I agree with Devitz who insist that LCME will take over COCA

[icevermin]

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[deleted]

 

[CrocodilePancake]

Man people like you really scare me. I know where I'll stand if somebody like you is elected to the national AOA - in the dark. ****

So its going to take ACGME trained DOs to convince the AOA that there is no discernible difference between the "osteopathic" and "allopathic" practice of medicine post med school graduation.

 

[user3]

I'm not sure I understand your point. DOs are often discriminated against for certain ACGME residency spots, not given the same consideration as an MD with identical board scores and similar qualifications. How can you argue that the osteopathic profession is responsible for the "Us vs Them" mentality?

Yes this is true. It's only true because it's a well known fact that DOs have historically relied on the ACGME for competitive specialties. If this were not the case, then DOs would never apply to ACGME residencies. So to the original guys point:

When he says its known that DOs match competitive specialties already, so why tighten standards? That is why. Because there is discrimination. Tighten standards, accept less students, advocate more for your students, establish permanent clinical faculty and permanent relationships with hospitals, establish quality residency programs. Oh by the way, no ACGME programs will be closing down post-merger. Only AOA affiliated. What's that mean about quality of clinical education again? Is this the fault of MDs too?

Man people like you really scare me. I know where I'll stand if somebody like you is elected to the national AOA - in the dark. ****

You're absolutely right. MDs are the reason for this entire dilemma. It's not the fault of the AOA, it's not the fault of DOs who were too afraid to admit to their misgivings from the Flexner report and start making amends. It's all the fault of MDs.

And MD schools are factories, absolutely correct. It's not their research that has advanced medicine to the stage its at now, nope. It's DOs that are doing cutting edge research in their institutions and ensuring that their students get a high quality education without any permanent clinical faculty. Yup it's all MD schools that are to blame!!

The impact factor of JAMA compared to to JAOA is an indicator as well by the way. I can't wait for you to rebut the significance of impact factors and journal quality.

Thank GOD for the AOA! Without them there wouldn't be cutting edge research, high quality facilities for their students, and an overall sense of contentment!!

Where would the DO schools acquire the funding streams necessary to support these other features you mention? (More faculty, smaller class sizes, clinical departments, research, stronger clinical affiliations, etc?)

 

[user3]

Let me clarify my point. When the COA relied on the national AOA to push for better facilities for them, either nationally or in CA, the AOA sat on their hands.

When the ACGME went around opening up University based medical institutions, the AOA didn't. Who is to blame here? There are still hospitals to this day that were once affiliated with DO schools but now have an associated MD school, hell some of these (*ahem* Northshore) don't even accept DOs anymore for residencies.

If you look at DOs on a whole, just like MDs, there are some that are bad and some that are great. If you take the average of the two obviously you will find that, on average, the clinical outcomes are similar. However, that doesn't say that having smaller classes with more student-centered learning (vs an auditorium filled with 250 students.. I mean really), dedicated clinical faculty, true University-based hospital affiliations will be a bad thing.

Now, there are DO schools opening up that don't even allow girls in a men's auditorium. That's kind of ridiculous. What right do they have. Mandatory classes, for all classes. Are we really in high school where attendance will determine whether somebody passes or fails?

LOL

Its unfortunate that DO schools are oftentimes more concerned about nonsense like mandatory class attendance or dress codes and less interested in building resources that could meaningfully enhance students' education.

 

[meliora27]

It's also unfortunate that the JAOA has an impact factor of 0.0

 

[Dr. Zombie]

LOL

Its unfortunate that DO schools are oftentimes more concerned about nonsense like mandatory class attendance or dress codes and less interested in building resources that could meaningfully enhance students' education.

I don't think such concerns are exclusive to DO students.

 

[Apoplexy__]

Every time I see the title of this thread displaying on the SDN main forum page, the "who insist" portion of it digs at me a little more.

 

[Jwalker]

You're absolutely right. MDs are the reason for this entire dilemma. It's not the fault of the AOA, it's not the fault of DOs who were too afraid to admit to their misgivings from the Flexner report and start making amends. It's all the fault of MDs.

And MD schools are factories, absolutely correct. It's not their research that has advanced medicine to the stage its at now, nope. It's DOs that are doing cutting edge research in their institutions and ensuring that their students get a high quality education without any permanent clinical faculty. Yup it's all MD schools that are to blame!!

The impact factor of JAMA compared to to JAOA is an indicator as well by the way. I can't wait for you to rebut the significance of impact factors and journal quality.

Thank GOD for the AOA! Without them there wouldn't be cutting edge research, high quality facilities for their students, and an overall sense of contentment!!

md schools were also equally affected by the flexner report. And at least the JAOA doesnt spam my mailbox like JAMA does LOL.

 

[hallowmann]

Every time I see the title of this thread displaying on the SDN main forum page, the "who insist" portion of it digs at me a little more.

The thing that bothers me the most is that OP spelled Gevitz's name wrong. I could deal with poor grammar and just being annoyed at the suggestion, but every freakin time I see that "D" it annoys me that much more.

 

[Apoplexy__]

The thing that bothers me the most is that OP spelled Gevitz's name wrong. I could deal with poor grammar and just being annoyed at the suggestion, but every freakin time I see that "D" it annoys me that much more.

Hahaha I didn't even know the guy's name was spelled wrong since I never previously clicked on this thread...

 

[NurWollen]

.

 

[GUH]

You're absolutely right. MDs are the reason for this entire dilemma. It's not the fault of the AOA, it's not the fault of DOs who were too afraid to admit to their misgivings from the Flexner report and start making amends. It's all the fault of MDs.

And MD schools are factories, absolutely correct. It's not their research that has advanced medicine to the stage its at now, nope. It's DOs that are doing cutting edge research in their institutions and ensuring that their students get a high quality education without any permanent clinical faculty. Yup it's all MD schools that are to blame!!

The impact factor of JAMA compared to to JAOA is an indicator as well by the way. I can't wait for you to rebut the significance of impact factors and journal quality.

Thank GOD for the AOA! Without them there wouldn't be cutting edge research, high quality facilities for their students, and an overall sense of contentment!!

I suspect that somewhere in that long sarcastic diatribe you are trying to make a specific recommendation for how to improve osteopathic medical education. Perhaps you can clarify. While you're at it, please also let me know what studies you have read which establish a causal relationship between the impact factor of the JAOA and DO patient outcomes.

Please also describe what you or your ideal candidate would do as AOA president, and whether you think that there should be DOs at all.

EDIT: And since you seem to be such a fan of evidence, please post an abstract of any study published in a reputable journal which indicates that DOs are worse pill-pushers than MDs. You did, after all, assert that DO schools are in danger of becoming "factories that produce people who push pills".

 

[user3]

I suspect that somewhere in that long sarcastic diatribe you are trying to make a specific recommendation for how to improve osteopathic medical education. Perhaps you can clarify. While you're at it, please also let me know what studies you have read which establish a causal relationship between the impact factor of the JAOA and DO patient outcomes.

Please also describe what you or your ideal candidate would do as AOA president, and whether you think that there should be DOs at all.

EDIT: And since you seem to be such a fan of evidence, please post an abstract of any study published in a reputable journal which indicates that DOs are worse pill-pushers than MDs. You did, after all, assert that DO schools are in danger of becoming "factories that produce people who push pills".

I think he feels that just because there may be no differences in clinical outcomes doesn't excuse our schools' lack of established hospital affiliations, lack of full time clinical faculty/clinical departments, lack of research, large class sizes, and other issues he feels are important.

 

[GUH]

I think he feels that just because there may be no differences in clinical outcomes doesn't excuse our schools' lack of established hospital affiliations, lack of full time clinical faculty/clinical departments, lack of research, large class sizes, and other issues he feels are important.

These are valid concerns. It would have been nice to see them expressed like that, without slamming the entire profession (or me for daring to imply that DOs are not entirely responsible for the division). It would also be nice to hear an explanation of why it is so important to our profession and our patients to improve in these areas, other than just referring to the Flexner report or merely saying "we should do it because they do it".

 

[preDoGuy24]

These are valid concerns. It would have been nice to see them expressed like that, without slamming the entire profession (or me for daring to imply that DOs are not entirely responsible for the division). It would also be nice to hear an explanation of why it is so important to our profession and our patients to improve in these areas, other than just referring to the Flexner report or merely saying "we should do it because they do it".

Do you really need an explanation on why it is important to our profession to have good clinical training? Why it is important for our students to have full time clinical staff? Why it may be important to have appropriate class sizes, with professor student ratios that aren't on the scale of some of the Caribbean schools?

I hope you really don't need an explanation for this.


Sent from my iPad using Tapatalk

 

[GUH]

Do you really need an explanation on why it is important to our profession to have good clinical training? Why it is important for our students to have full time clinical staff? Why it may be important to have appropriate class sizes, with professor student ratios that aren't on the scale of some of the Caribbean schools?

I hope you really don't need an explanation for this.


Sent from my iPad using Tapatalk

Most of us (including me) "feel" that these would be good things to work on changing, but "feeling" is not a great basis to advocate for reform. I'm willing to bet that somewhere out there, we could find truly good, current, non-anecdotal evidence to reform the items you mentioned, but again, it is important to express these reasons. Whining about how you think there should be no DO schools, especially on a public forum, is a non-starter and does nothing to make the aforementioned changes more likely.

 

[preDoGuy24]

Most of us (including me) "feel" that these would be good things to work on changing, but "feeling" is not a great basis to advocate for reform. I'm willing to bet that there are truly good reasons to reform the items you mentioned, but again, it is important to express these reasons. Whining about how you think there should be no DO schools, especially on a public forum, is a non-starter and does nothing to make the aforementioned changes more likely.

I'm not sure who is "whining" ? I think that standards should be equal between MD and DO school. Maybe we should just continue to open sub par DO schools without adequate clinical education until we get enough data so these "feelings" aren't so subjective? I do believe that at a minimum DO education should be at the same standards as MD. I think there are a fair amount of DO schools out there who fall flat when it comes to clin ed, and should be held responsible for this. As for MD taking over, I don't see that happening anytime soon and don't particularly think it's a great idea.

 

[GUH]

I'm not sure who is "whining" ?

Whining:

Its unfortunate that DO schools are oftentimes more concerned about nonsense like mandatory class attendance or dress codes and less interested in building resources that could meaningfully enhance students' education.

EDIT - More whining:

And very few LCME accredited institutions don't have affiliated teaching hospitals. On the other hand, COCA is opening up DO schools left and right, some with even dubious "ideologies" if you catch what I'm saying.

COCA, compared to LCME, is nothing more than a sick, money hungry institution. The student-faculty ratio is insane at any DO school, school support at a DO school compared to an MD school is not even comparable. I feel like I'm in undergrad all over again. What do we get? The "We're different" mentality. The "they think they are better than us, we are underdogs!" mentality. Historically even, its a shame. Rather than compete head to head (I mean hell, UC Irvine split from the AOA because the AOA wasn't giving *any* support!), the AOA retreated at every step. Rather than adopt scientific rigor and follow the Flexner report recommendations, the DO world fought tooth and nail for 20 years before moving on and finally accepting the scientific norm! It's ridiculous.

In fact, I'm all in favor of auditing all DO schools to ensure that they are meeting medical education standards. We're going to be physicians, not pill pushers. There are NPs and PAs for that job. Its sickening. It disgusts me. The standards of education *must* be higher.

What I foresee happening is schools turning into "Historically Osteopathic" universities, merging into larger MD systems with students who prefer to learn about the OMT and OPP material going to a historically osteopathic school while getting an MD or MDO or some variant thereof degree. Present DOs will be phased out and the medical systems will finally unite behind solid scientific ground.

 

[preDoGuy24]

Whining:

Could be considered whining, my school is 100% more concerned with you having a tie on and never missing a class then they are on providing students with good clinical rotations. I have had to seek out and set up my own rotations at tertiary care centers and have honestly seen cases that people at core sites have only read about. Not a good thing.

 

[NurWollen]

Could be considered whining, my school is 100% more concerned with you having a tie on and never missing a class then they are on providing students with good clinical rotations. I have had to seek out and set up my own rotations at tertiary care centers and have honestly seen cases that people at core sites have only read about. Not a good thing.

So, I don't go to your school, and this is a tangent, but how did you go about setting up these rotations. I'm under the impression that most teaching hospitals only take outside students for 4th year electives, and not for 3rd year.

 

[GUH]

Could be considered whining, my school is 100% more concerned with you having a tie on and never missing a class then they are on providing students with good clinical rotations. I have had to seek out and set up my own rotations at tertiary care centers and have honestly seen cases that people at core sites have only read about. Not a good thing.

If you can prove that the school is literally putting more resources into dress code and attendance enforcement than establishing good clinical rotation sites, then that would definitely be a good place to start advocating for change.

 

[JRO38]

.

 

[preDoGuy24]

If you can prove that the school is literally putting more resources into dress code and attendance enforcement than establishing good clinical rotation sites, then that would definitely be a good place to start advocating for change.

I'm not a forensic accountant and will be graduating in 3 months going into a very competitive specialty. Thanks for the homework but I'm good.

 

[GUH]

So unless a poster has a RCT and meta-analyses for every point they're trying to make, it is whining and nonproductive? Do you realize schools make much of this information unobtainable because it may make them look bad? Sometimes, the proof is in the pudding and if you have to schedule your own rotations that is pathetic (especially if you are still paying your school tuition.) You are extremely annoying - I'll go analyze all of your previous posts to prove it to you.

Kind of funny how some of the same folks who think that medicine should be evidence-based are willing to make outrageous claims without proving it.
Not even an RCT; just any evidence at all beyond anecdotal would be better than nothing.

I'm not a forensic accountant and will be graduating in 3 months going into a very competitive specialty. Thanks for the homework but I'm good.

Congratulations. Looks like your education and initiative have worked out in your favor.

 

[preDoGuy24]

So, I don't go to your school, and this is a tangent, but how did you go about setting up these rotations. I'm under the impression that most teaching hospitals only take outside students for 4th year electives, and not for 3rd year.

Plenty of teaching hospitals will accept 3rd years rotating through on elective or what have you. You are correct though there are plenty that will only allow 4th years, quite honestly this is institution dependent but in my experience tends to be places that have there own med school on site-most of the other institutions I have been to that are affiliated (have rotating students) but not directly are the ones that will. (example being big tertiary care community hospital vs univ of whatever). I don't know where you are rotating, sorry can't be much more help then that.

 

[JRO38]

.

 

[GUH]

What claim did I make? I see 2 opinions. Unless you think my claim of schools not disclosing internal financial information to students has no merit (OK, you got me, I didn't survey every COM and ask them to disclose everything to me).

Other posters on this thread have made outrageous claims to advocate for major reform, not you.

 

[meliora27]

What claim did I make? I see 2 opinions. Unless you think my claim of schools not disclosing internal financial information to students has no merit (OK, you got me, I didn't survey every COM and ask them to disclose everything to me).

With the exception of Rocky Vista which is for-profit, all other COM's are non-profits, thus they have to file 990's. Their financials are thus public record.

There seems to be a lot of LECOM chatter these days on SDN. Here are LECOM's financials:

https://www.citizenaudit.org/251698677/

 

[hallowmann]

With the exception of Rocky Vista which is for-profit, all other COM's are non-profits, thus they have to file 990's. Their financials are thus public record.

There seems to be a lot of LECOM chatter these days on SDN. Here are LECOM's financials:

https://www.citizenaudit.org/251698677/

Yeah, it's super obvious that concept wasn't clear to people. Thank you for pointing it out in spite of the fact that this has been posted many times.

If anything the sheer quantity being made by schools is massive. It's nothing new. The real question is, if LECOM can manage to make this much money and still keep its price well below almost any other private med school, what the heck is happening at the schools that charge double in tuition? Sure, you could say it covers better quality things, like paying for rotations (its not like it's a complete mess at LECOM - I mean some blah sites, but some very solid ones), but what about schools that just opened up, like LUCOM, that charge ~$15k more for tuition? Or what about the soon to be opened BCOM that will be for-profit and charge $20-$25k more per year ($50-$55k), and have plans to expand to 300 students over the next couple years (getting pretty close to even the size of LECOM-E/SH)?

Damn, forget treating the whole patient, I'm going to build a med school when I'm done. (just kidding, sort of)

 

[icevermin]

[deleted]

 

[icevermin]

[deleted]

 

[icevermin]

[deleted]

 

[AlteredScale]

I just skimmed through the link. It's pretty crazy isn't it? There are serious differences in COCA and LCME. It's crazy. I'm really wondering what the hell I can do as a student to tighten standards and up our training and education. Maybe part of the "distinctiveness" is fending for yourself and its all a big ploy. Who knows.

It certainly is. With this being a few years ago it would be a very optimistic viewpoint to assume that things have changed for the better. With seeing how COCA is willing to open these satellite campuses left and right so quickly is not doing us any favors.

What we should do is create a petition that calls for COCA to reevaluate their accreditation standards in light of the recent ACGME/AOA/AACOM merger. It's really the only direction the osteopathic profession can go. They're just scared of loosing the "distinction"....obviously I don't think that will go away since ACGME has complimented AOA programs with an entire ACGME osteopathic principles committee.

 

[icevermin]

[deleted]

 

[AlteredScale]

I'm all for doing something like that, I just don't know how to go about it. The President of the AOA will speak at my University soon, is that even an appropriate forum to bring something like this up?

Hmm I'm not too sure either. I have even started! Haha. But honestly would be good to contact SOMA or your schools SGA perhaps to go about it.

 

[GUH]

It's time to put it to rest. DO education is inferior to MD education and needs to be improved. There is no need to do a meta-analysis, it's an objective fact.

Is that how you're going to practice as a physician? Who cares about gathering any evidence when you "know" something is a fact, right?

Here are some examples of troll posts:

COCA, compared to LCME, is nothing more than a sick, money hungry institution.

It sounds like you're in favor of being one of Still's "Lesion Osteopaths" with very limited scope of practice bud.

Now, there are DO schools opening up that don't even allow girls in a men's auditorium.

The argument is centered entirely on how its presently run, and how its been RAN for its entirety. I even asked my professors about it and they are all deluded...
What I foresee happening is schools turning into "Historically Osteopathic" universities, merging into larger MD systems with students who prefer to learn about the OMT and OPP material going to a historically osteopathic school while getting an MD or MDO or some variant thereof degree. Present DOs will be phased out and the medical systems will finally unite behind solid scientific ground.

Thank GOD for the AOA! Without them there wouldn't be cutting edge research, high quality facilities for their students, and an overall sense of contentment!!

Go ahead, mention any of these things to the AOA President and continue to insist that no support is needed for your positions. Then come back and let us know how it went.

 

[JGimpel]

In the Wall Street arena, there are companies that specialize in M&A, Mergers and Aquisitions. For those that still believe that a Merger lays ahead for the DO and MD world, please know that it will definitely be more of the latter than the former. If you simply looked at the 28% participation number quoted in a previous post, you must notice that this is nowhere near the 50/50 deal most mergers have. Even for mergers, the staff made redundant as a result is inevitable, as is their termination. Will it be mostly MDs or DOs getting terminated? I know people like to say "takeover" a lot and they're on the right track, but the MD world will continue to acquire more and more of the power of the DO world for all of our sake.

The DOs in charge could have stopped the growing of medical schools like a rake on weeds and focused on improving the quality of education rather than the quantity of it years ago but didn't. It's only a matter of time before the Secretary of Education forces the final hand against us. Our formal leaders are all within 5 years of retiring, so they don't really care. Ultimately we'll be paying the price, so keep speaking up for your future as nobody else has any intention of doing it. If one more IRB request to use the MRI scanners to prove cranial works, especially with "virtual palpation" from the control room, we're all toast!

JGimpel DO
University of Phoenix College of Osteopathic Medicine, Monowi Campus.

 

[NurWollen]

In the Wall Street arena, there are companies that specialize in M&A, Mergers and Aquisitions. For those that still believe that a Merger lays ahead for the DO and MD world, please know that it will definitely be more of the latter than the former. If you simply looked at the 28% participation number quoted in a previous post, you must notice that this is nowhere near the 50/50 deal most mergers have. Even for mergers, the staff made redundant as a result is inevitable, as is their termination. Will it be mostly MDs or DOs getting terminated? I know people like to say "takeover" a lot and they're on the right track, but the MD world will continue to acquire more and more of the power of the DO world for all of our sake.

The DOs in charge could have stopped the growing of medical schools like a rake on weeds and focused on improving the quality of education rather than the quantity of it years ago but didn't. It's only a matter of time before the Secretary of Education forces the final hand against us. Our formal leaders are all within 5 years of retiring, so they don't really care. Ultimately we'll be paying the price, so keep speaking up for your future as nobody else has any intention of doing it. If one more IRB request to use the MRI scanners to prove cranial works, especially with "virtual palpation" from the control room, we're all toast!

JGimpel DO
University of Phoenix College of Osteopathic Medicine, Monowi Campus.

Did someone really do that?

 

[Stlblues17]

It's unfortunate that the AOA dropped the ball on opening more university COMs. I myself am grateful to start school next year, I am however not a fan of the state of clinical rotations come my 3rd year.

I personally wish that class sizes weren't so big as well. Can you imagine if MD schools had the class sizes of most DO programs.

Hopefully the future will be brighter.

 

[user3]

I personally wish that class sizes weren't so big as well.

But...they are addressing a primary care shortage. And they are giving so many more people an opportunity to realize their dreams...

 

[Stlblues17]

But...they are addressing a primary care shortage. And they are giving so many more people an opportunity to realize their dreams...

I am not suggesting that we pull the ladder up after us. As the DO route will give me the opportunity to become a physician without doing a masters and more just to get into an MD school.

With that said, I believe they should worry about shoring up clinical education. And if you can only get marginally decent sites, for 200+ people, what good is that.

Anyway, I don't have any answers. I plan on doing as many away tertiary rotations as I can.

 

[icevermin]

[deleted]

 

[meliora27]

I hope that all of us disenchanted DO students and DOs start/continue to pressure the AOA to make necessary changes to improve the state of medical education. It's below par presently.

The problem is that many of these DO's enter into ACGME training, and never look back. As soon as they graduate, pass Level 3 of COMLEX, and perhaps do the required things for a Resolution 42 waiver, they have nothing to do with the AOA ever again.

The people who tend to stay involved are those who enter into Osteopathic training, become involved in their state Osteopathic societies, etc.

 

[JGimpel]

The problem is that many of these DO's enter into ACGME training, and never look back. As soon as they graduate, pass Level 3 of COMLEX, and perhaps do the required things for a Resolution 42 waiver, they have nothing to do with the AOA ever again.

The people who tend to stay involved are those who enter into Osteopathic training, become involved in their state Osteopathic societies, etc.

I've done everything I could to quietly move away from the AOA and fast-food medical education that it peddles as better medicine and it feels great every door I can close to that world. I make sure my employer pays all those mafia-type membership fees to them and I encourage others to back away from those that don't have your best interests in mind. The Resolution 42 waiver is pretty much a rubber stamp but it's the necessary hoop to go through to make the AOA feel important. Question though, if you're in an MD institution probably getting a better education, why would you leave to come back to the DO world??? You want to be a PD of a DO program? Run for the fake elections that the AOA puts on for show? Take some pride in yourself and stay where you're at.