Alienman52

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Hi all,

I’m a bit confused about licensure for DO’s in PA. I’ve read a bit about how we have to complete an osteopathic approved internship year in order to get licensed for practice - is this in addition to a normal internship year? What if we are not seeking AOA licensure and are just seeking acgme licensure?

Any clarification on the licensing process in PA would be greatly appreciated - just thinking about completing residency in PA and want to know about additional hoops for licensure...



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hallowmann

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Hi all,

I’m a bit confused about licensure for DO’s in PA. I’ve read a bit about how we have to complete an osteopathic approved internship year in order to get licensed for practice - is this in addition to a normal internship year? What if we are not seeking AOA licensure and are just seeking acgme licensure?

Any clarification on the licensing process in PA would be greatly appreciated - just thinking about completing residency in PA and want to know about additional hoops for licensure...

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First for clarification: Doing residency in PA does not require an unlimited medical license, it simply requires a training license, and as such PA's requirements for an unlimited license for a DO doesn't really matter unless your residency requires an unlimited license prior to graduation from the program, you plan to moonlight, or you plan to stay in the state for work after you graduate.

Licensure is based on your state medical boards, there is no AOA or ACGME licensure. Some states have separate MD and DO state medical boards. PA is one of them, and the PA osteopathic medical board is further one of only 2 state osteopathic boards (FL is the other) that currently, and as far as I have heard will consistently, require an AOA-equivalent intern year in order to get unlimited medical licensure as a DO.

As of right now, there are 3 ways to achieve this:

1) Attend an intern year with "Osteopathic focus" prior to starting your ACGME-only residency. This means you'll have 2 intern years, which is stupid and you shouldn't do it.

2) Attend an ACGME residency program with "Osteopathic focus" and as such the first year should (as far as I have understood the changes with the merger) qualify as an AOA-equivalent intern year.

3) Complete an application for Resolution 42 in order have your ACGME intern year recognized as "AOA-equivalent".

The third option is the process/link that @samac posted. This can be fulfilled by completing the application online, completing some type of osteopathic thing (i.e. writing an osteopathic research paper, giving a presentation at your residency grand rounds about OPP, or attending an osteopathic conference to get 8 hours of AOA CME-1A credits), and getting a letter from your PD with a description of your intern year and stating that you satisfactorily completed it. From what I hear, this process is usually almost always approved assuming all requirements are fulfilled.

I actually attended my 8 hrs (and literally no more) DO conference in early March just before things shut down for the pandemic, and completely forgot that I didn't submit that letter from my PD yet, so thanks for reminding me. I'll let you know if I have any issues with this process, but if you never hear from me, assume its all straightforward like I described.
 
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Alienman52

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First for clarification: Doing residency in PA does not require an unlimited medical license, it simply requires a training license, and as such PA's requirements for an unlimited license for a DO doesn't really matter unless your residency requires an unlimited license prior to graduation from the program, you plan to moonlight, or you plan to stay in the state for work after you graduate.

Licensure is based on your state medical boards, there is no AOA or ACGME licensure. Some states have separate MD and DO state medical boards. PA is one of them, and the PA osteopathic medical board is further one of only 2 state osteopathic boards (FL is the other) that currently, and as far as I have heard will consistently, require an AOA-equivalent intern year in order to get unlimited medical licensure as a DO.

As of right now, there are 3 ways to achieve this:

1) Attend an intern year with "Osteopathic focus" prior to starting your ACGME-only residency. This means you'll have 2 intern years, which is stupid and you shouldn't do it.

2) Attend an ACGME residency program with "Osteopathic focus" and as such the first year should (as far as I have understood the changes with the merger) qualify as an AOA-equivalent intern year.

3) Complete an application for Resolution 42 in order have your ACGME intern year recognized as "AOA-equivalent".

The third option is the process/link that @samac posted. This can be fulfilled by completing the application online, completing some type of osteopathic thing (i.e. writing an osteopathic research paper, given a presentation at your residency grand rounds about OPP, or attending an osteopathic conference to get 8 hours of AOA 1A CME credits), and getting a letter from your PD with a description of your intern year and stating that you satisfactorily completed it. From what I hear, this process is usually almost always approved assuming all requirements are fulfilled.

I actually attended my 8 hrs (and literally no more) DO conference in early March just before things shut down for the pandemic, and completely forgot that I didn't submit that letter from my PD yet, so thanks for reminding me. I'll let you know if I have any issues with this process, but if you never hear from me, assume its all straightforward like I described.
How kind of you to write such a detailed response - I truly appreciate this. I have actually heard from the students who matched in PA (class above me) that this policy was no longer in effect nor had they ever heard of it. I think that everything you've outlined still holds true and honestly I am surprised they haven't heard of the policy before. A school administrator also told me that it may no longer be in effect but I guess I will have to assess the situation when I begin my intern year. Hopefully they do away with this silly policy, but if they don't I'll be pursuing resolution 42 as you've outlined.
 

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How kind of you to write such a detailed response - I truly appreciate this. I have actually heard from the students who matched in PA (class above me) that this policy was no longer in effect nor had they ever heard of it. I think that everything you've outlined still holds true and honestly I am surprised they haven't heard of the policy before. A school administrator also told me that it may no longer be in effect but I guess I will have to assess the situation when I begin my intern year. Hopefully they do away with this silly policy, but if they don't I'll be pursuing resolution 42 as you've outlined.
There used to be 5 states that required it, but most have dropped it in the setting of the merger and the only two left that didn't were PA and FL. As far as I know, these policies are still in place, but to be honest, I haven't really looked into it in the last year or so. The PA state osteopathic board was even proposing legislation ~2017 to make it harder to fulfill the requirement as a DO, so I would be surprised if they just up and dropped it.

I'll let you know if I find something that says it was eliminated, but I would just prepare as if you'll need to finish option 3 stuff.
 
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Alienman52

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There used to be 5 states that required it, but most have dropped it in the setting of the merger and the only two left that did were PA and FL. As far as I know, these policies are still in place, but to be honest, I haven't really looked into it in the last year or so. The PA state osteopathic board was even proposing legislation ~2017 to make it harder to fulfill the requirement as a DO, so I would be surprised if they just up and dropped it.

I'll let you know if I find something that says it was eliminated, but I would just prepare as if you'll need to finish option 3 stuff.
Solid advice - thank you.
 

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Solid advice - thank you.
Yeah, so as of right now it still requires it based on this info on their website:

The Board requires verification of completion of an American Osteopathic Association-approved internship. When your training hospital is verifying completion of your training, be sure they verify your internship year.

If your first year of training was not an American Osteopathic Association-approved internship, you must contact the American Osteopathic Association to have your first year of training recognized by them. A copy of the recognition letter must be submitted as part of your application.
 

Alienman52

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Yeah, so as of right now it still requires it based on this info on their website:


I see. I am assuming that a DO must be licensed under the Osteopathic board if the state has two bodies of licensure (MD & DO) so that there would be no way to avoid this - correct? I guess this is part of the everlasting debt of going to a DO school.
 

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I see. I am assuming that a DO must be licensed under the Osteopathic board if the state has two bodies of licensure (MD & DO) so that there would be no way to avoid this - correct? I guess this is part of the everlasting debt of going to a DO school.
Yup, and yup. I believe most states have only one medical board. The good thing is that once you have Resolution 42 approval, you're good. You don't have to do anything extra from then on (outside of whatever is different for the DO state board requirements, but most accept AMA CME credits in lieu of AOA CME credits).

If you want AOA board certification (not sure why you would necessarily subject yourself to this), you have to complete Resolution 56, and information for that can be found here: Recognition of PGY2+ - American Osteopathic Association
 
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Alienman52

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Yup, and yup. I believe most states have only one medical board. The good thing is that once you have Resolution 42 approval, you're good. You don't have to do anything extra from then on.

If you want AOA board certification (not sure why you would necessarily subject yourself to this), you have to complete Resolution 56, and information for that can be found here: Recognition of PGY2+ - American Osteopathic Association
Good to hear. Once I am through with DO state licensure I'll be pursuing ABIM board certification as opposed to AOA - the shorter I have to subject myself to OMT, the better.

One last question (and thank you again for all this information) - Medical licensure is separate from board certification, correct? In other words, if a state has DO and MD licensure boards like PA, as a DO I will have to be licensed under the DO medical board, but I can choose to pursue MD board certification for the rest of my life, right? As an add-on - there is nothing I need to do to maintain medical licensure, but obviously a lot I must do as an attending to maintain board certification?

Thanks again.
 

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Good to hear. Once I am through with DO state licensure I'll be pursuing ABIM board certification as opposed to AOA - the shorter I have to subject myself to OMT, the better.

One last question (and thank you again for all this information) - Medical licensure is separate from board certification, correct? In other words, if a state has DO and MD licensure boards like PA, as a DO I will have to be licensed under the DO medical board, but I can choose to pursue MD board certification for the rest of my life, right? As an add-on - there is nothing I need to do to maintain medical licensure, but obviously a lot I must do as an attending to maintain board certification?

Thanks again.
This is long, but hopefully will be helpful.

Medical licensure is what allows you to practice medicine unrestricted in a given state. It is purely state dependent. Board certification is a national certification designed by national specialty organizations to essentially demonstrate some degree of vetting for your training. Board certification in modern times almost always requires completion of a residency program, whereas licensure simply requires some designated amount of Graduate Medical Education, which again is state dependent. I for example have an unrestricted medical license in the state I'm training in, but I am not eligible for Board Certification, because I have not completed my residency program.

There is technically no such thing as "MD" or "DO" specialty boards, but this is sometimes used colloquially to describe the ABMS specialty boards and the AOA specialty boards. ABMS vs. AOA usually depends on the residency program that you complete, but with the merger, as long as you attend an accredited residency, it will be accredited by the ACGME and so certification will in virtually all cases (save maybe some specific types of fellowships) be through the ABMS. You can opt to do AOA board certification either if you attend a residency with Osteopathic focus or complete Resolution 42 and 56.

Maintaining board certification carries with it certain scholarly requirements that must be completed, including completion of Continuing Medical Education credits, in some cases practice improvement projects, and other Maintenance of Certification tasks. Board certification typically requires passing of specialty board exams. Depending on the specialty, you may need to retake the exam every 7 or 10 years to maintain certification and you will need to complete the MOC requirements at varying times, again depending on your specialty board.

Maintaining licensure does have some requirements, and every state varies with regards to this. Licenses usually last 1-3 years depending on the state, and they renew at a designated time, which again varies depending on the state, but in many cases is related to your year of birth. All states typically require an initial unrestricted license application as well as subsequent renewal applications. Basically all states also require a varying degree of CME as well, but if you are board certified, chances are your specialty board MOC will exceed these. Your license can be revoked or in some way limited by the medical boards if you are investigated for some type of wrongdoing. Also, in many states if you do not explicitly put your license on hold and just allow it to expire, it may have an action against it (most states have a hold/freeze or withdrawal of license option).
 
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Alienman52

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This is long, but hopefully will be helpful.

Medical licensure is what allows you to practice medicine unrestricted in a given state. It is purely state dependent. Board certification is a national certification designed by national specialty organizations to essentially demonstrate some degree of vetting for your training. Board certification in modern times almost always requires completion of a residency program, whereas licensure simply requires some designated amount of Graduate Medical Education, which again is state dependent. I for example have an unrestricted medical license in the state I'm training in, but I am not eligible for Board Certification, because I have not completed my residency program.

There is technically no such thing as "MD" or "DO" specialty boards, but this is sometimes used colloquially to describe the ABMS specialty boards and the AOA specialty boards. ABMS vs. AOA usually depends on the residency program that you complete, but with the merger, as long as you attend an accredited residency, it will be accredited by the ACGME and so certification will in virtually all cases (save maybe some specific types of fellowships) be through the ABMS. You can opt to do AOA board certification either if you attend a residency with Osteopathic focus or complete Resolution 42 and 56.

Maintaining board certification carries with it certain scholarly requirements that must be completed, including completion of Continuing Medical Education credits, in some cases practice improvement projects, and other Maintenance of Certification tasks. Board certification typically requires passing of specialty board exams. Depending on the specialty, you may need to retake the exam every 7 or 10 years to maintain certification and you will need to complete the MOC requirements at varying times, again depending on your specialty board.

Maintaining licensure does have some requirements, and every state varies with regards to this. Licenses usually last 1-3 years depending on the state, and they renew at a designated time, which again varies depending on the state, but in many cases is related to your year of birth. All states typically require an initial unrestricted license application as well as subsequent renewal applications. Basically all states also require a varying degree of CME as well, but if you are board certified, chances are your specialty board MOC will exceed these. Your license can be revoked or in some way limited by the medical boards if you are investigated for some type of wrongdoing. Also, in many states if you do not explicitly put your license on hold and just allow it to expire, it may have an action against it (most states have a hold/freeze or withdrawal of license option).
I see, so in a nutshell, if you maintain board certification, those requirements are likely to overlap with licensure maintenance so that there aren't any specific/additional activities to do in order to maintain licensure (in most cases, at least).


Very helpful, and answers all my questions quite well. Thank you for this - I wish there was a way to +1 rep on these forums but it doesn't look like that is the case. In any case I will be using this information for the foreseeable future!
 

hallowmann

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I see, so in a nutshell, if you maintain board certification, those requirements are likely to overlap with licensure maintenance so that there aren't any specific/additional activities to do in order to maintain licensure (in most cases, at least).


Very helpful, and answers all my questions quite well. Thank you for this - I wish there was a way to +1 rep on these forums but it doesn't look like that is the case. In any case I will be using this information for the foreseeable future!
From what I have seen the certification MOC usually exceeds the licensing requirements, but again this is all state dependent and specialty board dependent, so your best bet is to have a running document with requirements and completion to make sure you don't miss something. The thing is that each of these will likely renew at different times, so you may have certain deadlines that might be sooner for licensure than for board certification at times. This also gets more complicated if you have licenses in multiple states.

Glad I could help!
 
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@Alienman52 @hallowmann

Since we're on the state of Pennsylvania - there's an osteopathic catch. You will need AOA 1A CME to maintain your medical license. Being ABMS boarded doesn't require AOA CMEs (while AOA boarded requires AOA CMEs). So you will need to obtain 20 AOA 1A CMEs every 2 years to renew/retain your license.




The State Board of Osteopathic Medicine (SBOM) requires the following for unrestricted osteopathic physician license renewal:

• A minimum of 100 CME credits;
• A minimum of 20 Category 1A AOA CME credits;
• A minimum of 12 patient safety/risk management credits (Category 1 or Category 2);
• A minimum of 2 hours of board-approved education in child abuse recognition and reporting requirements (Category 1 or Category 2);
• A minimum of 2 hours of continuing education in pain management, the identification of addiction, or the practices of prescribing or dispensing of opioids (Category 1 or Category 2).



 
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First for clarification: Doing residency in PA does not require an unlimited medical license, it simply requires a training license, and as such PA's requirements for an unlimited license for a DO doesn't really matter unless your residency requires an unlimited license prior to graduation from the program, you plan to moonlight, or you plan to stay in the state for work after you graduate.

Licensure is based on your state medical boards, there is no AOA or ACGME licensure. Some states have separate MD and DO state medical boards. PA is one of them, and the PA osteopathic medical board is further one of only 2 state osteopathic boards (FL is the other) that currently, and as far as I have heard will consistently, require an AOA-equivalent intern year in order to get unlimited medical licensure as a DO.

As of right now, there are 3 ways to achieve this:

1) Attend an intern year with "Osteopathic focus" prior to starting your ACGME-only residency. This means you'll have 2 intern years, which is stupid and you shouldn't do it.

2) Attend an ACGME residency program with "Osteopathic focus" and as such the first year should (as far as I have understood the changes with the merger) qualify as an AOA-equivalent intern year.

3) Complete an application for Resolution 42 in order have your ACGME intern year recognized as "AOA-equivalent".

The third option is the process/link that @samac posted. This can be fulfilled by completing the application online, completing some type of osteopathic thing (i.e. writing an osteopathic research paper, giving a presentation at your residency grand rounds about OPP, or attending an osteopathic conference to get 8 hours of AOA CME-1A credits), and getting a letter from your PD with a description of your intern year and stating that you satisfactorily completed it. From what I hear, this process is usually almost always approved assuming all requirements are fulfilled.

I actually attended my 8 hrs (and literally no more) DO conference in early March just before things shut down for the pandemic, and completely forgot that I didn't submit that letter from my PD yet, so thanks for reminding me. I'll let you know if I have any issues with this process, but if you never hear from me, assume its all straightforward like I described.
Osteopathic recognition, not focus. It just means that the program has a Director of Osteopathic Education and you have requirements for OMT and there are additional Osteopathic educational requirements
 

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The State Board of Osteopathic Medicine (SBOM) requires the following for unrestricted osteopathic physician license renewal:

• A minimum of 100 CME credits;
Holy crap is that for real? 100 CME credits for a 2 year renewal? That's insane.

The two states I have licenses in are 48 CME per 2 year renewal and 60 per 3 year renewal.
 
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