellowship?

no. as of now, you can do an AOA residency and still complete an ACGME fellowship.
 
So if you do an AOA residency there is absolutely no way of doing a fellowship?

What SurgeDO said.

There are also DO fellowships too, but besides cardiology, there are not many. You can find them here http://opportunities.osteopathic.org/ (they're listed under residencies for some reason).

I heard the AOA has been on a mission to expand their fellowships since the acgme proposal was announced.
 
So why is this merger falling through such a bad thing?

Because the acgme is changing the rules.

Starting in the near future, they are requiring you to do an acgme internship to get into an acgme residency and an acgme residency to get into an acgme fellowship. The merger was going to make all current AOA programs acgme accredited, so it was going to allow you to go to a traditional aoa program and still go on to an acgme fellowship.
 
Because the acgme is changing the rules.

Starting in the near future, they are requiring you to do an acgme internship to get into an acgme residency and an acgme residency to get into an acgme fellowship. The merger was going to make all current AOA programs acgme accredited, so it was going to allow you to a traditional aoa program and still go on to an acgme fellowship.

So basically, if you are going to go DO and want to do a fellowship just make sure and get into an ACGME internship/residency?

Or if you know you aren't going to want a fellowship does none of this matter?
 
So basically, if you are going to go DO and want to do a fellowship just make sure and get into an ACGME internship/residency?

Or if you know you aren't going to want a fellowship does none of this matter?

yep, pretty much. The only people who currently go from an AOA residency to an acgme fellowship are AOA general surgeons and orthopods. No one else really does it.
 
So basically, if you are going to go DO and want to do a fellowship just make sure and get into an ACGME internship/residency?

Or if you know you aren't going to want a fellowship does none of this matter?

It would matter if you do any residency that requires a separate intern year. If you don't go into IM, FM, OB, or psych, many programs have you apply to different intern years. For example I am going into pm&r. I had to apply and interview for my intern year separately from my advanced (pm&r) training. At the time the original merger was in the air, so I applied ACGME for both. I would've applied to DO traditional years if the merger was announced before applications went out and stayed at the hospital I did 3rd and 4th year.

It isn't uncommon for DO's to do a traditional year in an osteopathic program and go on to train in their specialty program at an ACGME program. As cliquesh said the new ACGME proposals would also disallow this. These prelim medicine and transitional years (intern years) are not always easy to get because you are competing MD Rads, anesthesia, ophtho, neuro, pm&r, derm, rad onc, etc.

Hopefully the merger still works out, as it makes the road more difficult for DO's to specialize if they choose. The old guard of the AOA will do anything to keep their cush jobs and justify their existence.
 
About the AOA cancellation uproar:

Pre Medical Student: Why do we hate them Dad?

SDN: Because we have to hate them.

Pre med: They didn't do anything wrong

SDN: Because they are the heroes the DOs deserve, but not the one they need right now. So we'll hate them, because they can take it. Because the AOA are not heroes. They are silent guardians and the watchful protector of mid level competitive residencies like Ortho and General surgery in the osteopathic world. The dark DOs.


I see what you did here :) I'm surprised I'm the only one who caught this.
 
About the AOA cancellation uproar:

Pre Medical Student: Why do we hate them Dad?

SDN: Because we have to hate them.

Pre med: They didn't do anything wrong

SDN: Because they are the heroes the DOs deserve, but not the one they need right now. So we'll hate them, because they can take it. Because the AOA are not heroes. They are silent guardians and the watchful protector of mid level competitive residencies like Ortho and General surgery in the osteopathic world. The dark DOs.

:thumbup:
 
AOA CEOs don't want to lose their salary on their round table.

It's not about students, its not about residencies. It's about AOA CEO's not wanting to lose their salary on their round table.

If ACGME wants to take the AOA under their wing and raise the standards/quality of residencies and fellowships, AOA would not be opposed to it as long as they can still stay in power (they want their cake and eat it too) a.k.a. wanna mooch off ACGME without giving up anything for it.

The central round table only has a certain number of cushion chairs, so some AOA CEOs would be laid off if ACGME steps in--so you can guess the rest.
 
I'm on the fence about the merger.

With my stats it is most likely that I will end up in one of the more established DO schools (I hope). I'm an average to slightly above average DO applicant and an underdog MD applicant. WIth that said, I'd love the two heads of medicine in the US to be under the same umbrella. But, with the chances of my matriculation into a DO program, osteopathic students seemingly have it pretty good right now. They have the safety net of the Osteo match, and with this merger it might not be as cut and dry.

I love family medicine, but also really liked my time shadowing Orthopedic Surgery. Looking at the match numbers, as a DO, I am much better off going AOA. By sheer numbers, there are plenty more MD students that want to go into Orthopedics. With the merger, these stronger students (and IMG's) can now swoop into the old DO residencies.

I'm just a pre-med, and I don't really know, but I can see it as a possibility as this merger pushing DO's even further into primary care. I hope I'm wrong.
 
I'm on the fence about the merger.

With my stats it is most likely that I will end up in one of the more established DO schools (I hope). I'm an average to slightly above average DO applicant and an underdog MD applicant. WIth that said, I'd love the two heads of medicine in the US to be under the same umbrella. But, with the chances of my matriculation into a DO program, osteopathic students seemingly have it pretty good right now. They have the safety net of the Osteo match, and with this merger it might not be as cut and dry.

I love family medicine, but also really liked my time shadowing Orthopedic Surgery. Looking at the match numbers, as a DO, I am much better off going AOA. By sheer numbers, there are plenty more MD students that want to go into Orthopedics. With the merger, these stronger students (and IMG's) can now swoop into the old DO residencies.

I'm just a pre-med, and I don't really know, but I can see it as a possibility as this merger pushing DO's even further into primary care. I hope I'm wrong.

I understand where you are coming from. Keep in mind, it was never established that MDs would be able to match into traditional AOA residencies.

For everybody else in this thread who is bummed about the merger not going through, be cautious of bashing the AOA just yet. We have no idea what the details of the MOU entailed.
 
About the AOA cancellation uproar:

Pre Medical Student: Why do we hate them Dad?

SDN: Because we have to hate them.

Pre med: They didn't do anything wrong

SDN: Because they are the heroes the DOs deserve, but not the one they need right now. So we'll hate them, because they can take it. Because the AOA are not heroes. They are silent guardians and the watchful protector of mid level competitive residencies like Ortho and General surgery in the osteopathic world. The dark DOs.

h69A715C1
 
I understand where you are coming from. Keep in mind, it was never established that MDs would be able to match into traditional AOA residencies.

For everybody else in this thread who is bummed about the merger not going through, be cautious of bashing the AOA just yet. We have no idea what the details of the MOU entailed.

Very true about MD grads entering AOA residencies. A lot of people worried about that, but it was never more than a theoretical part of the plan, to be implemented at some unspecified later date. Plus, it's rather absurd to think that DO program directors of AOA programs would suddenly give preference to MD grads over DO grads. MD grads would hardly be 'swooping in' to take AOA residency spots.

I do wonder, however, if maybe it was this issue that kept the AOA from signing on to the MOU. I hope it was something more substantial than that.
 
Very true about MD grads entering AOA residencies. A lot of people worried about that, but it was never more than a theoretical part of the plan, to be implemented at some unspecified later date. Plus, it's rather absurd to think that DO program directors of AOA programs would suddenly give preference to MD grads over DO grads. MD grads would hardly be 'swooping in' to take AOA residency spots.

I do wonder, however, if maybe it was this issue that kept the AOA from signing on to the MOU. I hope it was something more substantial than that.

Frankly just as MD PDs discriminate DOs, so will DO PDs discrimate MDs. So we have much more to gain from the merger.
 
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