How unmatched DO spots are currently filled by MDs in dually accredited programs

[jdinovit]

I discovered something very interesting during my scramble, something I never heard about before. I don't know if this is approved by the AOA or not, but a program I contacted accidentally slipped up and told me that in their dually accredited program, the DO spots which are not filled after the Osteopathic match are freed up and converted to the Allopathic match.

The story is I didn't match in the Allopathic match so I was scrambling. I was calling up all of the DO programs in my area that listed they had spots open. The story is ALL of the dually accredited (MD/DO) programs said they had no spots left, but most of the DO only residencies had spots left, close to the number they released. So I was wondering why ALL of the MD/DO dually accredited programs had no spots open when they released that they did have spots open a few weeks ago, it didn't make sense. Then this program leaked to me what was going on, that they converted all the open slots to MD.

So it appears that in Dually Accredited programs, if they have free spots after the DO match, they convert them into MD spots for the MD match. So if any MD states that they are not able to match in DO places, you are actually able to already in a way. Very interesting. Anyone know about this before?

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[EastWestN2grt]

I discovered something very interesting during my scramble, something I never heard about before. I don't know if this is approved by the AOA or not, but a program I contacted accidentally slipped up and told me that in their dually accredited program, the DO spots which are not filled after the Osteopathic match are freed up and converted to the Allopathic match.

The story is I didn't match in the Allopathic match so I was scrambling. I was calling up all of the DO programs in my area that listed they had spots open. The story is ALL of the dually accredited (MD/DO) programs said they had no spots left, but most of the DO only residencies had spots left, close to the number they released. So I was wondering why ALL of the MD/DO dually accredited programs had no spots open when they released that they did have spots open a few weeks ago, it didn't make sense. Then this program leaked to me what was going on, that they converted all the open slots to MD.

So it appears that in Dually Accredited programs, if they have free spots after the DO match, they convert them into MD spots for the MD match. So if any MD states that they are not able to match in DO places, you are actually able to already in a way. Very interesting. Anyone know about this before?

Someone just talked about this issue in the latest DO or JAOA magazine. The author did make the point that while dual accreditation is generally seen as a good thing, the ability of a program to convert residency spots back and forth from DO to MD was identified as something of potential concern. I dont like to hear that you (and likely others) have already experienced what may be a not so subtle form of discrimination against the profession. I would notify the AOA about your experience just to make sure it is documented with them.

 

[Bacchus]

I don't think this is particularly discriminatory, but I'm not in a place to make a completely informed evaluation. As I interpreted it, the DO scramble was over/almost over and only a few spots remained. Maybe the spot had no interest attached to it during the scramble. Thus, it was converted over to be filled.

I don't see the harm, but I'm sure my opinion may change in 3 to 4 years.

 

[JonnyG]

Someone just talked about this issue in the latest DO or JAOA magazine. The author did make the point that while dual accreditation is generally seen as a good thing, the ability of a program to convert residency spots back and forth from DO to MD was identified as something of potential concern. I dont like to hear that you (and likely others) have already experienced what may be a not so subtle form of discrimination against the profession. I would notify the AOA about your experience just to make sure it is documented with them.

they need to fill the spots or they lose the funding. If they still have DOs in their program every year it is not discriminatory. Plus many places just tell DOs to rank them in the allopathic match and get in that way.

 

[Terpskins99]

So it appears that in Dually Accredited programs, if they have free spots after the DO match, they convert them into MD spots for the MD match. So if any MD states that they are not able to match in DO places, you are actually able to already in a way. Very interesting. Anyone know about this before?

A couple of things...

1. I don't think they are "converted". The training site already had the spot pre-approved to be dually accredited AOA/ACGME. So the spot is eligible to be filled either through the osteopathic and/or allopathic match.

2. The final list of available osteopathic slots left UNFILLED by the AOA match is last updated in February 9th. That is the final official updated list. So a DO student could have scrambled into that slot prior to the allopathic match, and the website would still state that the spot was "open".

3. Chances are, that is what happened with most of those "dually accredited slots" that seemed to have suddenly disappeared. Its no secret that these positions (particularly dually accredited pre-lim medicine) are most desirable to a number of applicants.

 

[nlax30]

Yea, the latest JAOA has a few articles regarding GME. I found the one specifically talking about dual/parallel programs interesting as I just didn't know a whole lot about them.

Training positions—or slots—for AOA/ACGME dual programs were primarily carved out of existing ACGME accredited program positions originally slotted for allopathic residents.

Hospitals have the flexibility to move slots between specialties and back and forth between the AOA Match and the NRMP. That is, if slots do not fill through the AOA Match, they can be transferred back to the NRMP for allopathic or osteopathic participants.

Particularly found this interesting......

An AOA/ACGME dual program can fill its AOA-approved slots and then attain additional DOs through the NRMP Match. Although the program is dually accredited, it does not necessarily mean the DOs are in approved positions and eligible for AOA board certification at the end of training. This can be confusing to DOs in ACGME slots who complete the same program as DOs in approved AOA slots. Unless the program increases its number of approved slots or the trainee is approved by submitting an application for approval through Resolution 42, the trainee will not be able to attain a license in the five states requiring the approved AOA internship. To the benefit of these students, the AOA approved a policy (Resolution 39 [M/2006]—Resolution for Program Approval for Residents Training in a Dual Track Program at the Time of AOA Approval) that if an ACGME program becomes AOA approved, any DO currently in the program is eligible for full AOA approval of their training.

 

[Terpskins99]

Yea, the latest JAOA has a few articles regarding GME. I found the one specifically talking about dual/parallel programs interesting as I just didn't know a whole lot about them.

Hey, thanks for the update.

Ugh, yet another reason why I think the AOA is STUPID. Looks like I'll have to double check with the AOA about my prelim medicine spot since the program made it for me outside of the match.

 

[nlax30]

Hey, thanks for the update.

Ugh, yet another reason why I think the AOA is STUPID. Looks like I'll have to double check with the AOA about my prelim medicine spot since the program made it for me outside of the match.

Yea, it could only be slightly more confusing You should have access to the article if not let me know and I could send you a pdf or something.

Is it a dual program you're going to?

 

[scpod]

Particularly found this interesting......

...Although the program is dually accredited, it does not necessarily mean the DOs are in approved positions and eligible for AOA board certification at the end of training...

You'll find this out when you are ready to apply. Usually, there are a certain number of "dual" spots. For instance, in an FP residency there may be 8 spots, but only two of them are AOA approved spots. Many residencies will tell you that you HAVE to match in the AOA match in order to get a "dual" spot.

 

[Terpskins99]

Yea, it could only be slightly more confusing You should have access to the article if not let me know and I could send you a pdf or something.

Is it a dual program you're going to?

The program is dually accredited. But I'm not sure about the spot they offered me (it is definitely ACGME).

I have to double check with the AOA itself. I ran into a related problem after I matched into ACGME neurology and wanted to find out if I could do an aoa internship. The neurology residency said it was fine by them. The ABPN said absolutely no.

 

[Handy388]

Someone just talked about this issue in the latest DO or JAOA magazine. The author did make the point that while dual accreditation is generally seen as a good thing, the ability of a program to convert residency spots back and forth from DO to MD was identified as something of potential concern. I dont like to hear that you (and likely others) have already experienced what may be a not so subtle form of discrimination against the profession. I would notify the AOA about your experience just to make sure it is documented with them.

wait, if a program is MD/DO dual accredited, and MDs are barred from matching into it even after DO match, isn't that discrimination against MDs?

 

[nlax30]

The program is dually accredited. But I'm not sure about the spot they offered me (it is definitely ACGME).

I have to double check with the AOA itself. I ran into a related problem after I matched into ACGME neurology and wanted to find out if I could do an aoa internship. The neurology residency said it was fine by them. The ABPN said absolutely no.

Gotcha. From that article it seemed like this Resolution 39 thing was for those type of situations, to give you AOA "approval" when you technically match into an ACGME designated slot within an program that's dually accredited.

Good luck though.

 

[nlax30]

wait, if a program is MD/DO dual accredited, and MDs are barred from matching into it even after DO match, isn't that discrimination against MDs?

DO match occurs first, so I think the issue is more that the DO "spots" don't fill and then programs switch them over to ACGME spots.

 

[Terpskins99]

DO match occurs first, so I think the issue is more that the DO "spots" don't fill and then programs switch them over to ACGME spots.

They're not "switched". Well, not usually anyhow (it depends on whether the residency program itself is already dually accredited). The point is, the spots are already dually accredited BEFORE the AOA match. If a DO matches into the spot through the AOA match, then they have secured a dually accredited spot.

A DO can still match into the spot through the NRMP match, but at this point the spot is now available for MD's since the NRMP is the only match process MD's can participate in.

At least, this is how I understand it.

 

[nlax30]

They're not "switched". Well, not usually anyhow (it depends on whether the residency program itself is already dually accredited). The point is, the spots are already dually accredited BEFORE the AOA match. If a DO matches into the spot through the AOA match, then they have secured a dually accredited spot.

A DO can still match into the spot through the NRMP match, but at this point the spot is now available for MD's since the NRMP is the only match process MD's can participate in.

At least, this is how I understand it.

Exactly. Say a dually accredited program has 10 spots, and 5 are AOA positions and 5 are LCGME. The article seemed to make the point that in some cases not all of those AOA slots fill and then the program can "turn them into" LCGME slots, but still 10 total overall. And of course a DO can still go through the NRMP and match into that program but they would technically match into an LCGME slot and not one of the approved AOA slots. I guess that was an issue before that resolution on those students not getting AOA "credit" in that situation.

 

[Terpskins99]

Exactly. Say a dually accredited program has 10 spots, and 5 are AOA positions and 5 are LCGME. The article seemed to make the point that in some cases not all of those AOA slots fill and then the program can "turn them into" LCGME slots, but still 10 total overall. And of course a DO can still go through the NRMP and match into that program but they would technically match into an LCGME slot and not one of the approved AOA slots. I guess that was an issue before that resolution on those students not getting AOA "credit" in that situation.

Well, they "can" convert them over but they usually don't because they feel its too much trouble. They need to contact and get approval from the ACGME to do so. This is why so many osteopathic rotating internship slots are left open.

As an example: most UPMC hospitals are dually accredited programs. These hospitals usually offer 3 kinds of internships: ACGME-only internships, AOA-only internships (usually these are osteopathic rotating internships) and AOA/ACGME dual-accredited internships. If those AOA-only internships do not fill with the osteopathic match, and nobody scrambles into them... the hospital cannot simply "convert" them into ACGME spots. I know this, because I tried to convince several of these programs to do just that for me. They told me they could not.

Now, I know for a fact that if they really wanted to they could have found a way to make it work since the hospital I ultimately landed at worked out an agreement with the ACGME to MAKE a spot for me. But it wasn't easy, and it definitely wasn't automatic.

 

[jdinovit]

Good to know that the JAOA knows about this too. I wish my school told me about this before the match.

If I knew about this before, I would have ranked more programs in the DO match. I just thought I would rank 1 program in the DO match, then go for the NMRP match and if I didn't get anything I would go back to the DO and DO/MD programs with open spots. Little did I know the dually accredited ones weren't available anymore since they had been converted, leaving not too many choices left in the DO only programs. Hopefully the next guy knows about this by reading this thread.

 

[Terpskins99]

Good to know that the JAOA knows about this too. I wish my school told me about this before the match.

If I knew about this before, I would have ranked more programs in the DO match. I just thought I would rank 1 program in the DO match, then go for the NMRP match and if I didn't get anything I would go back to the DO and DO/MD programs with open spots. Little did I know the dually accredited ones weren't available anymore since they had been converted, leaving not too many choices left in the DO only programs. Hopefully the next guy knows about this by reading this thread.

I actually did know about this prior to the AOA match. But I still didn't apply/rank them because I wasn't certain whether or not I would get pulled from the NRMP as a result (I would have only been applying to prelim spots through the AOA match).

To be honest, I'm still not sure.

 

[It'sElectric]

I guess I just don't see the issue. If I'm not mistaken, most DO students on these forums are calling for a combined match, yet some still want spots set aside just for DOs??? How is that fair?

Maybe I missed something in here. To be honest, I wasn't reading particularly closely. I'm not trying to be insulting or incendiary, just honestly curious.

 

[Terpskins99]

I guess I just don't see the issue. If I'm not mistaken, most DO students on these forums are calling for a combined match, yet some still want spots set aside just for DOs??? How is that fair?

Maybe I missed something in here. To be honest, I wasn't reading particularly closely. I'm not trying to be insulting or incendiary, just honestly curious.

You are mistaken. Not to be insulting or incendiary, but if you're honestly curious why don't you try reading the thread a little more carefully?

 

[It'sElectric]

You are mistaken. Not to be insulting or incendiary, but if you're honestly curious why don't you try reading the thread a little more carefully?

Can you explain to me where I'm mistaken?

The OP didn't match Allo, so he started scrambling for unmatched DO spots. These spots were previously open BEFORE the allo match, but were now filled. The DO scramble was long before the actual Allo match, so of course these programs are needing to fill the open spots (hence matching them through Allo match). If the OP wanted to match into these programs as a DO, he/she could've done it via the original DO scramble.

Now exactly what am I missing here?

 

[Handy388]

Good to know that the JAOA knows about this too. I wish my school told me about this before the match.

If I knew about this before, I would have ranked more programs in the DO match. I just thought I would rank 1 program in the DO match, then go for the NMRP match and if I didn't get anything I would go back to the DO and DO/MD programs with open spots. Little did I know the dually accredited ones weren't available anymore since they had been converted, leaving not too many choices left in the DO only programs. Hopefully the next guy knows about this by reading this thread.

See, I don't know how prevalent this is, but I can just imagine some kid would try to rank only one DO derm program and then goes to allo match, thinking that he/she DESERVE to scramble into a DO spot.

Nobody deserve to scramble into a spot. Allos aren't guaranteed a scramble spot, so shouldn't the DOs.

 

[aimee21]

Can you explain to me where I'm mistaken?

The OP didn't match Allo, so he started scrambling for unmatched DO spots. These spots were previously open BEFORE the allo match, but were now filled. The DO scramble was long before the actual Allo match, so of course these programs are needing to fill the open spots (hence matching them through Allo match). If the OP wanted to match into these programs as a DO, he/she could've done it via the original DO scramble.

Now exactly what am I missing here?

I don't believe the OP, or any of the other students who posted, were saying that the residency spots should be kept open for DO students after the DO match, but that they wished they knew that open DO spots in a dually accredited program were converted, for lack of a better word, into allo spots if unfilled after the DO scramble. Obviously, for DO students, this is very important information that apparently isn't widely known. At least, I didn't know.

 

[It'sElectric]

I don't believe the OP, or any of the other students who posted, were saying that the residency spots should be kept open for DO students after the DO match, but that they wished they knew that open DO spots in a dually accredited program were converted, for lack of a better word, into allo spots if unfilled after the DO scramble. Obviously, for DO students, this is very important information that apparently isn't widely known. At least, I didn't know.

EastWestN2grt: I dont like to hear that you (and likely others) have already experienced what may be a not so subtle form of discrimination against the profession. I would notify the AOA about your experience just to make sure it is documented with them.

As Terps already mentioned, the spots were not converted. They were dually accredited from day 1, so they could be filled by either DO/MD candidates. There's absolutely no issue there.

It's over and done with, apparently people didn't realize that dual accreditation means exactly that. Hopefully, no one else makes that same mistake. The spot can go to either candidate (MD/DO) - we can all only hope that one day there is 1 match.

Terps and some of the other posters went into a different subject, which certainly is much more complicated, but entirely unrelated to the OP's original question/statement.

Truthfully, I think I jumped the gun, because ultimately the thread changed courses when Terps and the others went into a different subject. I think I just get a little annoyed by the fact that we still expect to use ACGME spots, while we continue to absolutely outlaw MDs from entering our match. Ridiculous. Don't give me the OMM BS. I've seen the OMM curriculum at an osteopathic program (from FP to Gen Surg to ENT) - it's makes up less than 1% of the entire program.

 

[nlax30]

As Terps already mentioned, the spots were not converted. They were dually accredited from day 1, so they could be filled by either DO/MD candidates. There's absolutely no issue there.

It's over and done with, apparently people didn't realize that dual accreditation means exactly that. Hopefully, no one else makes that same mistake. The spot can go to either candidate (MD/DO) - we can all only hope that one day there is 1 match.

Well from reading that JAOA article, even IN dually accredited programs there are still DO spots and MD spots..... not like they are all lumped together. So if you AOA match you are going for the AOA approved spots WITHIN that dual program, and vice versa if you go through the ACGME match.

Not fully related to this thread but that was one of the issues the article brought up that was a problem for some students, that a DO student would match into a dual program through the ACGME match and thus would technically be in an allo spot and not get AOA credit for it, even though he was in a dually accredited program.

So even in dual programs there are still allo and osteo spots and according to the article those are not static.

 

[DrWBD]

Meh, dual accreditation is ridiculous anyway.

 

[scpod]

....Not fully related to this thread but that was one of the issues the article brought up that was a problem for some students, that a DO student would match into a dual program through the ACGME match and thus would technically be in an allo spot and not get AOA credit for it, even though he was in a dually accredited program....

But that's just it, the "program" is accredited... but only for a certain number of spots. You DON'T generally match into a dual spot except through the AOA match. Typically, a program might have 8 total spots, with two of them dual spots. What that means is that only TWO spots are available for the dual positions. If both fill in the AOA match, then that's it-- there are no more AOA (dual) spots available. If they don't fill in the AOA match it doesn't matter, because all 8 spots are approved by ACGME. They can fill them with anybody they want.

 

[Doctor Bob]

I think I just get a little annoyed by the fact that we still expect to use ACGME spots, while we continue to absolutely outlaw MDs from entering our match. Ridiculous. Don't give me the OMM BS. I've seen the OMM curriculum at an osteopathic program (from FP to Gen Surg to ENT) - it's makes up less than 1% of the entire program.

Amen

 

[Terpskins99]

I think I just get a little annoyed by the fact that we still expect to use ACGME spots, while we continue to absolutely outlaw MDs from entering our match. Ridiculous. Don't give me the OMM BS. I've seen the OMM curriculum at an osteopathic program (from FP to Gen Surg to ENT) - it's makes up less than 1% of the entire program.

I don't get it. What are you annoyed about? You want more MD's to take away your DO residency spots? For what purpose? Fairness?

Do you honestly believe MD's want to pursue osteopathic residencies?

You do realize that there are MANY acgme spots that are effectively untouchable by DO's. Program directors will throw your application into the trash just based upon your degree. Is that fair? The answer is: it doesn't matter. It is what it is. There is no point whining over it.

 

[It'sElectric]

I don't get it. What are you annoyed about? You want more MD's to take away your DO residency spots? For what purpose? Fairness?

Do you honestly believe MD's want to pursue osteopathic residencies?

You do realize that there are MANY acgme spots that are effectively untouchable by DO's. Program directors will throw your application into the trash just based upon your degree. Is that fair? The answer is: it doesn't matter. It is what it is. There is no point whining over it.

First, take a deep breath and relax. Second, I do think it matters. If the ACGME were to effectively close the match to osteopathic applicants tomorrow, we'd be in a sh@t load of trouble. No one can deny that.

As we all learned years ago from our mothers, 2 wrongs don't make a right. Just because SOME ACGME programs continue to discriminate, that doesn't give ALL AOA programs the right to discriminate.

Finally, I don't see it as "MDs taking away our spots", just like I don't see it as DOs taking away MD spots. You're missing my point entirely. If we're both equal (MD=DO, blah, blah like everyone sings from the hills here all day long), then we should start working towards that goal by having one, unifying match. I can guarandamntee there a number of MD applicants that would love to take a crack at some of our more competitive specialty programs, and why shouldn't they be able to? Just answer that question.

I'm not trying to piss you off or start a fight, Terpskins. I'm not even trying to single you or anyone else out. I just think it's absolutely insane that roughly 1/2 of osteopathic students match into allopathic residencies every year, while 0 MDs match into DO residencies.

 

[Terpskins99]

First, take a deep breath and relax. Second, I do think it matters. If the ACGME were to effectively close the match to osteopathic applicants tomorrow, we'd be in a sh@t load of trouble. No one can deny that.

As we all learned years ago from our mothers, 2 wrongs don't make a right. Just because SOME ACGME programs continue to discriminate, that doesn't give ALL AOA programs the right to discriminate.

Finally, I don't see it as "MDs taking away our spots", just like I don't see it as DOs taking away MD spots. You're missing my point entirely. If we're both equal (MD=DO, blah, blah like everyone sings from the hills here all day long), then we should start working towards that goal by having one, unifying match. I can guarandamntee there a number of MD applicants that would love to take a crack at some of our more competitive specialty programs, and why shouldn't they be able to? Just answer that question.

I'm not trying to piss you off or start a fight, Terpskins. I'm not even trying to single you or anyone else out. I just think it's absolutely insane that roughly 1/2 of osteopathic students match into allopathic residencies every year, while 0 MDs match into DO residencies.

lol, dude I'm not upset. I'm just confused at why you are making an issue out of this?

If the ACGME were to shut out DO's, then the AOA would accommodate us by opening more slots. Its that simple.

FWIW, if I had it my way there would no longer be an AOA and all the DO's would get converted to MD's. It would make life easier for everyone.

 

[It'sElectric]

lol, dude I'm not upset. I'm just confused at why you are making an issue out of this?

If the ACGME were to shut out DO's, then the AOA would accommodate us by opening more slots. Its that simple.

FWIW, if I had it my way there would no longer be an AOA and all the DO's would get converted to MD's. It would make life easier for everyone.

It's obviously all good then.

But you and I both know it would be impossible for the AOA to properly accommodate everyone, and the quality of those "new" residencies (aren't the # of new programs regulated by the gov't anyways) would be seriously lacking.

 

[Terpskins99]

It's obviously all good then.

But you and I both know it would be impossible for the AOA to properly accommodate everyone, and the quality of those "new" residencies (aren't the # of new programs regulated by the gov't anyways) would be seriously lacking.

No, it wouldn't be impossible. If the ACGME shut down those spots, the AOA has that many more spots they can obtain funding from the government. In case you forgot, in the past AOA residencies WERE the only residencies available to DO's. The ONLY reason why the AOA has fewer spots available now is because fewer DO's have been applying to/ranking them. When there is a demand for those spots, the government will respond.

As for "quality". Have you ever set foot on a medicine floor of an ACGME versus an AOA accredited program? Have you even started 3rd year yet? I would argue that the average AOA program provides better training than the average ACGME program. On average, faculty at AOA-programs seem to take a much more active role in teaching their residents. The biggest difference I have noticed is research and/or fellowships available at AOA sites versus University ACGME programs. Now how important you rank those is really up to you. But if you are comparing community programs of an AOA versus an ACGME site (NORMAL community programs, no freak-of-nature sites like Mass General or Cleveland Clinic), I would say the AOA sites almost always provide better training for their residents.