JAOA and post-grad changes

[BMW19]

---

Members don't see this ad.

If anyone has seen the new JAOA (got it yesterday) it lays out the new changes to the TRI and post grad. It seems that each specialty was given the opportunity to change how they classify the first year of your post-grad training. There are now three categories. My question is about the category ones. If you are interested in say EM and the DO residencies participating in this category now consider the first year as part of your residency and not internship will this change the amount of years of training and your status in the 5 infamous states? All DO programs in EM were 4 years in length due to the TRI/linked internship required but I am assuming that now they will still be 4 years but just have the 1st year count as residency. Is this how everyone else is reading this new change?

Thanks,

BMW-

 

[Dr JPH]

My understanding is that the 5 states still require a traditional osteopathic internship so if a program choses to change their internship from a TRI to a "specialty track" internship, it will not fulfill the requirement by the osteopathic societies of those states.

I can understand why many programs would want to move from a TRI to a more specialty focused internship. There are a good number of DO PGY2s out there, particularly in the surgical fields, that are significantly behind in surgical experience as compared to our MD counterparts.

If you are in an AOA program and have 3-5 months of surgery and the rest of the time you are fulfilling TRI required rotations (FP, IM, etc) then there is no way you could be at the same level technically as a true surgical intern who spends 10 months in the OR and 2 on the floors (which are often SICU).

The argument, of course, is "well...our graduates will be better doctors because they have the additional exposure to medicine patients during their internship year." Perhaps. But as a practicing surgeon of 15 years are you going to look back and say "well, I really know how to manage the medical aspects of my patients because I did 8 months of internal medicine as an intern." Not likely. It comes with experience.

The flip side is will a half a year less surgical experience as an intern dramatically affect your ability to become a surgeon with excellent technical skills? Probably not. So are you going to be behind the MDs in surgical experience? Not for your whole residency you wont.

But are they (those who did a true surgical internship) going to be behind you in managing the medical aspects of patients? Again...maybe as a PGY2...but things would likely plateau after that. And you can also argue that a strong surgical program, particularly Gen Surg, would expose you to a significant amount of medical issues anyway.

So is the TRI really beneficial? WHO is it benefitting? Seems like its benefitting the IM and FP interns who have more co-interns to share call with!


OK...stepping off my soap box now.

 

[Stimulate]

I think finally this change may force those 5 states to re-evaluate their TRI requirement. There are going to be scores of AOA specialty track residents graduating who will not be able to get licensure in their respective states.

 

[Dr JPH]

I think finally this change may force those 5 states to re-evaluate their TRI requirement. There are going to be scores of AOA specialty track residents graduating who will not be able to get licensure in their respective states.

I don't know if there will be a reversal of the internship requirement, but rather I see an easier time petitioning for licensure without having the internship year. Pennsylvania cannot afford to turn away doctors...not with the malpractice crisis in this state.

 

[JonnyG]

I don't know if there will be a reversal of the internship requirement, but rather I see an easier time petitioning for licensure without having the internship year. Pennsylvania cannot afford to turn away doctors...not with the malpractice crisis in this state.

and a govenor who gets all his money from trial lawyers.........................

 

[schrute]

guess i don't have to worry about that silly AOA nonsense...it seems there aren't any AOA path residencies. oh darn...

 

[Dr JPH]

and a govenor who gets all his money from trial lawyers.........................

No comment. 😀