I believe in Gevitz's letter regarding unintended consequences of ACGME merger

[MUSCULOSKELETAL23]

http://www.oucom.ohiou.edu/hpf/pdf/...intended Consequences of the ACGME Merger.pdf

even clinicians from osteopathic specialty admits this.

http://www.acoog.org/docs/default-s...ntunifiedgmeaccreditationmay2014.pdf?sfvrsn=2

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[MRSAful Fate]

I believe it too and I don't really care. I don't believe there is a compelling reason for there being two separate routes to become physicians in this country. If the merger leads to the eventual folding of osteopathic schools into mainstream medical education that's fine with me. If we lose 20% of our residency spots in the meantime because they deliver sub par training that's fine with me too.

 

[Bill Brasky]

Please note that if, in the event that any osteopathic- oriented programs place significant barriers or hurdles in the way of MD candidates to enter these programs because of osteopathic manipulative medicine requirements, MD candidates will sue in federal court and probably win their constitutional claim that these programs are violating the “equal protection clause” of the 14th Amendment. Most likely what will ultimately happen is that these osteopathic- oriented residency programs will simply pledge allegiance to the four osteopathic tenets and that will be the extent of the osteopathic component.

I find this interesting considering at least 20%+ of ACGME will not take DOs for no well-supported reason aside from institutional bias. Can the AOA turn around and sue for the exact same reason?

 

[OCDEMS]

I believe it too and I don't really care. I don't believe there is a compelling reason for there being two separate routes to become physicians in this country. If the merger leads to the eventual folding of osteopathic schools into mainstream medical education that's fine with me. If we lose 20% of our residency spots in the meantime because they deliver sub par training that's fine with me too.

I don't disagree with the merger, at least not all aspects of it, but I do have a problem with the above in bold. It assumes that the ACGME's standards, in their entirety, are the only way to accredit a residency. I don't doubt that the vast majority of ACGME standards have good cause for being there, but certainly there are some things they do, and that the AOA does not, that have some room for debate in the context of utility.

Blindly saying, "Good, I don't care because I 100% believe the ACGME is a flawless entity beyond reproach" isn't reasonable. I personally support any standard that is backed by clear and unequivocal research. Anything short of that is free game for debate during the merger. There has to be some debate about what "subpar" truly is.

 

[NurWollen]

I don't disagree with the merger, at least not all aspects of it, but I do have a problem with the above in bold. It assumes that the ACGME's standards, in their entirety, are the only way to accredit a residency. I don't doubt that the vast majority of ACGME standards have good cause for being there, but certainly there are some things they do, and that the AOA does not, that have some room for debate in the context of utility.

Blindly saying, "Good, I don't care because I 100% believe the ACGME is a flawless entity beyond reproach" isn't reasonable. I personally support any standard that is backed by clear and unequivocal research. Anything short of that is free game for debate during the merger. There has to be some debate about what "subpar" truly is.

Taking a stand for moderate perspectives on SDN. I like it.

I do have to say that Gevitz provided no real evidence for that 20% number. It was basically "I heard from colleagues..."

 

[MRSAful Fate]

I don't disagree with the merger, at least not all aspects of it, but I do have a problem with the above in bold. It assumes that the ACGME's standards, in their entirety, are the only way to accredit a residency. I don't doubt that the vast majority of ACGME standards have good cause for being there, but certainly there are some things they do, and that the AOA does not, that have some room for debate in the context of utility.

Blindly saying, "Good, I don't care because I 100% believe the ACGME is a flawless entity beyond reproach" isn't reasonable. I personally support any standard that is backed by clear and unequivocal research. Anything short of that is free game for debate during the merger. There has to be some debate about what "subpar" truly is.

Fair enough. One man's podunk low volume low pathology nightmare may be another man's quality ambulatory care based experience in a community hospital. I doubt there are going to be any large studies delineating exactly how to accredit a residency. Anyways, I'm not interested in rural family medicine in a tiny hospital so I accept that maybe I just don't get it.

 

[NurWollen]

Fair enough. One man's podunk low volume low pathology nightmare may be another man's quality ambulatory care based experience in a community hospital. I doubt there are going to be any large studies delineating exactly how to accredit a residency. Anyways, I'm not interested in rural family medicine in a tiny hospital so I accept that maybe I just don't get it.

I don't think you get OCDEMS' point. He's not saying it's ok to have residencies with such low volume you can't learn. He's simply wondering if there aren't at least some ACGME accreditation rules that are arbitrary and don't really have a tangible effect on the learning process.

Edit: Btw, there are plenty of ACGME residencies in rural, relatively low-volume places. That said, there might be some AOA residencies in hospitals that have no business having a residency. In that case, they should probably close.

 

[chizledfrmstone]

I find this interesting considering at least 20%+ of ACGME will not take DOs for no well-supported reason aside from institutional bias. Can the AOA turn around and sue for the exact same reason?

Can MDs sue for not being able to do AOA residencies?

 

[MRSAful Fate]

I don't think you get OCDEMS' point. He's not saying it's ok to have residencies with such low volume you can't learn. He's simply wondering if there aren't at least some ACGME accreditation rules that are arbitrary and don't really have a tangible effect on the learning process.

Edit: Btw, there are plenty of ACGME residencies in rural, relatively low-volume places. That said, there might be some AOA residencies in hospitals that have no business having a residency. In that case, they should probably close.

I assumed that his point was in response to the text he bolded from my original post which had nothing to do with the acceptability of all of ACGME's accrediting rules and essentially stated my apathy about the loss of sub par residency spots. I am no expert on the intricacies of ACGME's accrediting rules but it is my opinion that there are shady AOA residencies out there that will be no loss to the profession if they disappear.

 

[NurWollen]

I assumed that his point was in response to the text he bolded from my original post which had nothing to do with the acceptability of all of ACGME's accrediting rules and essentially stated my apathy about the loss of sub par residency spots. I am no expert on the intricacies of ACGME's accrediting rules but it is my opinion that there are shady AOA residencies out there that will be no loss to the profession if they disappear.

No argument on that point.
Though of course the ideal situation I think would be for those residencies to be brought up to standard rather than closed, but yeah, your point stands.

 

[OCDEMS]

I don't think you get OCDEMS' point. He's not saying it's ok to have residencies with such low volume you can't learn. He's simply wondering if there aren't at least some ACGME accreditation rules that are arbitrary and don't really have a tangible effect on the learning process.

Edit: Btw, there are plenty of ACGME residencies in rural, relatively low-volume places. That said, there might be some AOA residencies in hospitals that have no business having a residency. In that case, they should probably close.

Thank you. Precisely my point. As someone with a previous healthcare career, I completely understand the benefit of volume in medical education. Volume and diversity of patients are important for developing skill proficiency, clinical acumen, and perhaps most importantly, good old fashioned gestalt. However, I had the fortunate experience to train and eventually work in a variety of clinical settings and I do believe that the importance of volume, in some specific and unique cases, can be supplemented (not replaced) by the clinical opportunities afforded by training in a smaller center. I think the challenge for rural hospitals is to somehow arrange for their residencies to achieve the volume necessary while also providing the unique experiences of training in a rural area.

For example, and this may sound counterintuitive, but less supervision can be of unique value in developing professional autonomy. Corollary: this lack of supervision has to be graded and itself supervised. Whereas rural hospitals may lack exposure to lots of patients and may also have homogenous populations, they may also present residents the opportunity to invest more time in their patients, both personally and from the standpoint of investigating their pathology. This is largely conjecture on my part, but I think it is but one argument that some AOA-affiliated hospitals may counter with. I'm not speaking about any sort of validity to this argument; we all know such arguments are not always won based on what's right.

My personal thought is that there are a few specialities where it would be very hard to argue against volume, e.g. surgery. Repetition is important for mastery. I imagine it's possible to develop an approximate consensus among residency directors about what the "minimum" procedure count should be to obtain safe competence as an attending. If a program can't obtain that then it needs to be put on probation until it can, send its students out to achieve these procedures, and maybe even close.

 

[Elisabeth Kate]

I find this interesting considering at least 20%+ of ACGME will not take DOs for no well-supported reason aside from institutional bias

Where did you get that figure?

 

[Awesome Sauceome]

I believe it too and I don't really care. I don't believe there is a compelling reason for there being two separate routes to become physicians in this country. If the merger leads to the eventual folding of osteopathic schools into mainstream medical education that's fine with me. If we lose 20% of our residency spots in the meantime because they deliver sub par training that's fine with me too.

exactly
The reality is, that they have given a very generous portion of their board to DOs. Its something like 24% of their board even though DOs only represent like 9% of practicing physicians. They are not trying to oust DOs, they simply want a unified match where everyone meets the same high standards and is trained to the best that we currently have. I think that is important for patient outcomes





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[DocEspana]

I find this interesting considering at least 20%+ of ACGME will not take DOs for no well-supported reason aside from institutional bias. Can the AOA turn around and sue for the exact same reason?

Oh... entirely made up on the fly statistics I see. How interesting.

 

[Bill Brasky]

Oh... entirely made up on the fly statistics I see. How interesting.

Sorry, it was supposed to be taken as an out-of-the-butt number; that's what it is. Looking back, that feels too high but I wouldn't know. I didn't think the precise number is critical to the question in the post, though, because the number is not zero.

 

[DocEspana]

Sorry, it was supposed to be taken as an out-of-the-butt number; that's what it is. Looking back, that feels too high but I wouldn't know. I didn't think the precise number is critical to the question in the post, though, because the number is not zero.

What if the number is about 1%?

Because it is

 

[AlbinoHawk DO]

Gevitz makes a lot of leaps in logic that are completely unsupported. For example, he talks about LCME coming in and offering accreditation and that not taking it will result in them going to the media until they get what they want. Aside from being a slippery slope, there's no precedent to any of that. In addition, Osteopathic Medicine is stronger than ever. Are we really to believe that now the MDs will be able to pulverize the profession when they couldn't the past 100+ years that DOs were barely recognizable?

May we lose some residencies? Perhaps, but with 28% of the voting block being DO, I find it more likely that they'll pump money into those residencies. A lot easier to just make existing residencies better than to open new ones. I know the counterargument that then all MD will vote against the 28% minority, but is that realistic? We currently don't have anywhere close to that number of people in ACGME boards and they are offering us to join with 28% of the vote (larger than our population percentage). Is it then realistic to assume what Gevitz says? No. It's just Gevitz putting fear first.

 

[OCDEMS]

Update to this discussion: This is Gevitz's response back to AACOM.

http://www.saveogme.com/2014- Structure Dysfunction.pdf

Also, apparently the ACOOG (American College of Osteopathic Obstetricians and Gynecologist), ACOI (American College of Osteopathic Internist), and ACOFP (American College of Osteopathic Family Physicians) have in some way come out with reservations to the merger.

 

[DocEspana]

Update to this discussion: This is Gevitz's response back to AACOM.

http://www.saveogme.com/2014- Structure Dysfunction.pdf

Also, apparently the ACOOG (American College of Osteopathic Obstetricians and Gynecologist), ACOI (American College of Osteopathic Internist), and ACOFP (American College of Osteopathic Family Physicians) have in some way come out with reservations to the merger.

"reservations" is the appropriate word. As a group that is representing a diverse group of people, the single most stupid thing they can do is unilaterally support (or oppose) a controversial move. They should always appear to have soft support because that way the people in opposition feel like they had a voice and dont storm out of the organization but so that the group, which likely (unable to ever really know for certain) overwhelmingly favors it, still ends up on the right side of history.

 

[2021Doctor]

I read the links in the OP.

The ACOOG letter says "Will there be enough approved US GME positions to accommodate the excessive and ever increasing numbers of US DO graduates?"

Do people here reallly think it was appropriate for them to make that statement?

 

[Apprands31]

Gevitz is making the DO students sound like losers. I welcome the competition for residency spots. In pre-med, those who are good enough get into med school. Likewise , those med school graduates ( DO, MD, IMG) who are good enough will get a residency. This ensures only the best and brightest will practice medicine and thereby, benefit society in the whole. Survival of the fittest, baby!

 

[Mad Jack]

Update to this discussion: This is Gevitz's response back to AACOM.

http://www.saveogme.com/2014- Structure Dysfunction.pdf

Also, apparently the ACOOG (American College of Osteopathic Obstetricians and Gynecologist), ACOI (American College of Osteopathic Internist), and ACOFP (American College of Osteopathic Family Physicians) have in some way come out with reservations to the merger.

All of the osteopathic boards should be rightly terrified. With all residencies ACGME accredited moving forward, there will be no reason for DO grads to be members of the DO certification boards and colleges. With all DOs eligible for membership in the allo specialty boards and colleges, why would any bother to pay a second set of fees and go through a second round of exams? This merger will eventually cripple the DO specialty boards financially, leaving them ill equipped to provide services for those that completed AOA residencies prior to the merger that are ineligible for the equivalent allo boards.

As the osteo specialty boards die, so too will much of the ability for the profession to remain viably distinct, as no specialty boards aside from NMM will require osteopathic manipulation. With no incentive to learn and practice OMM post-graduation, it will fade into an even deeper level of obscurity than that in which it currently exists.

Personally none of that really concerns me. OMM is but a single treatment modality and redundant boards are ridiculous.

 

[Mad Jack]

Gevitz is making the DO students sound like losers. I welcome the competition for residency spots. In pre-med, those who are good enough get into med school. Likewise , those med school graduates ( DO, MD, IMG) who are good enough will get a residency. This ensures only the best and brightest will practice medicine and thereby, benefit society in the whole. Survival of the fittest, baby!

The trouble is, many of those medical students that don't obtain a residency are carrying damn near a half million in federally guaranteed debt that the US taxpayers are on the hook for should they be unable to pay. At current debt levels, if that med graduate got an ordinary job and used PAYE and had a 50k a year salary, their debt would be well into the seven figures by the time 25 years was up. Taxpayers paying 480k to train a grad now is a whole lot better for everyone than paying $2,000,000 to pay off their unpaid debt later. Unmatched grads are bad for society as a whole both financially and in a utilitarian sense, not just the grads themselves.

 

[NurWollen]

All of the osteopathic boards should be rightly terrified. With all residencies ACGME accredited moving forward, there will be no reason for DO grads to be members of the DO certification boards and colleges. With all DOs eligible for membership in the allo specialty boards and colleges, why would any bother to pay a second set of fees and go through a second round of exams? This merger will eventually cripple the DO specialty boards financially, leaving them ill equipped to provide services for those that completed AOA residencies prior to the merger that are ineligible for the equivalent allo boards.

As the osteo specialty boards die, so too will much of the ability for the profession to remain viably distinct, as no specialty boards aside from NMM will require osteopathic manipulation. With no incentive to learn and practice OMM post-graduation, it will fade into an even deeper level of obscurity than that in which it currently exists.

Personally none of that really concerns me. OMM is but a single treatment modality and redundant boards are ridiculous.

Funny how in defending osteopathic distinctiveness those opposed to the merger are put in the awkward position of admitting that most DO grads don't care about distinctiveness and won't remain AOA members unless forced to.

 

[BurghStudent]

All of the osteopathic boards should be rightly terrified. With all residencies ACGME accredited moving forward, there will be no reason for DO grads to be members of the DO certification boards and colleges. With all DOs eligible for membership in the allo specialty boards and colleges, why would any bother to pay a second set of fees and go through a second round of exams? This merger will eventually cripple the DO specialty boards financially, leaving them ill equipped to provide services for those that completed AOA residencies prior to the merger that are ineligible for the equivalent allo boards.

As the osteo specialty boards die, so too will much of the ability for the profession to remain viably distinct, as no specialty boards aside from NMM will require osteopathic manipulation. With no incentive to learn and practice OMM post-graduation, it will fade into an even deeper level of obscurity than that in which it currently exists.

Personally none of that really concerns me. OMM is but a single treatment modality and redundant boards are ridiculous.

Exactly. What do folks here think of a time in the future in which any physician could do an OMM fellowship to gain the extra skills? Does anyone think OMM is an entire philosophy itself, or another tool in your toolbox?

 

[costales]

Update to this discussion: This is Gevitz's response back to AACOM.
http://www.saveogme.com/2014- Structure Dysfunction.pdf

And in their response, they ought to highlight his response in red, double-indent it, and put it in 14 font... Why don't these people pick up the phone and talk to each other?

 

[GlowInTheDark]

Update to this discussion: This is Gevitz's response back to AACOM.

http://www.saveogme.com/2014- Structure Dysfunction.pdf

Also, apparently the ACOOG (American College of Osteopathic Obstetricians and Gynecologist), ACOI (American College of Osteopathic Internist), and ACOFP (American College of Osteopathic Family Physicians) have in some way come out with reservations to the merger.

That first page is so obnoxious I didn't even read the rest.

Complaining about formatting? What is this, the pre-allo forum?

 

[GlowInTheDark]

Exactly. What do folks here think of a time in the future in which any physician could do an OMM fellowship to gain the extra skills? Does anyone think OMM is an entire philosophy itself, or another tool in your toolbox?

The only people that hold to it as a life-altering philosophy are the ones with serious financial interest. The majority of the OMM adjunct faculty scoff at everything as it's being taught and mutter under their breath, "yea, I don't bother doing that. HVLA them and move on."

 

[GUH]

"reservations" is the appropriate word. As a group that is representing a diverse group of people, the single most stupid thing they can do is unilaterally support (or oppose) a controversial move. They should always appear to have soft support because that way the people in opposition feel like they had a voice and dont storm out of the organization but so that the group, which likely (unable to ever really know for certain) overwhelmingly favors it, still ends up on the right side of history.

Kind of like how SOMA came out in support of the merger, in spite of many of its members being opposed to it?

 

[chizledfrmstone]

Does Gevitz use OMM?

 

[GlowInTheDark]

Does Gevitz use OMM?

Too busy running academics for ATSU's six colleges to become a DO.

 

[AnonymousD.O.]

Bottom line is, it's happening, whether Gevitz wants it to or not. Plenty of surveys have gone out since this occurred, showing most physicians (and especially current med students! - the future who will be the ones that this affects) support the merger. The people that oppose it, although their opinions should be respected, aren't going to change anything most likely.

 

[DocEspana]

Kind of like how SOMA came out in support of the merger, in spite of many of its members being opposed to it?

Protip: don't use SOMA as an example of a group that makes the sound business decision. Or any student group. Student groups prefer to make principled stances, even if it is a strategically dumb decision.

 

[OCDEMS]

Bottom line is, it's happening, whether Gevitz wants it to or not. Plenty of surveys have gone out since this occurred, showing most physicians (and especially current med students! - the future who will be the ones that this affects) support the merger. The people that oppose it, although their opinions should be respected, aren't going to change anything most likely.

I wouldn't be so sure. The opposing groups are very organized and, as I've said before, the number of students in support at my school solidly dropped as more and more information (and misinformation) about the merger came out. I think the majority of the student body is still in support, but I wouldn't at all be surprised if the merger gets dropped when the issue goes to the House of Delegates. Unless the DO PD issue is addressed, I think it'll at least be a vigorous debate.

 

[NurWollen]

Does anyone here know how decisions are made at the AOA? Does the AOA HoD have to vote for the merger for it to become final? Do thy have the power to sink it?

 

[AnonymousD.O.]

I wouldn't be so sure. The opposing groups are very organized and, as I've said before, the number of students in support at my school solidly dropped as more and more information (and misinformation) about the merger came out. I think the majority of the student body is still in support, but I wouldn't at all be surprised if the merger gets dropped when the issue goes to the House of Delegates. Unless the DO PD issue is addressed, I think it'll at least be a vigorous debate.

Aren't residencies beginning the transition next year? - it is supposed to start on July 1st 2015 Why would they have the transition period from 2015 to 2020 if things weren't finalized. The AOA and ACGME has been in discussion for a very long time for this (according to my dean who spoke to us), why would they come out with all the announcements about the merger if it wasn't finalized. I'm confused.

 

[Spikebd]

I wouldn't be so sure. The opposing groups are very organized and, as I've said before, the number of students in support at my school solidly dropped as more and more information (and misinformation) about the merger came out. I think the majority of the student body is still in support, but I wouldn't at all be surprised if the merger gets dropped when the issue goes to the House of Delegates. Unless the DO PD issue is addressed, I think it'll at least be a vigorous debate.

You sound like a left-wing journalist. You keep repeating the same catchphrase "The opposing groups are very organized." Who cares? It's irrelevant. The proponents of the merger look pretty damn organized as well, and they don't show any signs of disbanding- especially based off that recent rebuke they served to Gevitz. The PD issue is the only real issue here. It's beginning to sound as if you are a PD yourself.

EDIT- Just to post a disclaimer, I have no problems doing an AOA residency. However, I want the option to do a fellowship if I want, and there are way more ACGME fellowships.

 

[OCDEMS]

You sound like a left-wing journalist. You keep repeating the same catchphrase "The opposing groups are very organized." Who cares? It's irrelevant. The proponents of the merger look pretty damn organized as well, and they don't show any signs of disbanding- especially based off that recent rebuke they served to Gevitz. The PD issue is the only real issue here. It's beginning to sound as if you are a PD yourself.

EDIT- Just to post a disclaimer, I have no problems doing an AOA residency. However, I want the option to do a fellowship if I want, and there are way more ACGME fellowships.

Listen, I'm mostly a proponent of the merger. I'm just trying to let people down softly. The merger was killed once before by the same well-organized minority. I can tell you, based on the experiences I have had at my school, that they're operating with the type of confidence of people who know what they're doing. I'd put their chances of success at 60/40, with a 60% chance of the merger going forward.

Aren't residencies beginning the transition next year? - it is supposed to start on July 1st 2015 Why would they have the transition period from 2015 to 2020 if things weren't finalized. The AOA and ACGME has been in discussion for a very long time for this (according to my dean who spoke to us), why would they come out with all the announcements about the merger if it wasn't finalized. I'm confused.

All that exists right now is an MOU, one that specifically allows either party to back out at anytime. MOUs are typically followed up by a more solidified legal framework. In this case, nothing is settled until the ACGME and AOA make the appropriate moves to merge their residencies (votes by both boards, etc).

 

[GUH]

...
EDIT- Just to post a disclaimer, I have no problems doing an AOA residency. However, I want the option to do a fellowship if I want, and there are way more ACGME fellowships.

Ad hominem attack aside, if you want to ensure your eligibility to do an ACGME fellowship then just attend an ACGME residency (like most DO students do).

 

[NeuroLAX]

Ad hominem attack aside, if you want to ensure your eligibility to do an ACGME fellowship then just attend an ACGME residency (like most DO students do).

Are you fine with DOs who complete an AOA internship or residency being prohibited from applying to ACGME residencies and fellowships, respectively?

 

[Spikebd]

Ad hominem attack aside, if you want to ensure your eligibility to do an ACGME fellowship then just attend an ACGME residency (like most DO students do).

Looks like all DO students will remain eligible for them

 

[DrEnderW]

Ad hominem attack aside, if you want to ensure your eligibility to do an ACGME fellowship then just attend an ACGME residency (like most DO students do).

It's not that simple, as you know.

What about the hundreds of DO grads every year going into GS, ortho, ENT, uro, NS, derm, rads where AOA is the primary option? 40% of students wouldn't be able to subspecialize, it's not like it's 95% ACGME to 5% AOA. Many of these students are the most competitive and are crucial to the DO image in those fields.

This doesn't even include the students that do AOA for other, less competitive specialties for whatever reason (location, program preference, family ties to area, not competitive enough, OMM, etc).

 

[GUH]

Are you fine with DOs who complete an AOA internship or residency being prohibited from applying to ACGME residencies and fellowships, respectively?

No. I disagree with the ACGME's decision, just like I disagree with their tolerance of residency programs refusing to consider DO students on an level field with MD applicants or count DO PD's as equals to their MD counterparts, and just like I disagree with the AOA's decision to give up exclusively DO residency programs without any guarantee from the ACGME that this discrimination will not be tolerated.

 

[Spikebd]

No. I disagree with the ACGME's decision, just like I disagree with their tolerance of residency programs refusing to consider DO students on an level field with MD applicants or count DO PD's as equals to their MD counterparts, and just like I disagree with the AOA's decision to give up exclusively DO residency programs without any guarantee from the ACGME that this discrimination will not be tolerated.

GUH, you have to prioritize your wants. This is politics and you usually don't get everything you want in a negotiation. As the merger deal stands, there will be a place for you and me at the residency and fellowship table. Will it be Harvard? No. Thankfully there are still 20,000+ or so other residencies out there where we are given consideration. Do you really care more about the DO PD's losing their jobs more than you potentially being locked out from opportunities to pursue the medical specialty you desire? I agree the DO PD's should be given equal status, and that's something ACGME and AOA need to work out, but this deal offers you and me a great deal.

 

[GUH]

GUH, you have to prioritize your wants. This is politics and you usually don't get everything you want in a negotiation. As the merger deal stands, there will be a place for you and me at the residency and fellowship table. Will it be Harvard? No. Thankfully there are still 20,000+ or so other residencies out there where we are given consideration. Do you really care more about the DO PD's losing their jobs more than you potentially being locked out from opportunities to pursue the medical specialty you desire? I agree the DO PD's should be given equal status, and that's something ACGME and AOA need to work out, but this deal offers you and me a great deal.

Which specific residency program that was closed to you and me before will be open to us after the merger and because of the merger? Because I haven't heard of any.

 

[Awesome Sauceome]

Which specific residency program that was closed to you and me before will be open to us after the merger and because of the merger? Because I haven't heard of any.

Its not necessarily that they are any more open than they were yesterday. But at least they wont legitimately be closed forever to DOs, which is what could have happened if they did not come to this agreement. Or worse, the government could have taken over instead of letting the AOA and ACGME find a middle ground.
And even if not for residencies, fellowships are now open.

 

[GUH]

Its not necessarily that they are any more open than they were yesterday. But at least they wont legitimately be closed forever to DOs, which is what could have happened if they did not come to this agreement. Or worse, the government could have taken over instead of letting the AOA and ACGME find a middle ground.
And even if not for residencies, fellowships are now open.

To the best of my knowledge there is no evidence that ACGME had plans to close off all residencies to DO's and there is no evidence that the merger would prevent them from doing this if they wanted to.

But maybe you all have read a memo that I haven't? I'm seriously wondering whether I missed an important announcement or something.

 

[Awesome Sauceome]

To the best of my knowledge there is no evidence that ACGME had plans to close off all residencies to DO's and there is no evidence that the merger would prevent them from doing this if they wanted to.

But maybe you all have read a memo that I haven't? I'm seriously wondering whether I missed an important announcement or something.

I think it just goes like this...

fear of not getting a residency or fellowship > fear of losing some of the DO distinctiveness (which would be a result if you lose DO PDs)

Either way is not ideal, but I think they chose the lesser of two bad situations.

 

[NurWollen]

To the best of my knowledge there is no evidence that ACGME had plans to close off all residencies to DO's and there is no evidence that the merger would prevent them from doing this if they wanted to.

But maybe you all have read a memo that I haven't? I'm seriously wondering whether I missed an important announcement or something.

The ACGME had no plans to ban DO's from their residencies altogether, no. But given the way things were headed, it's not hard to imagine. Dr. Gevitz himself cited the MD side's fear of the impending residency crunch as a reason that the MD schools would, in some theoretical future, try to close DO schools by holding them to a higher accreditation standard. If that were the MD world's plan, wouldn't it just be easier for the ACGME to refuse the merger and ban DO's altogether?

With the merger, the AOA and AACOM will be constituent parts of the ACGME. There is no imaginable way the ACGME bans DO's from their residencies post-merger.

 

[Awesome Sauceome]

The ACGME had no plans to ban DO's from their residencies altogether, no. But given the way things were headed, it's not hard to imagine. Dr. Gevitz himself cited the MD side's fear of the impending residency crunch as a reason that the MD schools would, in some theoretical future, try to close DO schools by holding them to a higher accreditation standard. If that were the MD world's plan, wouldn't it just be easier for the ACGME to refuse the merger and ban DO's altogether?

With the merger, the AOA and AACOM will be constituent parts of the ACGME. There is no imaginable way the AOA bans DO's from their residencies post-merger.

In fact I would argue that AOA residencies will be just as biased towards DO students as the top MD residencies are towards MD students. People are freaking out because then MD students can swipe up all of the AOA residencies in competitive specialties, but I would argue that they are likely to maintain the same level of restrictions for DO students as those competitive ACGME residencies already hold on DO students.