Internship year and Allopathic residency

[MaximLA]

I am not completely sure I understand correctly,

Are those DO's who go to allopathic residencies ineligible to practice medicine in FL, PA, and 3 more states?

Do they have to go through a year of rotating internship first, and then apply to allopathic residency to be eligible to practice in those states or is there an alternate way for someone who went straight into allopathic residency?

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[Dr JPH]

I am not completely sure I understand correctly,

Are those DO's who go to allopathic residencies ineligible to practice medicine in FL, PA, and 3 more states?

Do they have to go through a year of rotating internship first, and then apply to allopathic residency to be eligible to practice in those states or is there an alternate way for someone who went straight into allopathic residency?

AOA internship is required in FL, PA, WV, OK and MI

Once you complete the internship then you can complete any residency, allopathic or osteopathic.

There are ways of petitioning the AOA to bypass the internship requirement, but its no guarantee.

In the last few years only about 50% of petitions were granted.

There are some new internship requirements in the last few months. I would suggest reading up at the AOA website on these.

 

[spicedmanna]

SDN thread on similar topic: Still confused about resolution 42...

DO-Online.org information on Resolution 42.

 

[MaximLA]

The DO-online web page states:

"to be eligible for AOA internship approval of ACGME training the osteopathic physician must complete all six of the traditional rotating internship’s core rotations: 2 months internal medicine, 1 month emergency medicine, 1 month family practice, and two additional core rotations (internal medicine, surgery, female reproductive medicine, pediatrics, family practice, or emergency medicine"

I am not aware, but do allowpathic residencies usually have these core rotations, or is it only a few. Because if its only a few then it seems there is no other way but

1) Spending a whole extra year in osteopathic internship, which doesnt happen to md
2) applying for approval with 50% chance

any other options?

 

[Dr JPH]

The DO-online web page states:

"to be eligible for AOA internship approval of ACGME training the osteopathic physician must complete all six of the traditional rotating internship's core rotations: 2 months internal medicine, 1 month emergency medicine, 1 month family practice, and two additional core rotations (internal medicine, surgery, female reproductive medicine, pediatrics, family practice, or emergency medicine"

I am not aware, but do allowpathic residencies usually have these core rotations, or is it only a few. Because if its only a few then it seems there is no other way but

1) Spending a whole extra year in osteopathic internship, which doesnt happen to md
2) applying for approval with 50% chance

any other options?

It depends if the allopathic internship is a rotating internship, in which case you will likely fulfill those requirements. If it is a specialty internship (surgery, for example) you will not get all of those months.

I suggest researching your options before getting frustrated.

Look into osteoapthic residencies, dually accredited residencies and allopathic residencies with a built-in internship year.

I think youre making this out to be a bigger deal than it is. Personally I dont see an internship year as being "wasted". In fact it often improves your chances of matching the next year into an allopathic spot, not to mention makes your transition into that program much nicer. Also gives you a chance to impress your first year there...while your other classmates are struggling with being a new intern.

I dont think the internship requirement should be ditched simply because the MDs dont have it.

IMHO there are a lot of things we do better.

Finally, I wouldnt worry about this now. Arent you still a premed? Worry about gross anatomy and pharmacology first. All of these things will play out in due time.

 

[tkim]

In the last few years only about 50% of petitions were granted.

I'm seeing higher numbers than that.

http://www.jaoa.org/cgi/content/ful...INDEX=0&sortspec=relevance&resourcetype=HWCIT

Between July 2001 and October 2006, a total of 1241 osteopathic physicians petitioned the AOA for approval of their first year of ACGME postgraduate training. As of October 10, 2006, 774 (62%) of these applications have been approved; 455 (37%), approved pending completion of residency training or requirements under Resolution 42; and 12 (<1%), denied.

To me, this means that 99% of applicationswill be approved by intern year's end. As noted, less than 1% are denied outright.

There's another JAOA letter that supports a pretty high approval rating - particularly in NY and PA:

http://www.jaoa.org/cgi/content/ful...INDEX=0&sortspec=relevance&resourcetype=HWCIT

Kenneth J. Steier, DO, FACOI, FCCP, Associate Professor of Medicine

To the Editor: I was fortunate to have had my letter to the editor published in the pages of this JOURNAL in August 2004. In that letter, I opposed the routine granting of American Osteopathic Association (AOA) credit for non-AOA&#8211;approved internships and residencies under Resolution 42 (A/2000), the "hardship exception" (J Am Osteopath Assoc. 2004;104[8]:314-315). In my letter, I described the documented (at the time) 99% approval rate for the hardship exception as excessive and unjustifiable, especially given the large number of quality AOA-approved residency programs available in many areas.

My position continues to be that the specific criteria included in Resolution 42 must be vigorously applied; applicants with internship or residency experience that fails to meet the criteria should not be routinely granted AOA-approval for such experience.

Michael I. Opipari, DO, chairman of the Council on Postdoctoral Training, wrote a response to my letter (published in the same issue) disagreeing with my position. In his response, Dr Opipari provided updated data on the granting of this exception. His data are consistent with the percentages presented in my letter, including a 94% hardship exception approval rate for applicants from New York and a 95% hardship exception approval rate for applicants from Pennsylvania.

Here's a good breakdown of the numbers:

http://www.jaoa.org/cgi/content/ful...=0&sortspec=relevance&resourcetype=HWCIT#TBL1

This one clarifies it a bit to say that only 79% at intern year's end get final approval (1% rejected outright):

One applicant in 100 is denied preliminary approval based on a special circumstance, but 20 applicants in 100 fail to complete the prescribed curriculum and thus are denied approval of their ACGME-accredited training as an AOA-approved internship.

Finally, because my interest is EM, here's an interesting article regarding EM and osteopathic internships:

http://www.jaoa.org/cgi/content/ful...INDEX=0&sortspec=relevance&resourcetype=HWCIT

Most residents (38 [83%]) perceived themselves to be more proficient with history-taking and physical examinations during the first year of their residency training compared with their colleagues who did not complete a separate preresidency internship. However, this additional proficiency steadily decreased with each year of residency training to be more in line with their counterparts. By the start of the fourth year, only 2 (4%) residents perceived that they were more proficient than their counterparts. More than half (23 [57%]) of the responding program directors also felt that these residents were more proficient during the first year of their EM residency, but the program directors' perception of residents' proficiency also steadily declined after the first year of residency. No program directors felt that these residents were more proficient in these skills than their counterparts during their fourth year of residency training. Most (34 [74%]) residents also perceived themselves to be more proficient with basic medical procedures during the first year of residency training, but by the fourth year, this perception was held by only 1 (2%) resident. This initial gain in proficiency was also noted by their program directors (18 [45%]), an opinion that dropped to 0 after the second year.

Most (35 [76%]) residents felt that the internship was "extremely" or "moderately" valuable for patient care during their first year of residency training. As residents progressed through their training, many continued to perceive the internship to be of current value, but the percentage steadily declined to 9% at the start of the fourth year. Program directors seemed less convinced of the internship's value, with 11 (27%) rating the internship as "extremely" or "moderately" valuable during the first residency year in the emergency department and 0 during the fourth year.

Most (33 [72%]) residents were glad that they had completed the internship, with 30 (65%) indicating that they would take it "if they had to do it all over again." However, most osteopathic physicians who completed the internship because of licensure requirements would not have done so if it were not required (18 [67%]). In addition, 39 of 40 program directors would not recommend that medical trainees complete a nonrequired internship before beginning an ACGME-accredited EM residency program.

There's a mixed message in that last quote, but what I took from this when I was debating 3 year allopathic versus 4 year allopathic and osteopathic EM programs was whether I'd be a better resident with the additional year of training. Though the sample size is small, it's pretty clear that in the beginning of residency, residents with the additional year are more comfortable, look more competent, but near the end, everything pretty much equalizes out - from the standpoint of the resident *and* the PD.

 

[MaximLA]

Wow this is great info thanks a lot.

Seems like the chances are good if you completed those internship requirements but if you didnt u cant get approved and therefore cant practice in those five states. Does anyone what specialties/primary care allopathic residencies have those internship rotations as a part of their training requirements?