HOD Resolution Allowing MD Students Into AOA Residencies

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HockeyDr09

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I was reviewing the resolutions for the upcoming AOA House of Delegates and came across this

SUBJECT: LIAISON COMMITTEE ON MEDICAL EDUCATION (LCME)
STUDENT ADMISSIONS TO AMERICAN OSTEOPATHIC
ASSOCIATION RESIDENCIES
SUBMITTED BY: Osteopathic Physicians and Surgeons of California
REFERRED TO: Committee on Educational Affairs
1 WHEREAS, the Accreditation Council of Graduate Medical Education (ACGME) currently
2 allows admission into their graduate training programs, allopathic physicians from
3 schools certified by both the Liaison Committee on Medical Education (LCME), non-
4 LCME institutions (foreign medical schools) and all American Osteopathic Association
5 (AOA) accredited Osteopathic medical school graduates; and
6 WHEREAS, there is a projected physician shortage of 200,000 physicians by 2020; and
7 WHEREAS, both LCME accredited medical schools and AOA accredited medical schools have
8 increased in either class size or school numbers, however little increase has been
9 recognized in licensed physicians practicing medicine due to the lack of commensurate
10 increase in residency size and or number; and
11 WHEREAS, the AOA and osteopathic medical schools have made considerable headway in the
12 development of new graduate medical education programs despite significant
13 impediments in program development due to the inability of allopathic physicians to
14 train in these new programs; and
15 WHEREAS, the AOA residency standards allow allopathic physicians as preceptors in resident
16 training in every AOA approved residency/fellowship despite the fact they do not allow
17 allopathic physicians to train in any AOA residency/fellowship program; and
18 WHEREAS, the AOA and American Academy of Osteopathy (AAO) have allowed allopathic
19 physicians to receive training in dual approved AOA/ACGME residencies; and
20 WHEREAS, ACGME has expressed concerns about the prerequisite training requirements in
21 non-ACGME and AOA residency/fellowships and has considered exclusion of
22 matriculates from these non-ACGME programs to participate in ACGME residencies
23 and fellowships; and
24 WHEREAS, the AOA does not have the oversight or ability to determine the medical
25 equivalency of non-LCME institutions to assess whether residency prerequisite
26 requirements are met; and
27 WHEREAS, four states in the United States require AOA approved PGY-1 positions for
28 osteopathic physicians to obtain state licensure; and
RES. NO. H-206 - A/2012 – Page 2
1 WHEREAS, the percentage of graduates that become AOA board certified in dual approved
2 ACGME and AOA programs is less than 20%; and
3 WHEREAS, the AOA has deeming authority from the Centers for Medicare and Medicaid
4 Services (CMS) for oversight of residencies and board certifications for their member
5 providers; now, therefore be it
6 RESOLVED, that the American Osteopathic Association allow Liaison Committee on Medical
7 Education (LCME) graduates participate in new AOA residency and fellowship training
8 and become eligible to take that residency’s corresponding certifying AOA board with
9 AOA membership; and, be it further
10 RESOLVED, that the AOA assure the revised residency and fellowship standards retain
11 osteopathic autonomy such as maintaining the seven core competencies to include
12 osteopathic manipulative principles and practices and an osteopathic program director;
13 and, be it further
14 RESOLVED, that current AOA accredited residency or fellowship programs are exempt from
15 any standards allowing participation of LCME graduates.

I'm on the fence about whether or not this is a good idea. It will be voted on by the AOA HOD by end of the week, and we'll be discussing it on Wednesday at the National Osteopathic Student Caucus in Chicago. Should be an interesting debate.




EDIT: Add .pdf of ALL resolutions (there are quite a few)

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Yea its a tricky subject.

If there was no DO discrimination/DO students didnt need to take USMLE to be competitive, I would be more on board with this.

However, it hurts DO applicants more than helps MD applicants.

Presumably MD applicants will only apply to highly competitive specialty DO residencies, crowding out DO's from specialties.
 
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I think it is a good idea in the long-term. But, agree that MD students are going to be shooting for competitive specialties. I cant exactly see them scrambling for FM residencies in the middle of nowhere.
 
Now if this were to open up DO residencies to FMG/IMGs I can see DO FM residencies actually becoming filled which would likely be a good thing.
 
Now if this were to open up DO residencies to FMG/IMGs I can see DO FM residencies actually becoming filled which would likely be a good thing.

I believe this resolution is only referencing LCME accredited schools, so it shouldn't apply to FMG's/Carb Students.
 
The bold states that only NEW AOA approved programs would be required to allow LCME graduates to apply. I am not sure if the last sentence implies that the current ones would be able to consider MD's but not be required to, or just not allowed at all ("exempt")
 
Well then that is a terrible idea. Why open only new DO residencies to MD students? Either open all of em or don't. Can't really 1/2 ass it. Oh wait its the AOA, nevermind they can then.
 
If the AOA's track record is any indication, this resolution will likely not pass. I think this resolution could potentially open up doors that may lead to the end of DO discrimination, but the AOA has been pretty adamant in the past about not allowing MD graduates to train in DO residencies. I doubt this will change that.

Aside from the issue of MD graduates "pushing out" DO graduates from the traditionally competitive residencies, are there any other significant pitfalls of this resolution? The implication that this resolution will only make new AOA residencies available to MD graduates doesn't really sit well with me, but I'm afraid I'm being too shortsighted about this to formulate an educated opinion. Please continue to keep us updated, HockeyDr09.
 
For the sake of discussion, figured I'd throw a few more of the more interesting resolutions. I'll bold the resolved (action to be taken).

I'll keep everyone updated

SUBJECT: LOAN DEFERMENT DURING RESIDENCY
SUBMITTED BY: Texas Osteopathic Medical Association
REFERRED TO: Committee on Educational Affairs
1 WHEREAS, the median debt amount for graduates of public medical schools is $155,000 and
2 for graduates of private medical schools is $180,000, as of October 20111; and
3 WHEREAS, effective July 1, 2009, in order to qualify for deferment, the monthly debt must
4 total at least 20 percent of a resident physician’s monthly income, and total income
5 minus the loan debt cannot be more than 150 percent of the federal poverty level (a
6 dramatic decrease from 220 percent), thus disqualifying the 67 percent of all incoming
7 resident physicians, who would have qualified for deferment with the previous “20/220
8 pathway” system2,3; and
9 WHEREAS, interest payments on medical school loans, which can be a significant percentage
10 of medical residents’ wages, would still have to be made during forbearance4; and
11 WHEREAS, the debt accrued during medical school continues to increase with growing tuition
12 rates thus causing considerably high debt repayment amounts during residency5; and
13 WHEREAS, the modest salary during residency leaves little financial flexibility to resident
14 physicians for increasing payments for the debt accrued during medical school5; and
15 WHEREAS, poor quality of life due to increased financial burden may increase medical resident
16 burnout5; and
17 WHEREAS,, graduate and professional students will not be eligible to receive interest
18 subsidized Federal Direct Stafford Loans beginning July 1, 20126; and
19 WHEREAS, post-graduate students will no longer be eligible for a credit on the 1% origination
20 fee, even though they don’t miss a payment for twelve consecutive months6; and
21 WHEREAS, AMA policies (H-305.965 and D-305.966) support the deferment of payments of
22 medical education loans by resident physicians and support the reinstatement of the
23 “20/220 pathway”7; now, therefore be it
24 RESOLVED, that the American Osteopathic Association supports legislation that would allow
25 resident physicians to defer the repayment of their federal medical school loans until the
26 completion of residency training; and, be it further
27 RESOLVED, that the AOA is encouraged to actively work to reinstate the qualification
28 criterion referred to as the “20/220 pathway” for economic hardship deferment and
RES. NO. H-203 - A/2012 – Page 2
1 support mechanisms that address the financial needs of resident physicians with medical
2 school loan debt.




SUBJECT: OSTEOPATHIC DIRECTOR OF MEDICAL EDUCATION (DME)
SUBMITTED BY: Pennsylvania Osteopathic Medical Association
REFERRED TO: Committee on Educational Affairs
1 WHEREAS, a large part of what makes osteopathic medicine unique is its philosophy and its
2 history; and
3 WHEREAS, osteopathic medicine is a unique profession utilizing the approach to treat the
4 patient as a whole: mind, body and spirit; and
5 WHEREAS, osteopathic medicine is unique in that both the physical skills found only within
6 the profession and the philosophical approach is different from that of other medical
7 professionals; and
8 WHEREAS, Directors of Osteopathic Medical Education (DME) oversee Osteopathic
9 Program Directors, Osteopathic Residents, Osteopathic Interns, and Osteopathic
10 Medical Students, in truly Osteopathic training programs; and
11 WHEREAS, the training of physicians in osteopathic medicine is unique; and
12 WHEREAS, the basic standards of osteopathic training programs incorporate the osteopathic
13 principles in the core competencies; and
14 WHEREAS, only osteopathic physicians possess the unique osteopathic perspective to oversee
15 these medical professionals; and
16 WHEREAS, in order to have a truly Osteopathic training program, it is inappropriate for
17 non-osteopathic physicians to oversee osteopathic program directors, osteopathic
18 residents, osteopathic interns, and osteopathic medical students due to the inherent lack
19 of unique Osteopathic knowledge, clinical skills and philosophy; now, therefore be it
20 RESOLVED, that the American Osteopathic Association continue to adhere to its policy
21 requiring that a director of osteopathic medical education (DME) be an osteopathic
22 physician in good standing with the AOA; and, be it further
23 RESOLVED, that the AOA will oppose any movement allowing non-osteopathic physicians
24 serving in the position of director of osteopathic medical education.


SUBJECT: MD OPTION AT THE TEXAS COLLEGE OF OSTEOPATHIC
MEDICINE (TCOM)

SUBMITTED BY: Texas Osteopathic Medical Association
REFERRED TO: Committee on Educational Affairs
1 WHEREAS, the leaders of the University of North Texas (UNT) and the UNT Health Science
2 Center (HSC) have reiterated their intent to establish a second medical school (MD
3 program) on their Fort Worth campus; now, therefore be it
4 RESOLVED, that the American Osteopathic Association House of Delegates unequivocally
5 and completely opposes all attempts to establish an MD medical school on the
6 University of North Texas Health Science Center / Texas College of Osteopathic
7 Medicine campus in Fort Worth, Texas; and, be it further
8 RESOLVED, that the AOA House of Delegates continues its support of the existing Texas
9 State law that protects Texas’ only osteopathic medical school, the Texas College of
10 Osteopathic Medicine, by specifically prohibiting the UNT Board of Regents from
11 granting an MD degree
.
 
SUBJECT: MD OPTION AT THE TEXAS COLLEGE OF OSTEOPATHIC
MEDICINE (TCOM)
SUBMITTED BY: Texas Osteopathic Medical Association
REFERRED TO: Committee on Educational Affairs
1 WHEREAS, the leaders of the University of North Texas (UNT) and the UNT Health Science
2 Center (HSC) have reiterated their intent to establish a second medical school (MD
3 program) on their Fort Worth campus; now, therefore be it
4 RESOLVED, that the American Osteopathic Association House of Delegates unequivocally
5 and completely opposes all attempts to establish an MD medical school on the
6 University of North Texas Health Science Center / Texas College of Osteopathic
7 Medicine campus in Fort Worth, Texas; and, be it further
8 RESOLVED, that the AOA House of Delegates continues its support of the existing Texas
9 State law that protects Texas’ only osteopathic medical school, the Texas College of
10 Osteopathic Medicine, by specifically prohibiting the UNT Board of Regents from
11 granting an MD degree.

confused here...so is the AOA also not happy with MSU and UMDNJ for having both MD and DO schools? Didn't MSU-COM students at one point even share some classes with their MD student counterparts?
 
Have we seen this movie before?
 
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confused here...so is the AOA also not happy with MSU and UMDNJ for having both MD and DO schools? Didn't MSU-COM students at one point even share some classes with their MD student counterparts?
Still do share classes with MD program......the entire first year is joint DO/MD for basic science classes unless they changed it with the new curriculum changes recently added......
 
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hey im ok with this
as long as those program offer the same discrimination that DOs have for MD spots!!

having 1 MD with 10 DOs will be perfect
 
confused here...so is the AOA also not happy with MSU and UMDNJ for having both MD and DO schools? Didn't MSU-COM students at one point even share some classes with their MD student counterparts?

Well it wouldn't improve the DO:MD school ratio ;). It would be nice to add another DO school at a university with an MD school though...

Sigh, the AOA's failure (or lack of interest?) to open more state university affiliated DO programs like MSU upsets me.
 
I pretty much called it in the "email the ACGME" thread. Cant have it both ways. Once the topic is on the table either MDs have access to AOA spots or DOs are excluded from ACGME. The current system sets up a bias where competition for higher ranking specialties is not equal across the board.
 
once that happens they start blurring the lines between the DO and MD difference..

..omt?

at the end of the day u keep making circles as to...why NOT dont the DOs join both degrees under 1 umbrella...call it all MD and make it happen


we do have a new president
but i highly doubt that its in his agenda
 
confused here...so is the AOA also not happy with MSU and UMDNJ for having both MD and DO schools? Didn't MSU-COM students at one point even share some classes with their MD student counterparts?

They used to take some first year basic science classes together. New curriculum doesn't have them taking any classes together. And the MD school at MSU was founded before the DO school was. So I suppose the AOA only agrees to an institution having an MD & DO school if you are adding a DO school to an institution that already has an MD school but not vice versa.
 
Well it wouldn't improve the DO:MD school ratio ;). It would be nice to add another DO school at a university with an MD school though...

Sigh, the AOA's failure (or lack of interest?) to open more state university affiliated DO programs like MSU upsets me.

:thumbup::thumbup::thumbup::thumbup::thumbup:
 
The resolution was pulled, and not voted on. I will post a comprehensive update about things pertaining to us when I get the chance.

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The resolution was pulled, and not voted on. I will post a comprehensive update about things pertaining to us when I get the chance.

Sent from my EVO using SDN Mobile

I honestly did not see that coming...not.
 
The resolution was pulled, and not voted on. I will post a comprehensive update about things pertaining to us when I get the chance.

Sent from my EVO using SDN Mobile

What does pulled mean? The people who proposed it retracted it after being pressured behind the scenes?

I don't think many MD students would be interested in the AOA match, nor would those applicants match even if they tried (reverse racism lol?) but the AOA should at least reciprocate the generosity of the ACGME.
 
I wish the matches could just be combined, have US MD or DO be allowed to apply to either, and have US MD and DO considered equally (like the military match does.)
 
Sigh, the AOA's failure (or lack of interest?) to open more state university affiliated DO programs like MSU upsets me.

How do you expect them to do that exactly? DO schools apply to COCA for accreditation and state/ established prestigious schools aren't going to spend money opening up a DO school when they can open a MD school instead. Furthermore schools with existing MD schools like MSU need to have huge fundings or else they end up stretching their resources and no one wins.


I wish the matches could just be combined, have US MD or DO be allowed to apply to either, and have US MD and DO considered equally (like the military match does.)


It'd be nice if the AOA match would be after the ACGME match, that way people can apply and try their luck in the ACGME for residencies like gen surgery.
 
How do you expect them to do that exactly? DO schools apply to COCA for accreditation and state/ established prestigious schools aren't going to spend money opening up a DO school when they can open a MD school instead. Furthermore schools with existing MD schools like MSU need to have huge fundings or else they end up stretching their resources and no one wins.





It'd be nice if the AOA match would be after the ACGME match, that way people can apply and try their luck in the ACGME for residencies like gen surgery.

So how come there was a brief period of success in the 70's when several state schools were opened?
 
So how come there was a brief period of success in the 70's when several state schools were opened?

Optimism and a lack of desire to create DO schools for the lack of generating easy revenue.
 
So how come there was a brief period of success in the 70's when several state schools were opened?

For MSU, the DO School was originally a seperate college completely that got absorbed by MSU.

MSU is a weird beast in that almost every single college in it was originally a seperate college. For example, their law school was originally Detroit College of Law a private school.

The truth is, as serenade said, if a public school has the funding they're far more likely to open an MD school than a DO school 9.99999999999/10.
 
For MSU, the DO School was originally a seperate college completely that got absorbed by MSU.

MSU is a weird beast in that almost every single college in it was originally a seperate college. For example, their law school was originally Detroit College of Law a private school.

The truth is, as serenade said, if a public school has the funding they're far more likely to open an MD school than a DO school 9.99999999999/10.

+1. The College of Human Medicine (md school) was founded by MSU though
 
I wish the matches could just be combined, have US MD or DO be allowed to apply to either, and have US MD and DO considered equally (like the military match does.)


........
It'd be nice if the AOA match would be after the ACGME match, that way people can apply and try their luck in the ACGME for residencies like gen surgery.


:thumbup::thumbup:
 


Yes, because the AOA wants even more bottom barrel candidates? They already get the scraps, do you really think they'd want to give their best candidates even more chances to escape their clutches?

"Well, we could make you sign on the dotted line by submitting a rank list and agreeing to be bound to it prior to your chance at the more desirable ACGME programs, but we are so nice we'll let you try for them first and then if you fail to match you can come to our program. Think of us sort of like that chick you drunk text as a last resort."

The world doesn't work that way. Hell will freeze over before the AOA match occurs after or during the ACGME match.
 
Yes, because the AOA wants even more bottom barrel candidates? They already get the scraps, do you really think they'd want to give their best candidates even more chances to escape their clutches?

"Well, we could make you sign on the dotted line by submitting a rank list and agreeing to be bound to it prior to your chance at the more desirable ACGME programs, but we are so nice we'll let you try for them first and then if you fail to match you can come to our program. Think of us sort of like that chick you drunk text as a last resort."

The world doesn't work that way. Hell will freeze over before the AOA match occurs after or during the ACGME match.

Agreed.
 
The AOA is so annoying. They need to get their heads out of their asses and realize that by continually trying to separate themselves from LCME, they are hurting the profession of medicine as a whole. AOA = big giant UGH.
 
The AOA is so annoying. They need to get their heads out of their asses and realize that by continually trying to separate themselves from LCME, they are hurting the profession of medicine as a whole. AOA = big giant UGH.

Yes, because the AOA wants even more bottom barrel candidates? They already get the scraps, do you really think they'd want to give their best candidates even more chances to escape their clutches?

"Well, we could make you sign on the dotted line by submitting a rank list and agreeing to be bound to it prior to your chance at the more desirable ACGME programs, but we are so nice we'll let you try for them first and then if you fail to match you can come to our program. Think of us sort of like that chick you drunk text as a last resort."

The world doesn't work that way. Hell will freeze over before the AOA match occurs after or during the ACGME match.


The AOA doesn't always to seem to have our best interests as heart, but as students we have a little more power than we realize. Also, hell may be freezing over far earlier than you had imagined considering the AOA reached out the ACGME years ago about the possiblity of the combining the match. They just want to still have control of their own residencies and not relinquish all control to the ACGME (which is understandable IMO).

For all of you that are students and are interested in our future, GET INVOLVED with SOMA. As a direct branch of the AOA we have the ability to put forth resolutions directly onto the AOA HOD floor. We had a resolution written in March that went through SOMA, went to the AOA HOD floor last week and passed! We have more power than is realized. Even if it doesn't pass the AOA at least our opinions are known.

As for an update from the HOD

The resolution for Loan Deferment During Residency was passed.

The resolution that mandated you must be a DO to be an AOA residency director was withdrawn after facing resistance.

The resolution on opening AOA residencies to MD students was referred (can be looked at in the future) because of a few reasons. The resolution stated MD students would have to learn the seven core competencies and it was unclear how MD students would learn this and OMM without any prior training.

There was a resolution called "Is Your Doctor a Physician" which would start a campaign to explain the difference between Physicians (MD's/DO's) and "Doctors" (NP's, DPT, PA, etc). This would include pamphlets, radio ad's, t.v commercials and billboards. Our student caucus met before the AOA HOD to have a unifying student voice voted for this resolution. Unfortunately, when the resolution went to a review committee they changed the wording and made it more about MD vs DO and it was not passed.


The resolution that stated the AOA should look into more residency funding was passed.

I remember those being the most important resolutions for us, although there were another ~150. Let me know if you have any questions.
 
The AOA doesn't always to seem to have our best interests as heart, but as students we have a little more power than we realize. Also, hell may be freezing over far earlier than you had imagined considering the AOA reached out the ACGME years ago about the possiblity of the combining the match. They just want to still have control of their own residencies and not relinquish all control to the ACGME (which is understandable IMO).

For all of you that are students and are interested in our future, GET INVOLVED with SOMA. As a direct branch of the AOA we have the ability to put forth resolutions directly onto the AOA HOD floor. We had a resolution written in March that went through SOMA, went to the AOA HOD floor last week and passed! We have more power than is realized. Even if it doesn't pass the AOA at least our opinions are known.

As for an update from the HOD

The resolution for Loan Deferment During Residency was passed.

The resolution that mandated you must be a DO to be an AOA residency director was withdrawn after facing resistance.

The resolution on opening AOA residencies to MD students was referred (can be looked at in the future) because of a few reasons. The resolution stated MD students would have to learn the seven core competencies and it was unclear how MD students would learn this and OMM without any prior training.

There was a resolution called "Is Your Doctor a Physician" which would start a campaign to explain the difference between Physicians (MD's/DO's) and "Doctors" (NP's, DPT, PA, etc). This would include pamphlets, radio ad's, t.v commercials and billboards. Our student caucus met before the AOA HOD to have a unifying student voice voted for this resolution. Unfortunately, when the resolution went to a review committee they changed the wording and made it more about MD vs DO and it was not passed.


The resolution that stated the AOA should look into more residency funding was passed. No brainer, but not actually accomplishing anything.

I remember those being the most important resolutions for us, although there were another ~150. Let me know if you have any questions.


Sooooo, basically nothing really got done, sounds like an awesome use of time.
 
Over 140 resolutions passed. They affected physicians far more than med students. If more students were active and wrote resolutions on what they felt should be changed we may see more progress. I do appreciate the optimism however. We need to stop thinking the aoa isn't going to do anything and stand up as students and be heard.

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An organization that absolutely FORCES people to be a member in order to be licensed, is not one I think of that cares what its membership thinks. But, I admire your optimism. I just think it is unfounded and perhaps a bit naive.
 
Nobody is forced by the AOA to be a member to be licensed. If that is the case somewhere it is a state licensing board requirement.

If you do an osteopathic residency, however, your board certification is tied to your membership. I do know docs who simply rejoin the AOA the year they need to take their board recertification exam, though, so there are ways around it.
 
Nobody is forced by the AOA to be a member to be licensed. If that is the case somewhere it is a state licensing board requirement.

If you do an osteopathic residency, however, your board certification is tied to your membership. I do know docs who simply rejoin the AOA the year they need to take their board recertification exam, though, so there are ways around it.


This is essentially forcing membership is it not?
 
the AOA reached out the ACGME years ago about the possiblity of the combining the match. They just want to still have control of their own residencies and not relinquish all control to the ACGME (which is understandable IMO)

I'd love to hear more about this. Why did the ACGME say no?

Also, the ACGME puts out a document that tells you how each residency program did in the match, which ones filled, which ones didn't, etc. Is there something like this from the AOA by any chance?
 
An organization that absolutely FORCES people to be a member in order to be licensed, is not one I think of that cares what its membership thinks. But, I admire your optimism. I just think it is unfounded and perhaps a bit naive.

I think you may be misunderstanding my stance on the AOA (or I didn't make it clear). I can say that I believe the AOA has made a few questionable decisions over the years.

The past is the past, and sitting around being upset with the AOA isn't going to change their policies. Instead, I believe we can be proactive and fight for our future and have a say on the future of osteopathic medicine. SOMA is the only student organization that can bring a resolution directly to the AOA House of Delegates and I believe that's an opportunity that should not be taken lightly. The COSGP has a say with AACOM and if we work together we can make progress. Yes that may sound overly optimistic, but I believe we have more say than we're given credit for. If you're upset with the AOA then take a stand.

I'd love to hear more about this. Why did the ACGME say no?

Also, the ACGME puts out a document that tells you how each residency program did in the match, which ones filled, which ones didn't, etc. Is there something like this from the AOA by any chance?

The spreadsheet that I made http://forums.studentdoctor.net/showthread.php?t=813819 has the data that you're looking for (the red chart labeled AOA data).

As for combining the AOA and NMRP (ACGME) match, I can't say why it never came to fruition. That happened before I was around, but I believe there were a few issues, and it was not necessarily that the ACGME said no.
 
Found it! Wow, you sure did a lot of work. Thanks!
 
I am starting to realize that the AOA and the entire institution that controls Osteopathic Medicine is it's own worst enemy and does absolutely nothing good for any of us.
 
I am starting to realize that the AOA and the entire institution that controls Osteopathic Medicine is it's own worst enemy and does absolutely nothing good for any of us.

Occupy the AOA.
 
Bahh fine not "licensed" but "board certified." Regardless, the heart of the matter remains and this is just arguing over details that quite frankly are pointless to argue over.
 
The difference between licensure and renewing your board certification is hardy pointless. Once you have your board cert your employer will consider it good until the renewal date is up (usually 10 years later, depending on your specialty).

Lose your license and you cannot work at all in that state. The difference is very important, especially when someone has made the assertion that the AOA is requiring membership for you to be licensed to practice.
 
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